Holmium Laser Ureteroscopy in the Treatment of the Upper Urinary Tract Stones: Concerning 54 Cases in the Surgical Department of the Saint Camille Hospital of Ouagadougou (Burkina Faso)

The treatment of urinary stones uses a varied therapeutic arsenal. Nowadays the mini-invasive techniques are the most used. We report our first experience on the results of flexible and semi-rigid ureteroscopy in the treatment of the upper urinary tract stones. Materials and Methods: A 20-month prospective study on flexible laser ureteroscopy was conducted at the Saint Camille Hospital of Ouagadougou. The inclusion criteria were for patients who had given informed consent and the presence of an unilateral obstructive upper urinary tract stone with an indication of surgical management. Results: 54 patients were treated with Holmium laser photo vaporization between January 2018 and August 2019. The average age of patients was 37.74 ± 17 years (11 - 83 years). The men were predominant at 55.56%, or a sex-ratio of 1.25. The average size of stones of 17.55 mm ± 4.16 mm (11 mm to 25 mm) with pyelic, ureteral and calyceal localization in respectively 42.6%, 33.3% and 24.1% of cases. The average duration of the interventions was 77.92 ± 43.57 minutes (11 to 180 minutes). We used drainage in 90.91% of the cases. The average duration of hospitalization was 1.2 ± 0.73 days with extremes ranging from one day to 6 days. The vaporization without residual fragment which is a success was 78.46%. Conclusion: Laser ureteroscopy is a newly used method at the Saint Camille hospital. The achievement of good results and its low morbidity encourage us to promote its extension and its use in sub-Saharan African hospitals.

Contribution of Laser Photovaporisation in the Management of Lower Urinary Tract Symptoms Related to Prostatic Tumours: Preliminary Study of 29 Cases at the Saint Camille Hospital of Ouagadougou (Burkina Faso)

The treatment of prostatic tumour-related lower urinary tract symptoms (LUTS) uses a varied therapeutic arsenal. In our country, the treatment is dominated by open surgery. Laser treatment is becoming an efficient alternative to trans-urethral prostatic resection or prostatic adenomectomy. We report our experience with the results of Thulium laser photovaporization in the treatment of prostatic tumour-related LUTS. Materials and Methods: A prospective study was conducted between November 2018 and August 2019 at the Saint Camille hospital of Ouagadougou. The inclusion criteria were the presence of LUTS related to a prostatic tumour with an operative indication. Results: 29 patients were treated with Thulium laser prostatic photovaporization. The average age of patients was 72.58 ± 25.34 years (54 - 84 years). The average vaporization duration was 71.24 ± 21.65 minutes (15 - 210 minutes) for an average prostatic volume of 80.97 ml. The average duration of hospitalization for patients was 1.93 days (1 - 5 days). The average bladder sounding duration was 1.68 days (1 - 4 days). A capsular perforation, a sphincter lesion and urinary retention after removal of the catheter were the complications. Conclusion: Laser photovaporization is a newly used method at the Saint Camille Hospital. The benefit is the reduction of the risk of bleeding, the short duration of hospital stay and bladder sounding. Photovaporization deserves to be popularized in our daily practices.

Urological Cancers in Burkina Faso: Epidemiological and Anatomopathological Aspects of 2204 Cases

Purpose: To study the epidemiological and anatomopathological aspects of urological cancers in Burkina Faso from 1988 to 2018. Patients and Methods: A cross-sectional, retrospective and descriptive study of histologically confirmed cancers that are collected from pathological anatomy laboratory records. The aspects studied were age, sex, location and histological type. Results: A total of 2204 cases of urological cancer were collected. The predominance was male with a sex-ratio of 9.6. The average age was 63.32 years. We found 1602 cases of prostate cancer (72.68%), 361 cancers of the bladder and excretory tract (16.4%), 180 cancers of the kidney (8.16%), 33 testis cancers (1.5%) and 28 penile cancers (1.3%). The predominant histological type of prostate cancer was adenocarcinoma (96.4%) with a Gleason score 7 in 30.4% of cases. Bladder cancer consisted of 50% epidermoid carcinomas. Kidney cancer was mostly nephrotoblastomas with 42.2% of cases. We noted 42.4% of seminomas among testis cancers and 89.3% of epidermoid carcinomas within penile cancers. Conclusion: The incidence of urological cancers is increasing in Burkina Faso. These cancers occur at a relatively advanced age with male predominance. Prostate cancers are at the forefront of these urological cancers. The establishment of a cancer registry would allow better follow up of cancers in our countries.

Male Urethral Strictures in Ouagadougou (Burkina Faso): Epidemiological Diagnostic and Therapeutic Aspects

Purpose: To conduct a study of epidemiological, diagnostic and therapeutic aspects of urethral strictures at Yalgado Ouedraogo University Teaching Hospital. Patients and methods: It was about a retrospective and descriptive study conducted in the urology division of Yalgado Ouedraogo Hospital from October 1st 2009 to September 30th 2014. All the patients, included in this study, had a urethral stricture confirmed by the voiding retrograde cystourethrogram (VCUG) or during surgical intervention with useful surgical report and medical file. Results: During the period of study, 127 complete medical records were found. The hospital prevalence was 10.1%. The average age of the patients was 50.5 (from 3 to 80 years). 55.6% of the patients were from rural areas. Dysuria and urinary retention were the major causes of consultation with respectively 66.7% and 33.3%. The aetiology of urethral stricture was infectious in 71.4% of the cases. The VCUG permitted to objectify the characteristics of the stenosis. The urethral stenoses were single in the majority of the cases, about 88.8% of cases. The bulbar urethral stricture was the major location. Escherichia coli was isolated in 77.7% of the urinary infections. The majority of patients (61.9%) had undergone open surgery including 39.7% end to end anastomosis. No endoscopic treatment was recorded. Conclusion: The urethral stenosis is frequent in our division. Its major aetiology is infectious. The treatment is dominated by open surgery in our context.