Iatrogenic Ureteral Injuries Associated with Gynecological and Surgical Procedures: Our Experience About 18 Cases and Literature Review.

AIM: To describe the epidemiological aspects, etiology and outcome of iatrogenic ureteral injury repair at the urology division of Souro Teaching Hospital of Bobo Dioulasso (Burkina-Faso). PATIENTS AND METHODS: This was a retrospective descriptive study of consecutive patients with iatrogenic ureteric injuries who were referred and managed in the urology division of Souro Sanou Teaching Hospital (Bobo-Dioulasso) from January 2012 to December 2017. Variables studied were age, the time at the diagnosis, the causative event, the method of repair, and the outcome of the management. RESULTS: The mean age was 37.72±3.5 years coming from the rural population in most cases. The mean time at the diagnosis was 15 days. The injuries were due to gynecologic surgeries with hysterectomy (66%) and caesarian section (33%). Ureteric reimplantation with anti-reflux system was performed in seventeen patients. The rate of treatment success was 94% and the postoperative course was uneventful for all the patients. CONCLUSION: Iatrogenic ureteric lesions at the department of urology of Sanou Sourou teaching hospital of Bobo Dioulasso were mainly caused by gynecologic and obstetric surgeries like hysterectomy and caesarian section.

Adult Granulosa Cell Tumor of the Testis: A case report and review of the literature.

Adult Granulosa Cell Tumor of the Testis (AGCTT) is a rare sex-cord stromal tumor. About 73 cases have been previously reported in the literature. We report a case of AGCTT in a 64 years old male, located in the left testis. We performed left radical inguinal orchiectomy. A sagittal section of orchiectomy specimen showed a solid yellowish-white mass measuring 1cm of long axis. On microscopic examination, we noted a well-limited tumor proliferation of solid architecture. The proliferation was made up of cells with scant cytoplasm and incised oval nuclei in a fibrous stroma. Rare Call-Exner bodies were noted.

Predictive factors for orchiectomy in adult's spermatic cord torsion: a case-control study.

BACKGROUND: Spermatic cord torsion (SCT) is a surgical emergency. Any delay in diagnosis or treatment may compromise the vital and functional prognosis of the testicle. The orchiectomy rate remains very high in the literature; it can even reach 50 % in certain series. Several factors have been reported in the literature as being significantly correlated with the risk of orchiectomy: duration of symptoms, the number of turns, the younger ages, etc. The objective of this study has been to analyse the predictive factors of orchiectomy in adult SCT in our context. RESULTS: During the study period, 74 cases of SCT were included. Orchidopexy was performed in 43.2 % (32/74) versus orchiectomy in 56.8 % (42/74) of cases. The patients' median age was 22 years (interquartile range (IQR) = 18-26.75 years). The duration of symptoms (p = 0.009), the previous medical management (p < 0.001), performing a scrotal ultrasonography (p = 0.004) were statistically significant at univariate analysis. On multivariate analysis only the previous medical management was statistically significant (p = 0.017). CONCLUSIONS: The orchiectomy rate was very high in our cohort. The previous medical management was the only significant predictive factor of orchiectomy on multivariate analysis. Our findings demonstrated that the delay in diagnosis is the determining factor in testicular loss in our context.

RéSUMé: CONTEXTE: La torsion du cordon spermatique est une urgence chirurgicale. Tout retard dans le diagnostic ou le traitement peut compromettre le pronostic vital et fonctionnel du testicule. Le taux d'orchidectomie reste très élevé dans la littérature;il peut même atteindre 50 % dans certaines séries. Plusieurs facteurs ont été rapportés dans la littérature comme étant significativement corrélés au risque d'orchidectomie. L'objectif de cette étude était d'analyser les facteurs prédictifs d'orchidectomie dans la torsion du cordon spermatique de l'adulte dans notre contexte. RéSULTATS: Durant la période d'étude 74 patients ont été inclus. Une orchidopexie a été réalisée dans 43,2 % (32/74) des cas et une orchidectomie dans 56,8 %(42/74) des cas. L'âge médian des patients était de 22 ans (écart interquartile=18-26,75 ans). La durée des symptômes (p = 0,009), la prise en charge médicale antérieure(p<0,001), la réalisation d'une échographie des bourses (p = 0,004) étaient significativement corrélées au risque d'orchidectomie à l'analyse univariée. A l'analyse multivariée, seule la prise en charge médicale antérieure était significativement corrélée au risque d'orchidectomie (p=0.017). CONCLUSION: Le taux d'orchidectomie était très élevé dans notre cohorte. La prise en charge médicale antérieure était le seul facteur prédictif significatif de l'orchidectomie à l'analyse multivariée. Nos résultats ont montré que le retard diagnostic est le facteur déterminant de la perte testiculaire dans notre contexte. MOTS CLéS: Torsion du cordon spermatique, Orchidectomie, Orchidopexie, Facteurs prédictifs, Urgence chirurgicale.

