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Background: There is an increasing tendency to close midline abdominal wounds with staples because of the speed of closure. The aim of this study was to compare the use of skin staples and vertical mattress sutures in the closure of midline abdominal wounds. Materials and Methods: Patients who met inclusion criteria and were booked for laparotomy in our teaching hospital were counseled on the two methods of skin closure using vertical mattress sutures or the use of staples (35 W Surustap, Suru International PVT Ltd, India). Alternating post-laparotomy wounds were closed using skin staples and with a vertical mattress, using nylon 2(0) (3 metric) sutures. The parameters assessed were speed of closure, cost of closure using the different methods, wound infection rate, and short-term cosmetic appearance of wounds. Data were analyzed using SPSS version 21 (IBM, SPSS, Chicago, Illinois). Results: Sixty patients met the inclusion criteria and were recruited for the study. The speed of closure of midline laparotomy skin wound was significantly higher in "the staple group" than in "the suture group" (0.14 vs. 0.034 cm/s), P < 0.05, while the cost of use of staples was significantly more than the cost for closure with sutures (184 vs. 26 Naira/cm), P < 0.05. The mean operative time was significantly less in "the staple group" than in "the suture group" (128.9 minutes versus 157.6 min), P < 0.05. There was no significant difference in the infection rates and cosmetic appearance between the two groups (P > 0.05). Conclusion: Midline abdominal wound closure with staples is faster. There was no difference in wound complication rates and scar appearance when compared with skin closures using the vertical mattress technique. Wound closure with staples is, however, more costly.
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Background: Management of urethral stricture disease remains a challenge in the field of urology. Though several options exist for its management, urethroplasty has proved to give the best outcome. Methodology: This is a retrospective study of urethral strictures and urethroplasties for 5years spanning from January 2015 to December 2019 at a tertiary teaching hospital in Anambra, South East Nigeria. Data was retrieved from the case notes of all the urethral strictures cases which presented to our facility in these 5 years and analysed using Microsoft Excel. Results: A total of 186 patients were diagnosed with urethral stricture disease within the 5 years' period. However, only 28 (15.1%) of them had urethroplasty within the period, mostly due to lack of fund. Of those who had urethroplasty, their ages ranged from 4 - 64 years with a median of 29.50 years. Motor vehicular road traffic accident (RTA) was the most common (46.43%) aetiology. Excision and anastomosis was the most common type of urethroplasty performed (71.43%) and the most common complication was stricture recurrence (32.14%). Conclusion: Though urethroplasty techniques have become more refined, accessibility of care continues to hamper treatment in Sub-Saharan Africa due to socioeconomic issues.
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INTRODUCTION: Prostate cancer has an increasing global burden. The clinical course varies from an indolent disease to a rapidly aggressive cancer. It is associated with higher mortality in less developed nations due to late presentation. The Gleason scoring system for prostatic adenocarcinoma has prognostic implications in diagnosed cases. Obesity has been associated with the evolution of many cancers including prostate cancer. There are conflicting reports on the relationship between obesity, as measured by body mass index (BMI), and prostate cancer aggressiveness, as measured by Gleason score. This study is aimed to determine if a correlation exists between BMI and Gleason score in men with prostate cancer. METHODOLOGY: This was a prospective, hospital-based, cross-sectional study involving consecutive patients with prostate cancer. Clinical evaluation including anthropometry, digital rectal examination, and relevant investigations were done for each patient and data collected with pro forma. This was followed by prostate needle biopsy and those diagnosed with adenocarcinoma of the prostate had their Gleason grades and scores obtained. Data were analyzed statistically using Spearman Correlation. RESULTS: The mean age of the patients was 69.54 ± 8.61 years (range 47-83 years). The BMI ranged from 16.98 to 36.45 kg/m2, with a mean of 27.03 ± 5.03 kg/m2. Twenty-six of the patients (36.1%) were overweight and 34.7% were obese. The mean total prostate-specific antigen was 118.65 ± 84.43 ng/ml, with a range of 31-406 ng/ml. The modal Gleason score was 9 with a range of 4-10. There was a strong positive correlation between BMI and Gleason score (r = 0.817, P = 0.0003). CONCLUSION: The BMI of patients with prostate cancer correlated positively with their Gleason score.
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BACKGROUND: Benign prostatic hyperplasia is one of the most common diseases in aging males. For men that need surgical treatment, transurethral resection of the prostate (TURP) is the gold standard. The aim of this article is to retrospectively review the complications of TURP over a 3-year period in Nnamdi Azikiwe University Teaching Hospital Nnewi and a Specialist Urology Center in Awka all in Anambra South-East Nigeria using Clavien-Dindo classification. PATIENTS AND METHODS: The study was a retrospective review of consecutive TURPs done over a 3-year period. Patients' information and complications arising from the procedure were collected and graded using the Clavien-Dindo classification with a pro forma designed for the study and analyzed with the Statistical Package for the Social Sciences software version 20.0. RESULTS: Ninety-seven patients had TURP during the period of this study. Twenty-nine complications were noted in 24 patients. The postoperative morbidity rate was 24.74%, and no mortality was recorded. Most of the complications were grade 2 (55%), followed by grade 1 and 3 (20.69%) each. Grade 4a complication accounted for only 3.45%. No grade 5 complication was recorded. CONCLUSION: TURP is safe, with minimal life-threatening morbidity even in a resource-poor economy where TURP is gradually gaining grounds.
