Medico-surgical treatment in an emphysematous pyelonephritis case caused by urolithiasis in a non-diabetic patient: About one case report in a subsahara university hospital.

Authors report an emphysematous pyelonephritis case of bilateral urogenital lithiasis diseases on one hand, and on other, therapeutic approach through 38-year-old patient observation, non-diabetic, treated by percutaneous drainage in first intention, followed by a Nephro-ureterolithotomy and the right double J probe installation. Evolution post-treatment was satisfactory.

Prevalence of metabolic abnormalities in patients with urolithiasis in Kinshasa, Democratic Republic of Congo.

INTRODUCTION: metabolic abnormalities are key factors in urolithiasis patients because they can be modified to prevent the risk of urinary stones. The objectives of this study were to estimate the frequency of metabolic abnormalities in the urine of patients with urolithiasis and to determine their possible link with the chemical composition of stones. METHODS: we conducted a cross-sectional study evaluating 73 patients referred for urolithiasis in 8 clinics in Kinshasa, between January 2017 and September 2019. Twenty four-hour or early morning urine were collected and analyzed in the Tenon Hospital in Paris. Parameters analyzed included pH, specific gravity, creatinine, uric acid, calcium, phosphate, oxalate, citrate and magnesium. Chi square test or chi-square likelihood-ratio and student's t test were used as statistical tests. RESULTS: overall, 89% (n=65) of patients with lithiasis had metabolic abnormalities. Mean (SD) age of patients was 47.0 (14.2) years with male to female ratio of 1.6: 1. The mean (SD) 24-hour diuresis was 1836.4 (1216.9) ml; the mean (SD) urine density was 1.018 (0.007); and the mean (SD) pH was 6.1(0.8). Hypocitraturia was the most frequently observed metabolic abnormality and was found in 76.7% patients. Other significant metabolic abnormalities were low magnesuria (35.6%), hyperoxaluria (11%), and low sulphaturia (74%). Whewellite (73.5%) was the main chemical component. The mean pH was higher in patients with carbapatite and struvite stones (p=0.031). CONCLUSION: this study suggests that inadequate diuresis and hypocitraturia were important lithogenic factors. The population should be encouraged to increase water intake to limit the frequency of urine super saturation with crystals.

[Chemical composition of urinary stones and associated factors in the Democratic Republic of Congo]. / Composition chimique des calculs urinaires et caractéristiques épidémiologiques associées en République Démocratique du Congo.

To compare the chemical composition of the upper and lower urinary tract stones in Congolese patients, and to identify factors associated with the different types of stones. Stones from 119 patients originating from the upper tract and 75 from the lower tract were analyzed by infrared spectrophotometry. Among 119 patients with upper tract stones, age ranged from 10 to 81 years with a mean (SD) of 45.8 (13.6) years; males were the majority (55.5%). The main types of stones identified were whewellite (79%). For the 75 patients with lower apparatus stones, age ranged from 4 to 87 years with a mean (SD) of 51.6 (21.6) years; the majority were males (89.3%). The main types of stones were whewellite (44%) and anhydrous uric acid (22.7%). Overall, the factors associated with calcium oxalate included: site [4.95 (95% CI 2.35-10.44)] and diameter [3.03 (95% CI 1.45-6.25)]; patient's place of residence [0.05 (95% CI 0.01-0.29)] was associated with calcium phosphate. Infection stones were associated with; site [0.19 (95% CI 0.06-0.63)] and diameter [0.10 (95% CI 0.03-0.38)]. Finally, age 0.26 (95% CI 0.09-0.71) and stone site [0.23 (95% CI 0.07-0.68)] were associated with uric stones. The epidemiological and chemical profile of upper and lower tract stones were different. Several factors were associated with the chemical and crystalline composition of stones in the Democratic Republic of Congo.

Urinary incontinence in a female adolescent due to an ectopic ureter opening into the vestibulum: A case report.

Ectopic ureter opening into the vestibulum (EUV) is a rare congenital cause of urinary incontinence in female adolescents. Diagnosis be challenging. We report an EUV in a 16- year-old female. This is the first case of EUV reported in DR Congo. The evaluation and diagnosis are discussed.

Profil épidémiologique des calculs urinaires aux cliniques universitaires de Kinshasa epidemiological profile of urinary stones at Kinshasa university hospital

Contexte et objectif. Bien que la lithiase urinaire (LU) constitue un problème mondial majeur de santé publique, les données des pays d'Afrique subsaharienne sont paradoxalement inexistantes. Les objectifs de la présente étude était de décrire le profil épidémiologique de la LU et d'en déterminer la nature chimique. Méthodes. Une étude documentaire des patients avec lithiase urinaire a été conduite entre janvier 2008 et décembre 2016 aux Cliniques Universitaires de Kinshasa. Les paramètres d'intérêt englobaient les données anthropométriques, socio-démographiques, cliniques et la composition chimique des calculs (n= 45 examinés à l'Hôpital TENON de Paris). Le test de chi-carré de Pearson a été utilisé pour la comparaison des proportions et le test t de student pour les moyennes majorées de l'écart-type. Résultats. Sur les 762 admissions, la LU rendait compte de 14% d'hospitalisations. Le sexe masculin était prépondérant (59% avec sexe ratio H/F de 1,4). La fréquence globale de la LU augmentait avec l'âge jusqu'à la tranche d'âge de 40-59 ans. Le haut appareil était le siège de 85,1% des calculs. La fréquence hospitalière de la LU a augmenté de 6 fois en huit ans. Le grand axe moyen des calculs était de 20,9 ± 16,3 mm et 15,5% des patients présentaient une insuffisance rénale obstructive. La whewellite (oxalate de calcium monohydraté, C1) a été le composant le plus retrouvé. Conclusion. La fréquence de la LU (troisième cause d'hospitalisation) est en progression dans cette institution universitaire. De siège essentiellement rénal, la fréquence de calculs augmente avec l'âge avec un pic après la quarantaine. Ces calculs composés de la whewellite, avec un grand diamètre moyen assez important, sont souvent associés à l'insuffisance rénale, témoignant du caractère tardif de la prise en charge

[Postoperative ureterocolonic fistula: a case report]. / Fistule urétérocolique postopératoire.

Postoperative ureterocolonic fistula is exceptional: only one case has been published over the last 32 years. The authors report a case of postoperative ureterocolonic fistula observed after right hysteroadnexectomy in a 38-year-old woman with a solitary right kidney. This patient initially presented with anuria and fever followed by urine-smelling liquid diarrhoea. In a context of inadequate urological imaging equipment, the diagnosis of ureterocolonic fistula was suspected on the basis of the specific features of the diarrhoea, ultrasound which revealed ureterohydronephrosis above a pelvic obstacle, and normal cystography. Surgical exploration demonstrated a ureterosigmoidfistula. This case represents the 20th case of ureterocolonic fistula reported in the literature, including 2 postoperative cases.