Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Ku...Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Kuss-Anderson technique. Because of the minimally invasive nature of the laparoscopic approach, it has become the approach of choice for the management of this pathology. We present the results of laparoscopic transperitoneal pyeloplasty used in the management of PUJS. Materials and Methods: This was a retrospective study from 2015 to 2020, including 26 patients who underwent laparoscopic transperitoneal pyeloplasty for PUJS. Results: Twenty-six patients, including 18 (69.2%) men and 6 (30.8%) women, with a mean age of 35.42 ± 13.62 years, were treated. Renal colic was the primary symptom in the majority of the cases (22, 84.6%)). The diagnosis was confirmed in all patients through an abdominal CT scan, which revealed that all 26 patients had hydronephrosis. Half of the patients (50.0%) were classified as Valayer-Cendron Type II, and eight (30.8%) patients had associated stones. Seventeen (65.4%) patients had pathologies on the left side, and all patients were treated using the Kuss-Anderson technique with a median operating time of 108.5 (90.0 - 136.0) minutes. The uncrossing of lower pole vessels was performed in 10 patients. The average duration of hospitalisation was 2.23 ± 0.82 days. No conversion was observed, and after an average follow-up of 53.69 days, the success rate was 92.3%. Conclusion: Laparoscopic pyeloplasty is a minimally invasive technique of choice for the treatment of pyelo-ureteral junction obstruction. It is dependable, repeatable, and produces good functional outcomes that are equal to those of traditional surgery.展开更多
Background: Prostate cancer, which is the second most frequent cancer diagnosis made in men, more commonly occurs in the elderly. This disease is often diagnosed late in resource-limited settings, which results in peo...Background: Prostate cancer, which is the second most frequent cancer diagnosis made in men, more commonly occurs in the elderly. This disease is often diagnosed late in resource-limited settings, which results in people having advanced forms of the disease and a poor prognosis. This study aimed to identify factors indicative of prostate cancer aggressivity and a poor prognosis in patients with prostate cancer at a single center in Douala, Cameroon. Methods: We performed a retrospective study from 2015 to 2020 at the Centre medico-chirugical d’urologie in Douala, Cameroon, in which we included 203 patients aged 41 years to 85 years who had prostate cancer diagnosed via histopathology after either prostate biopsyor laparoscopic prostatectomy. Epi-info 7 was used for data analysis and logistic regression analyses were performed to identify factors associated with prostate cancer aggressivity and patients’ outcomes (survival or mortality). Results: The mean age of our study participants was 64.76 ± 7.48 years. Ten patients had a contributive family history of prostate cancer. The patients presented with lower urinary tract symptoms in 61.58% of cases. All patients had serum prostate-specific antigen (PSA) levels of >4 ng/ml, 100 patients were anemic, and 36 patients had aggressive forms of the disease. Eighty-eight patients had remarkable digital rectal examination (DRE) findings. The median prostate volume, as determined via transrectal ultrasonography (TRUS), was 59 [43 - 80] ml. Fifty-nine patients had abnormal prostate echostructures, and 33 patients died during follow-up. The presence of paraplegia and the practice of professions requiring unskilled labor were significantly associated with aggressive prostate cancer. The presence of lymphoedema, abnormal DRE findings, anemia, enlarged prostate glands (prostate volume >50 ml), and abnormal prostatic echostructures were significantly associated with both prostate cancer aggressivity and patients’ outcomes. Conclusion: The late diagnosis of prostate cancer is a major public health problem in Cameroon because of the complications and poor prognosis of the disease at an advanced stage. Certain clinical, biological, and imaging factors are associated with prostate cancer aggressivity and a poor prognosis, whose identification could help guide clinicians in making therapeutic choices for their patients.展开更多
Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at...Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at a urology center in Douala, Cameroon. Patients and Methods: This was a retrospective study carried out from 2015 to 2019 on 32 patients with bladder tumors that were managed at the Centre medico-chirugical d’urologie in Douala, Cameroon. The relevant data were obtained from patients’ clinical records. Results: A total of 32 patients (25 men and 7 women) aged 29 - 75 years were included in this study. The mean age of the study participants was 58.63 ± 11.00 years. Among our study participants, there were 10 smokers (31.25%). Eight (25%) of them had occupational exposure while 2 (6.25%) had residential exposure to bladder cancer. Thirty (93.75%) presented with hematuria, 2 (6.25%) presented with recurrent urinary tract infections, and 1 (3.13%) presented with acute urinary colic. Nineteen (59.38%) of them were anemic, with 4 (12.5%) requiring blood transfusions. Twenty-seven (84.38%) of them had pedunculated tumors while 5 (15.62%) had sessile tumors. The tumor diameters ranged from 1 cm to 5 cm, with a mean diameter of 2.75 ± 1.22 cm. Complete resection was performed in 27 (84.38%) participants while partial resection was performed in 5 (15.62%) patients. The early single instillation of intravesical chemotherapy with mitomycin was performed in 8 (25%) patients. Only one (3.13%) patient had a postoperative complication, and seven (21.88%) patients experienced tumor recurrence and underwent a second TURBT. Two (6.25%) of the 32 patients died and 30 (93.75%) survived. Conclusion: TURBT is the gold standard method of managing bladder tumors. This procedure is at the same time diagnostic and therapeutic for tumors that do not invade the walls of the urinary bladder.展开更多
Background and Objective: Laparoscopy can be an alternative modality in the management of ureteral stones. We herein present our experience with laparoscopic ureterolithotomy although most ureteral stones are managed ...Background and Objective: Laparoscopy can be an alternative modality in the management of ureteral stones. We herein present our experience with laparoscopic ureterolithotomy although most ureteral stones are managed using endourologic techniques, open surgery, or shockwave lithotripsy. Materials and Methods: This retrospective study was performed from January 2014 to December 2019 on 20 patients with ureteral stones who were treated using transperitoneal laparoscopic access. We collected data on patients’ ages, genders, clinical profiles, relevant medical history, sizes of the calculi, localisation of the calculi as confirmed by imaging, and outcome of lithotripsy. Continuous data were presented as mean values and standard deviations (for normally distributed data) and medians with interquartile ranges (for skewed data). Categorical data were presented as frequencies and percentages. Results: We included 20 patients (13 males and 7 females) with a mean age of 40.40 ± 13.25 years. The mean stone size was 18.5 ± 3.05 mm and all procedures were completed laparoscopically. The mean operative time was 96 ± 22.34 minutes. The mean estimated blood loss was less than 150 ml, and none of the patients received a blood transfusion. There was no intraoperative complication or postoperative complications, except for leakage of urine in the suture area. The mean hospital stay was 2.05 ± 0.69 days and the double J stent was removed after an average of 20 days post-operatively. The stone-free rate was 100% and after a mean follow-up period of 3 months, there was no stone recurrence. Conclusion: Laparoscopic ureterolithotomy is an effective and safe technique in the management of ureteric stones. The benefits of this technique include minimal postoperative morbidity, short postoperative hospitalization, a short convalescence period, and remarkable cosmetic results.展开更多
文摘Background and Objectives: Pyelo-Ureteral Junction Syndrome (PUJS) is the most common obstructive malformation of the upper urinary tract in children and adults. The standard treatment is open pyeloplasty using the Kuss-Anderson technique. Because of the minimally invasive nature of the laparoscopic approach, it has become the approach of choice for the management of this pathology. We present the results of laparoscopic transperitoneal pyeloplasty used in the management of PUJS. Materials and Methods: This was a retrospective study from 2015 to 2020, including 26 patients who underwent laparoscopic transperitoneal pyeloplasty for PUJS. Results: Twenty-six patients, including 18 (69.2%) men and 6 (30.8%) women, with a mean age of 35.42 ± 13.62 years, were treated. Renal colic was the primary symptom in the majority of the cases (22, 84.6%)). The diagnosis was confirmed in all patients through an abdominal CT scan, which revealed that all 26 patients had hydronephrosis. Half of the patients (50.0%) were classified as Valayer-Cendron Type II, and eight (30.8%) patients had associated stones. Seventeen (65.4%) patients had pathologies on the left side, and all patients were treated using the Kuss-Anderson technique with a median operating time of 108.5 (90.0 - 136.0) minutes. The uncrossing of lower pole vessels was performed in 10 patients. The average duration of hospitalisation was 2.23 ± 0.82 days. No conversion was observed, and after an average follow-up of 53.69 days, the success rate was 92.3%. Conclusion: Laparoscopic pyeloplasty is a minimally invasive technique of choice for the treatment of pyelo-ureteral junction obstruction. It is dependable, repeatable, and produces good functional outcomes that are equal to those of traditional surgery.
