Prevalence and Clinical Anatomic Characteristics of Cryptorchidism in Schools in the City of Conakry

Objective: To report the prevalence, anatomic and clinical characteristics of cryptorchidism in schools in the city of Conakry. Material and Methods: We carried out a 6-month cross-sectional study which took place in 32 public and private general education establishments in the city of Conakry. Each student boy was interviewed and examined;some information was collected from parents over the phone. Results: The prevalence of cryptorchidism was 3.6%. It was higher among children of mothers who were not in school, and among those who attended public institutions. The average age of students with cryptorchidism was 9.84 ± 2.33 years, with extremes of 4 and 17 years. 85% of these pupils were born in a care structure (CHU, municipal hospital, health center). Cryptorchidism sat on the right in 64 cases (37.4%), on the left in 44 cases (25.7%), it was bilateral in 63 cases (36.9%). The testicle was palpable at the inguinal level in 77 cases or 45% of the cases. Conclusion: Many school children have cryptorchidism at advanced ages, thus exposing them to the risk of complications (infertility and malignant degeneration of the testicle). Raising awareness among the various players could reverse this trend.

Transection Type, Vesico-Vaginal Fistula Surgery

The objective of the study was to report the results of the surgery of the Vesico-vaginal fistula (VVF) transection types at CHU Conakry. Methods: This was a prospective descriptive study that focused on 64 patients operated for VVF transection type at the Urology department of CHU Conakry between January 2013 and December 2015. Four types of transection were defined according to the state of the urethra and vagina, the size of the fistula, the peri-fistulous tissue and associated lesions. The variables studied were the proportion of transection, age, the type of transection, the number of previous cures, the operative technique, the complications and the results after a follow-up of 3 months. Results: Transection accounted for 47.05% of the obstetric fistulas. The average age was 25.18 years old (14-43 years old). This was a Type I transection (11 cases), type II (27 cases), type III (19 cases) and type IV (7 cases). The surgical approach was vaginal in 64 cases. Fistulorraphy with a confection of a new cervix and cervico-urethral anastomosis was conducted in 19 patients, combined with bladder flap urethroplasty (30 patients) or vaginal flap (15 others). We recorded healing in 37 cases. Conclusion: Transection type VVF is a severe VVF. The preferential surgical approach was vaginal. Technical difficulties were related to associate lesions and the continence system affected.

Clinico-Biological Profile of the Azoosperm Patient at the Urology and Andrology Department, Conakry University Hospital

Objective: Azoospermia is one of the most important causes of couple infertility. The objective of our study is to report the clinical-biological profile of the azoosperm patient to the Urology-Andrology Department of the Conakry University teaching Hospital. It aims to take stock of the diagnostic management of azoospermia at this time where the world scientific community seems to be turned towards the intracytoplasmic sperm injection in the treatment of men with severe spermiological dysfunction. Patients and Method: This was a descriptive retrospective study lasting 12 months from January 1 to December 31, 2015. It collected 151 patients out of a set of 544 follow-ups for desire to have children. Were included the patients whose files contained all the information of the clinical observation (general information, reason for consultation, evolution, history, data of the physical examination) and a paraclinical assessment consisting of the FSH level and two spermograms spaced three months, confirming the diagnosis of azoospermia. Results: The mean age was 36.4 years with extremes of 23 and 56 years old. Urogenital infections (36.4%) followed by a notion of inguinal surgery had been the main patients’ history. Primary infertility accounted for 76.8% of cases. The mean duration of infertility was 6.5 years with extremes of 2 and 19 years. Azoospermia affected 27.76% of patients who consulted for the desire to have a child. It was judged secretory in 59.6% of cases, excretory in 25.8% of cases, and undetermined in 14.6% of cases. Varicocele was the main associated abnormality (46.3%) followed by testicular hypotrophy (36.4%). Neisseria Gonorrhoeae was the most common germ in sperm culture (21.7%). Chlamydia serology was positive in 21.7% of patients. Conclusion: Azoospermia affects a non-negligible proportion of men admitted by consulting for desire to have a child in our context. Strengthening the diagnostic and therapeutic arsenal is necessary to improve the care of affected patients.