The predictive value of intravesical prostatic protrusion on the outcome of trial without catheter in patients with acute urinary retention from benign prostatic hyperplasia at Jos University Teaching Hospital, Nigeria: a prospective observational study.

Introduction: acute urinary retention represents a significant and painful event in the natural history of benign prostatic hyperplasia. This study was to determine the value of intravesical prostatic protrusion in predicting the outcome of trial without catheter in patients presenting with acute urinary retention from benign prostatic hyperplasia. Methods: this was a prospective observational study carried out over a one-year period among 78 patients with acute urinary retention from benign prostatic hyperplasia who presented at the Accident and Emergency Department of Jos University Teaching Hospital. They were clinically evaluated, and a urethral catheter was passed to relieve the retention. Trans-abdominal ultrasound assessment of intravesical prostatic protrusion, was performed after relief of acute urinary retention. Patients were placed on tamsulosin tablets 0.4mg daily for three days and they had a trial without catheter on the third day. A receiver operating characteristic curve was used to determine the predictive power of intravesical prostatic protrusion on the outcome of trial without catheter in patients with acute urinary retention from benign prostatic hyperplasia. A p value of <0.05 was considered as significant. Results: seventy-eight patients were enrolled in the study. The mean age and was 65.00 (SD 7.28) years. The mean intravesical prostatic protrusion, voided volume and maximum flow rate were 13.04 (SD 10.94) mm, 89.46 (SD 6.14) mls and 7.63 (SD 5.69) ml/s respectively. Intravesical prostatic protrusion (area under the curve= 0.843, p=0.001) predicted the outcome of trial without catheter with a cut off mark of <7.4, using the receiver operating characteristic curve. Conclusion: intravesical prostatic protrusion significantly predicted the outcome of trial without catheter in patients with benign prostatic hyperplasia presenting with acute urinary retention. It is a useful tool in the initial evaluation of patients with benign prostatic hyperplasia presenting with acute urinary retention.

Dorsal onlay buccal mucosa graft urethroplasty for bulbar urethral stricture: a single centre experience.

INTRODUCTION: the successful treatment for urethral strictures demands not just attention to surgical details but careful selection of the reconstructive technique. For long segment urethral strictures substitution urethroplasty is required. This study sought to determine the success rate and complications of dorsal onlay buccal mucosal graft (BMG) urethroplasty for long segment urethral strictures in our hospital. METHODS: this was a retrospective study carried out at Jos University Teaching Hospital from March 2015 to March 2018. The case notes of male patients who had dorsal onlay buccal mucosal graft urethroplasty for long segment bulbar urethral stricture within the study period were retrieved. Patients´ demographics, cause and nature of urethral strictures, duration of follow up, the success rate and complications were collected and subjected to statistical analysis using SPSS® version 22. RESULTS: twenty-four men with mean age of 45 years (range 14-67 years) had dorsal onlay buccal mucosal graft urethroplasty during the study period. The mean stricture length was 4.5cm (range, 2-7cm). After a mean follow up duration of 2 years (range, 1 4 years), 21(87.5%) patients had a successful urethroplasty as they were able to pass urine at one year post urethroplasty without lower urinary tract symptoms, while 3(12.5%) had recurrence of the urethral stricture. At the recipient site, 2(8.3%) patients had primary bleeding that did not require blood transfusion. Also, 2(8.3%) patients had superficial wound infection which was treated with antibiotics. At the donor site, 4(16.7%), 2(8.3%), 4(16.7%) had donor site swelling, transient bleeding and soreness respectively. CONCLUSION: dorsal onlay BMG urethroplasty has a good success rate and minor complications and therefore suitable for long segment bulbar urethral strictures.

Problems with administration of international prostate symptom score in a developing community.

BACKGROUND: The IPSS form has been found useful for assessing symptom severity, which assists in treatment choice and in monitoring patients on therapy. The form should be self-administered and requires some level of literacy. We assessed the problems associated with its administration in a developing community. MATERIALS AND METHODS: The IPSS form was administered to patients with benign prostatic hyperplasia at the Urology Clinic of the Jos University Teaching Hospital from November 2004 to October 2005. Those who did not understand the questions or who could not read English required explanations. RESULT: There were a total of 70 patients who agreed to fill out the forms. Their ages ranged from 40 to 104 years with a mean of 63.6. The IPSS scores ranged from 3 to 35 with a mean of 18.3. About 56.7% of the patients had quality of life scores of ≥ 5. Only 2 (2.9%) patients were initially uncooperative in filling out the forms. Twenty-four (34.3%) did not understand English. Of the 46 (65.7%) that understood English, 28 (40.0%) could speak but could not read English, thus 52 (74.3%) could not read English. Ten (14.3%) patients thought the questions were either not comprehensive or clear enough. CONCLUSION: Illiteracy is a major drawback with the administration of the IPSS form, with 74.3% of patients unable to read English. Attempts should be made to draft the forms in the main language(s) spoken or read in a particular locality so as to gain maximally from the benefits of the IPSS. Relevant bodies should improve on the education of the populace.

Problems with Administration of International Prostate Symptom Score in a Developing Community

Background: The IPSS form has been found useful for assessing symptom severity; which assists in treatment choice and in monitoring patients on therapy. The form should be self-administered and requires some level of literacy. We assessed the problems associated with its administration in a developing community.Materials and Methods: The IPSS form was administered to patients with benign prostatic hyperplasia at the Urology Clinic of the Jos University Teaching Hospital from November 2004 to October 2005. Those who did not understand the questions or who could not read eng required explanations.Result: There were a total of 70 patients who agreed to fill out the forms. Their ages ranged from 40 to 104 years with a mean of 63.6. The IPSS scores ranged from 3 to 35 with a mean of 18.3. About 56.7 of the patients had quality of life scores of ? 5. Only 2 (2.9) patients were initially uncooperative in filling out the forms. Twenty-four (34.3) did not understand eng. Of the 46 (65.7) that understood eng; 28 (40.0) could speak but could not read eng; thus 52 (74.3) could not read eng. Ten (14.3) patients thought the questions were either not comprehensive or clear enough.Conclusion: Illiteracy is a major drawback with the administration of the IPSS form; with 74.3 of patients unable to read eng. Attempts should be made to draft the forms in the main language(s) spoken or read in a particular locality so as to gain maximally from the benefits of the IPSS. Relevant bodies should improve on the education of the populace