RESUMO
BACKGROUND: Kidney cancer is the third most common urological tumour. Diagnosis is made in most cases at an advanced stage of the disease in our setting. AIM & OBJECTIVES: The aim of this work was to describe the management of solid tumors of the kidney and the outcome at the National University Hospital, Cotonou, Benin Republic, from January 2008 to December 2014. PATIENTS & METHODS: This is a retrospective, descriptive study conducted at the Clinic of Urology and Andrology at the National University Hospital CNHU-Hubert Koutoukou MAGA in Cotonou, Benin Republic. We included patients managed for solid kidney tumours from January 2008 to December 2014. The demographics, clinical presentations, management and outcome were recorded and the data obtained were analyzed using Epi info 3.2.2. RESULTS: Hospital frequency of solid renal mass was 1.9% with a mean age of 54 years and sex ratio of men to women of 1.6. Hematuria, back pain and lumbar mass were the most frequent clinical presentation found in 79.5% of cases. In all, 5% presented at an early stage while 95% presented at a late stage. Diagnosis was based on imaging; histopathological examination was requested in all the case though some could not afford the cost. Radical nephrectomy was performed in 51.5% of cases.The non- operated cases were those whose poor general condition as well as those who could not afford the procedure. Undifferentiated adenocarcinoma was the predominant pathological type found in 78% of operated cases. No patients underwent other treatments such as radiation therapy, immunotherapy or chemotherapy. Mortality occured in 10 cases including 1 intra operative death, 3 patients died in the early post operative period due to respiratory distress and 7 patients died from metatstasis discovered post operatively. CONCLUSION: This study has shown that majority of patients with solid renal tumours in this environment present late with advanced stages of the disease. The absence of the necessary investigative equipment, poverty and absence of adjuvant and adjunct therapeutic facilities make the treatment outcome poor.
RESUMO
BACKGROUND: Gangrene of the male genitalia called Fournier's gangrene is not an uncommon surgical condition in the urological service at Cotonou, Benin Republic; it is associated with high mortality and morbidity. PATIENTS & METHODS: This is a retrospective, descriptive study conducted at the Teaching Clinic of Urology and Andrology at the National and Hospitable Center CNHU- Hubert Koutoukou MAGA in Cotonou, Benin Republic. The study is on patients managed for Fournier's gangrene from January 2002 to December 2012. The demographics, clinical presentation, management and outcome were recorded in a proforma and the data obtained were analyzed using SPSS 10.0 software. RESULTS: Fournier's gangrene represented 1.8% of hospitalizations with an annual average of 5 cases. The mean age was 52 years with range of 21 - 85 years. 77.7% of patients were 40 - 59 years and; while 22.3% were 60 years and above. About 28% had a predisposing factor (diabetis, HIV, leukaemia, high blood pressure). Etiological factors were urogenital (42.5%), anorectal (22.5%), and cutaneous (17.5%). In 17.5% of cases, no etiologic factor was found. The diagnosis was clinically obvious because of late presentation, 95% of patients were admitted in the acute phase. CONCLUSION: Fournier's gangrene mostly affects young males and the diagnosis was clinical. It is a disease with high morbidity and mortality in Benin Republic.
RESUMO
This a case report of an immunocompetent (HIV negative) 54 years old man who had been diagnosed with epididymo-testicular tuberculosis. This happened 13 years after he had suffered from pulmonary tuberculosis. The diagnosis was made after a testicular biopsy for infertility. The outcome of anti-tuberculosis treatment was good although the azoospermia lasted. The aim of this report is to emphasize that the genital tuberculosis still exists in our sub-region and that high index of suspicion is required with effective anti-tuberculous therapy in order to achieve good outcome.