Domestic donkey bite of genitalia: an unusual etiology of penile glans amputation in Burkina Faso (case report and literature review).

A 15-years-old boy was admitted in our hospital emergency unit with complaints of injured and hemorrhagic penile glans after donkey bites. The accident occurred during domestic activity with the animal when the boy attempted to guide the donkey. After thorough physical examination, the patient presented a penile glans amputation. Tetanic prophylaxis was started. The patient benefited from hemostatic suturing, stump regularization and penile glans reconstructive surgery and there was no complication. Functional and cosmetic results were satisfactory with good quality of micturition after six months' follow-up.

Subcutaneous Dorsal Penile Vein Thrombosis or Penile Mondor's Disease: A Case Report and Literature Review.

A 34-year-old man, trader, and married with four wives, otherwise healthy, without any remarkable medical history, was admitted in urology ward in emergency with superficial venous thrombosis of the penis known also as Penile Mondor's Disease (PMD), a rare nosologic entity of the penis associated with pain and an indurated dorsal cord of the root of the penis. The patient receives nonsteroidal anti-inflammatory drugs and coagulation and platelet aggregation inhibitors drugs. Healing and total recovery occur after eight weeks without any complications.

Reconstructive surgery for giant penoscrotal elephantiasis: about one case.

Elephantiasis of the external genitalia is characterized by lymphedema and thickening of the subcutaneous tissues. This gives the skin an appearance similar to a pachyderm skin. This pathology is invalidating for the patient. Reconstructive surgery is often the only way to restaure aesthetic and functional aspects of the external genitalia. We aim to report a 52 year man with huge penoscrotal elephantiasis who underwent excision and penoscrotal reconstruction at the department of Urology, Yalgado Ouedraogo Teaching Hospital at Ouagadougou.

L'éléphantiasis des organes génitaux externes est caractérisé par un lymphodème et un épaississement des téguments responsable de l'aspect de peau de pachyderme. C'est une pathologie invalidante. La chirurgie de reconstruction constitue souvent la seule alternative pour restaurer l'aspect esthétique et fonctionnel de ces organes atteints. Nous rapportons un cas d'un volumineux éléphantiasis des organes génitaux externes chez un sujet de 52 ans qui a bénéficié avec succès d'une plastie péno scrotale dans le service d'urologie du CHU/YO.

Prostate cancer outcome in Burkina Faso.

INTRODUCTION: African-American black men race is one of non-modifiable risk factors confirmed for prostate cancer. Many studies have been done in USA among African- American population to evaluate prostate cancer disparities. Compared to the USA very few data are available for prostate cancer in Sub-Saharan African countries. The objective of this study was to describe incident prostate cancer (PC) diagnosis characteristics in Burkina Faso (West Africa). METHODS: We performed a prospective non randomized patient's cohort study of new prostate cancer cases diagnosed by histological analysis of transrectal prostate biopsies in Burkina Faso. Study participants included 166 patients recruited at the urology division of the university hospital of Ouagadougou. Age of the patients, clinical symptoms, digital rectal examination (DRE) result, serum prostate-specific antigen (PSA) level, histological characteristics and TNM classification were taking in account in this study. RESULTS: 166 transrectal prostate biopsies (TRPB) were performed based on high PSA level or abnormal DRE. The prostate cancer rate on those TRPB was 63, 8 % (n=106). The mean age of the patients was 71, 5 years (52 to 86). Urinary retention was the first clinical patterns of reference in our institution (55, 7 %, n = 59). Most patients, 56, 6 % (n = 60) had a serum PSA level over than 100 ng/ml. All the patients had adenocarcinoma on histological study of prostate biopsy cores. The majority of cases (54, 7 % n = 58) had Gleason score equal or higher than 7. CONCLUSION: Prostate cancer is diagnosed at later stages in our country. Very high serum PSA level and poorly differentiated tumors are the two major characteristics of PC at the time of diagnosis.