Place of urolithiasis in the spectrum of urological pathologies, practices and use of endourological procedures in the management of calculi of the upper urinary tract: results of a survey of referral centres in Africa.

Our aim was to determine the current trend of endourology in the management of upper urinary tract calculi in Africa reference centres. We conducted an online multiple-choice questionnaire survey involving 46 centres from 27 countries using a structured well-designed Google Form (®) questionnaire. The questionnaires were distributed to the head of service through their emails. The questions collected demographic data about the centre, the epidemiology of urolithiasis, diagnostic means and management of upper urolithiasis, especially access to endourology procedures and their practices. Descriptive analyses were performed. The participation rate was 77.9%. Urinary lithiasis was one of the three main pathologies encountered in 42/46 centres. 33 centres had easy access to CT scanners and 34 had operating theatres equipped with endo-urological surgery equipment. Of these 34 centres, 30 perform endourology for the management of upper urinary tract stones. Rigid ureteroscopy is the main technique used by the centres. It is the only endourology technique used for stone management by 12 centres (40%). 7/30 (23.3%) have the option of performing rigid ureteroscopy, flexible ureteroscopy and percutaneous nephrolithotomy. The frequency of procedures varies widely, with 43.3% rarely performing endourological surgery. Seventeen centres have their operating theatre equipped with a fluoroscope and 6/42 centres have extracorporeal lithotripsy. Open surgery is still used in 29/42 centres (69.1%). Laparoscopy is available in 50% of centres, but none reported performing laparoscopic lithotomy. In Africa, urinary lithiasis plays an important role in the activities of referral centres. Modern management techniques are used to varying degrees (not all centres have them) and with very variable frequency. Open surgery is still widely performed as a management. Rigid ureteroscopy is the main endourological technique. It is essential to develop the practice of modern urology in Africa, mainly endourology.

Innocuité d'une recette médicinale traditionnelle utilisée pour l'infertilité masculine en Côte d'Ivoire / Safety of a traditional medicinal recipe used for male infertility in Ivory Coast

L'infertilité masculine est incriminée dans 50% des cas d'infertilité du couple. C'estun réel problème de santé publique en Afrique.Le présent travail avaitpour objectif d'évaluer l'innocuité et la tolérabilitéd'une recette médicinaletraditionnelle utilisée pour la prise en charge del'infertilité masculine dans le District Autonome d'Abidjan/Côte d'Ivoire. Cette étude a été réalisée dans le cadre de la valorisation de la pharmacopée africaine.Le matériel végétal était constitué de la recette médicinale et le matériel biologiquede 42 volontaires de sexe masculinsélectionnés sur une base raisonnée à postériori.Les volontaires ont été soumis à un traitement sur troismois. Lesvariables étudiées étaient: la glycémie,l'urée, la créatinine, les transaminases, les triglycérides et le cholestérol total. Leseffets secondaireset indésirablesont été notifiés.L'âge moyen de la populationd'étudeétait de 41,78 ans (± 7,73). Aux termes des trois mois d'utilisation de la recette médicinale, l'analyse statistiquedes variables biochimiquesa révélé: la glycémiep = 0,12; les transaminases p = 0,75; la créatinine p = 0,26; l'urée p = 0,04; les triglycérides p =0,95et le cholestérol total p = 0,64contre p< 0,05.Le principal effet secondaire notifié était la polyurie (97,5%).Ces résultatsaffirmentla sécurité de la recette médicinalepourl'utilisateur. Ils encouragentson utilisation chez les hommes infertileset un suivimédicaldespersonnes sous antihypertenseur.La recette médicinale présente une bonne innocuité et une bonne tolérabilité

Male infertility is incriminated in 50% of cases of couple infertility. This is a real public health problem in Africa.The present work aimed to evaluate the safety and tolerability of a traditional medicinal recipe used to treatmale infertilitMale infertility is incriminated in 50% of cases of couple infertility. This is a real public health problem in Africa.The present work aimed aimed to the safety and tMale infertility is incriminated in 50% of cases of couple infertility. This is a real public health problem in Africa.The present work aimed to evaluate the safety and tolerability of a traditional medicinal recipe used to treatmale infertility in the Autonomous District of Abidjan/Côte d'Ivoire. This study was carried out as part of the promotion of the African pharmacopoeia.The plant material consisted of the medicinal recipe and the biological material of 42 male volunteers selected purposively asposteriori. The volunteers underwent treatment over three months. The variables studied wereblood sugar, urea, creatinine, transaminases, triglycerides and total cholesterol. Side effects and undesirable effects were reported.The average age of the study population was 41.78 years (± 7.73). After three months of use of the medicinal recipe, the statistical analysis ofbiochemical variables revealedblood sugar p = 0.12; transaminases p = 0.75; creatinine p = 0.26; urea p = 0.04; triglycerides p = 0.95 and total cholesterol p = 0.64 versus p < 0.05. The main side effect reported was polyuria (97.5%).These results affirm the safety of the medicinal recipe for the user. They encourage its use in infertile men and medical monitoring of people on antihypertensive medication.The medicinal recipe isgood safety and tolerability.

Urethrovaginal fistula in a 5-year-old girl.

Urethral fistulas are rare in girls. They occur most of the time during trauma. The case presented here is an iatrogenic fistula. The treatment was simple and consisted of a simple dissection and suture of urethra and vagina.

[Hemorrhagic cystitis due to adenovirus in a renal transplant recipient: the first reported case in black Africa in a setting of a very beginning of a kidney transplantation program and review of the literature]. / Cystite hémorragique à adénovirus chez le transplanté rénal: à propos d'un premier cas en Afrique noire survenu dans un tout débutant programme de greffe rénale et revue de la littérature.

Viral infections are an important complication of transplantation. Polyomavirus are the commonest viruses that infect the renal allograft. Herpes virus nephropathy has also been described. In the past 15 years, adenovirus nephritis has emerged as a potentially life-threatening disease in renal transplant patients in developed countries. Most of the papers devoted to adenovirus nephritis are reported cases. The fate of such patients in resources-limited countries is not known. Herein, we describe the clinical, biological and prognostic findings of a black African transplanted patient with adenoviral hemorrhagic cystitis. This case is the very first of its kind reported in black Africa in a setting of a start of a renal transplantation pilot project. The patient is a 54-year-old man admitted at the nephrology service for gross haematuria and fever occurred 1 month after kidney transplantation. The diagnosis of adenoviral hemorrhagic cystitis has been suspected because the patient has displayed recurrent conjunctivitis and gastroenteritis well before transplantation, which was then confirmed by the real-time polymerase chain reaction performed on the blood. Conservatory measures associated with immunosuppression reduction have permitted the discontinuation of haematuria. This case has been discussed in regard of the epidemiology, the diagnosis, the treatment, the evolution and the prognosis of the adenoviral infection in the renal transplant patient. A review of the literature has been performed subsequently.