Testicular necrosis and subsequent orchiectomy as a complication of inguinal mesh infection surgery: a case report.

The management of inguinal hernias has been revolutionised with mesh-based techniques, which are now the gold standard. In rare cases, complications can occur, the most common being prosthesis infection. The course is unpredictable, causing considerable morbidity and multiple interventions in the case of chronicity. We treated a 38-year-old patient for an inguinal mesh infection that evolved for 8 years before definitive management. The peculiarity of this finding is the occurrence of testicular necrosis following complete removal of the prosthesis, which is likely to be related to spermatic vessel injuries. This observation shows that although healing is achieved, there may be significant sequelae, and infection prevention must be a constant concern while inserting a mesh.

Prostate cancers in men under the age of 50: about a series in Togo, Sub-Saharan Africa.

BACKGROUND: Prostate cancer is a public health problem and increasingly diagnosed in men under 50 years of age. This cancer occurs much more in subjects of advanced age, generally over sixty. The aim of the study was to describe the epidemiological, clinical and histopathological aspects of prostate cancer in men under the age of 50 in Togo. METHODS: It was a retrospective descriptive, cross-sectional study of histologically confirmed cases of prostate cancer in young adults at the Pathological Laboratory of Lomé over a period of 10 years (2011-2020). RESULTS: In total, 29 cases of prostate cancer in patients under 50 years of age. The proportion of prostate cancers in men under 50 was 0.7% of all prostate cancers, The average age of the patients was 45 years with extremes of 35 and 49 years. Twelve patients had a family history of prostate cancer, with a statistically significant relationship between the existence of a family history of prostate cancer and the age of onset of the cancer (p-value = 0.03). The dominant clinical information was prostatic hypertrophy (40.37%), followed by acute urine retention (20.69%) and micturition disorders (17.27%). The median Prostate Specific Antigen (PSA) was 188 ng/ml with extremes of 20 ng/ml and 2100 ng/ml. A large proportion of patients had a PSA between 100 and 500 ng/ml. Histologically, they were all prostatic acinar adenocarcinomas. These adenocarcinomas were well differentiated (48%) and moderately differentiated (38%). The predominant histoprognostic grade was ISUP (International Society of Urological Pathology) grade 1 which was noted in 65.52%, followed by grade 2 in 20.69%. CONCLUSION: Prostate cancer in men under 50 years of age is relatively rare in Togo, sometimes occurring in the context of a family history of prostate cancer. Hence the importance of raising awareness among the male population, especially with a family history of prostate cancer, to start screening early, around the age of 40.

Prostate cancer screening: A survey of medical students' knowledge in Lome, Togo, and associated determinants in a resource-limited African context.

OBJECTIVES: The aims of this study were to assess the knowledge of medical students in Lomé about these means of screening for prostate cancer in a context of limited resources and controversy about prostate cancer screening, and to identify the determinants associated with these results. METHODS: This was a prospective descriptive and cross-sectional study conducted in the form of a survey of medical students regularly enrolled at the Faculty of Health Sciences of the University of Lomé for the 2019-2020 academic years. RESULTS: Of the 1635 eligible students, 1017 correctly completed the form, corresponding to a rate of 62.20%. The average age was 22 ± 3.35 years. The sex ratio (M/F) was 2.5. Undergraduate students were the most represented (53.69%). Students who had not received any training on prostate cancer were the most represented (57.13%). Only 12.88% of the students had completed a training course in urology. Concerning the prostate-specific antigen blood test, there was a statistically significant relationship between the students' knowledge and some of their socio-demographic characteristics, namely age (p value = 0.0037; 95% confidence interval (0.50-1.77)); gender (p value = 0.0034; 95% confidence interval (1.43-2.38)); study cycle (p value ˂ 0.0001; 95% confidence interval (0.56-5.13)) and whether or not they had completed a placement in a urology department (p value ˂ 0.0001; 95% confidence interval (0.49-1.55)). On the contrary, there was no statistically significant relationship between students' knowledge of the digital rectal examination and their study cycle (p value = 0.082; 95% confidence interval (0.18-3.44)). CONCLUSION: Medical students in Lomé have a good theoretical knowledge and a fair practical level of the digital rectal examination clinical examination and an average theoretical knowledge and a below average practical level of prostate-specific antigen, increasing however along the curriculum in the context of prostate cancer screening.

Papillary Renal Cell Carcinoma Revealed by Renal Traumatism: A Case Report in Lomé.

This study is a report on a case of papillary carcinoma of the kidney revealed by an abdominal contusion. The results of radiological investigations were discordant with the low intensity of the shock. The treatment consisted of radical nephrectomy because of the suspicion of a pre-existing malignancy. Histological analysis revealed a papillary carcinoma pT3N0M0. We focus on the need for performing diagnostic tests in order to avoid missing a pre-existing anomaly to the kidney trauma.

Evolution of the Histo-Epidemiological Profile of Urological Cancers in Togo

Background: Urological cancers are an important public health issue and pose problems with diagnosis and adequate management in developing countries. Our aim was to determine and report epidemiological and histological features of urological cancers in Togo. Materials and methods: A retrospective descriptive study was conducted of cases of urological cancers observed in the laboratory of pathological anatomy of the CHU Tokoin over the last 4 years (2012-2016). The parameters studied were frequency, age, sex, sites of development and histological type. Results: Epidemiological data were collected for 182 cases, representing 16.4% of all cancers (1108 cases). The annual frequency was 45.5±1.1 cases on average. The male:female sex ratio was 8.6 with a mean age of 60.2 years. Regarding location, in decreasing order of frequency, the tumors were found in the prostate (n=121 cases; 66.5%), bladder (n=28; 15.4%), kidney (n=19; 10.4%), testis (n=10; 5%), penis (n=3; 1.7%) and scrotum (n=1; 0.5%). Histologically, prostate cancers were predominantly adenocarcinomas (n=116 cases; 95.8%) with a Gleason score of 6 (n=46; 39.7%) predominant. Bladder cancers were mainly squamous cell carcinomas (n=11; 39.3%) followed by transitional carcinomas (n=9 cases; 32.1%) and adenocarcinomas (n=7; 25%). Kidney cancers were predominantly nephroblastomas (n=10, 52.6%) in children and clear cell carcinomas (n=8 cases; 42.1%) in adults. Testicular cancers were Burkitt lymphomas in 5 cases. The cases of penis and scrotum cancers were all squamous cell carcinomas. Conclusion: Urological cancers are experiencing an upsurge in frequency in Togo, dominated by prostate cancer, with a high frequency of squamous cell carcinoma of the bladder due to endemic bilharziasis.