文摘Background: Prostate cancer, which is the second most frequent cancer diagnosis made in men, more commonly occurs in the elderly. This disease is often diagnosed late in resource-limited settings, which results in people having advanced forms of the disease and a poor prognosis. This study aimed to identify factors indicative of prostate cancer aggressivity and a poor prognosis in patients with prostate cancer at a single center in Douala, Cameroon. Methods: We performed a retrospective study from 2015 to 2020 at the Centre medico-chirugical d’urologie in Douala, Cameroon, in which we included 203 patients aged 41 years to 85 years who had prostate cancer diagnosed via histopathology after either prostate biopsyor laparoscopic prostatectomy. Epi-info 7 was used for data analysis and logistic regression analyses were performed to identify factors associated with prostate cancer aggressivity and patients’ outcomes (survival or mortality). Results: The mean age of our study participants was 64.76 ± 7.48 years. Ten patients had a contributive family history of prostate cancer. The patients presented with lower urinary tract symptoms in 61.58% of cases. All patients had serum prostate-specific antigen (PSA) levels of >4 ng/ml, 100 patients were anemic, and 36 patients had aggressive forms of the disease. Eighty-eight patients had remarkable digital rectal examination (DRE) findings. The median prostate volume, as determined via transrectal ultrasonography (TRUS), was 59 [43 - 80] ml. Fifty-nine patients had abnormal prostate echostructures, and 33 patients died during follow-up. The presence of paraplegia and the practice of professions requiring unskilled labor were significantly associated with aggressive prostate cancer. The presence of lymphoedema, abnormal DRE findings, anemia, enlarged prostate glands (prostate volume >50 ml), and abnormal prostatic echostructures were significantly associated with both prostate cancer aggressivity and patients’ outcomes. Conclusion: The late diagnosis of prostate cancer is a major public health problem in Cameroon because of the complications and poor prognosis of the disease at an advanced stage. Certain clinical, biological, and imaging factors are associated with prostate cancer aggressivity and a poor prognosis, whose identification could help guide clinicians in making therapeutic choices for their patients.
文摘Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at a urology center in Douala, Cameroon. Patients and Methods: This was a retrospective study carried out from 2015 to 2019 on 32 patients with bladder tumors that were managed at the Centre medico-chirugical d’urologie in Douala, Cameroon. The relevant data were obtained from patients’ clinical records. Results: A total of 32 patients (25 men and 7 women) aged 29 - 75 years were included in this study. The mean age of the study participants was 58.63 ± 11.00 years. Among our study participants, there were 10 smokers (31.25%). Eight (25%) of them had occupational exposure while 2 (6.25%) had residential exposure to bladder cancer. Thirty (93.75%) presented with hematuria, 2 (6.25%) presented with recurrent urinary tract infections, and 1 (3.13%) presented with acute urinary colic. Nineteen (59.38%) of them were anemic, with 4 (12.5%) requiring blood transfusions. Twenty-seven (84.38%) of them had pedunculated tumors while 5 (15.62%) had sessile tumors. The tumor diameters ranged from 1 cm to 5 cm, with a mean diameter of 2.75 ± 1.22 cm. Complete resection was performed in 27 (84.38%) participants while partial resection was performed in 5 (15.62%) patients. The early single instillation of intravesical chemotherapy with mitomycin was performed in 8 (25%) patients. Only one (3.13%) patient had a postoperative complication, and seven (21.88%) patients experienced tumor recurrence and underwent a second TURBT. Two (6.25%) of the 32 patients died and 30 (93.75%) survived. Conclusion: TURBT is the gold standard method of managing bladder tumors. This procedure is at the same time diagnostic and therapeutic for tumors that do not invade the walls of the urinary bladder.
文摘Background and Objective: Laparoscopy can be an alternative modality in the management of ureteral stones. We herein present our experience with laparoscopic ureterolithotomy although most ureteral stones are managed using endourologic techniques, open surgery, or shockwave lithotripsy. Materials and Methods: This retrospective study was performed from January 2014 to December 2019 on 20 patients with ureteral stones who were treated using transperitoneal laparoscopic access. We collected data on patients’ ages, genders, clinical profiles, relevant medical history, sizes of the calculi, localisation of the calculi as confirmed by imaging, and outcome of lithotripsy. Continuous data were presented as mean values and standard deviations (for normally distributed data) and medians with interquartile ranges (for skewed data). Categorical data were presented as frequencies and percentages. Results: We included 20 patients (13 males and 7 females) with a mean age of 40.40 ± 13.25 years. The mean stone size was 18.5 ± 3.05 mm and all procedures were completed laparoscopically. The mean operative time was 96 ± 22.34 minutes. The mean estimated blood loss was less than 150 ml, and none of the patients received a blood transfusion. There was no intraoperative complication or postoperative complications, except for leakage of urine in the suture area. The mean hospital stay was 2.05 ± 0.69 days and the double J stent was removed after an average of 20 days post-operatively. The stone-free rate was 100% and after a mean follow-up period of 3 months, there was no stone recurrence. Conclusion: Laparoscopic ureterolithotomy is an effective and safe technique in the management of ureteric stones. The benefits of this technique include minimal postoperative morbidity, short postoperative hospitalization, a short convalescence period, and remarkable cosmetic results.
