Suprapubic Cystostomy at Urological Emergency Unit of CHU-YO, Ouagadougou, Burkina Faso: Indications, Technique and Complications

Introduction: Cystostomy allows under certain circumstances deriving the urine. This is the most performed surgery in uro-andrological emergencies. Complications can occur. We aim to analyze the indications, technical aspects and complications of suprapubic cystostomies in the urological emergency unit at CHU-YO. Patients and Methods: Between October 2013 and May 2014 we conducted a prospective study of all patients who underwent suprapubic cystostomy. Results: 86 cases of cystostomy were noted or 77.5% of surgical procedures performed in uro-andrological emergency. All patients were male. The average age of patients was 52.5 years. The AUR represented 88.4% of indications. The prostate tumor represented 65.8% of the etiologies of AUR. The cystostomy was performed under local anesthesia in 87.2% of cases. Peritoneal gap was noted in 5.8%, parietal suppuration in 12.8%. A death by generalized acute peritonitis was noted in one case. Conclusion: Suprapubic cystostomy presents a non-negligible morbidity and mortality and must be mastered.

Surgical Management of Obstructive Urolithiasis in Small Ruminants by Tube Cystostomy in Chittagong, Bangladesh

The present study was conducted to evaluate minimally invasive tube cystostomy technique in goats and calves suffering from obstructive urolithiasis having intact and ruptured urinary bladder. This clinical study was carried out on 84 clinical cases （61 goats and 23 calves） based on the history, clinical signs and physical examination along with common laboratory techniques at the Chittagong Veterinary and Animal Sciences University during January 2015-December 2016. Physical parameters like heart rate, respiratory rate, rectal temperature and dehydration status of animals were noted and corrected abnormality before surgery. Some cases had slightly higher haemoglobin （Hb）, packed cell volume （PCV） and uric acid and epithelial casts in urine. The study revealed that abnormal calcium-phosphorus ratio was predisposing the animals to urolithiasis. It was found that young ruminants （3-5 months） were most commonly affected in both species. All affected animals were male in this study, in which calves were not castrated but in goats 95.08% animals were castrated. Rupture of bladder was more common in calves as compared to goats. Postoperatively all cases were administered with broad-spectrum antibiotic, anti-inflammatory agent and caliculolytic agents like ammonium chloride. Tube cystostomy with Foley’s catheter was the most satisfactory technique for the management of obstructive urolithiasis in small ruminants. Postoperative complications were recorded only in four animals and remaining 80 animals had a normal recovery from tube cystostomy. Tube cystostomy is a simple, inexpensive and very effective procedure for the treatment of urolithiasis in ruminants.

Suprapubic cystostomy versus nonsuprapubic cystostomy during monopolar transurethral resection of prostate： a propensity score-matched analysis

We aim to reassess the safety of the monopolar transurethral resection of the prostate （M-TURP） without suprapubic cystostomy at our institution over the past decade. This retrospective study was conducted in patients who underwent M-TURP at Peking University First Hospital between 2003 and 2013. A total of 1680 patients who had undergone M-TURP were identified, including 539 patients in the noncystostomy group and 1141 patients in the cystostomy group. After propensity score matching, the number of patients in each group was 456. Smaller reductions in hemoglobin and hematocrit （10.9 g vs 17.6 g and 3.6% vs 4.7%, respectively） were found in the noncystostomy group. In addition, patients undergoing surgery without cystostomy had their catheters removed earlier （4.6 days vs 5.2 days）, required shorter postoperative stays in the hospital （5.1 days vs 6.0 days）, and were at lower risk of operative complications （5.7% vs 9.2%）, especially bleeding requiring blood transfusion （2.9% vs 6.1%）. Similar findings were observed in cohorts of prostates of 30-80 ml and prostates 〉80 ml. Furthermore, among patients with a resection weight 〉42.5 g or surgical time 〉90 min, or even propensity-matched patients based on surgical time, those with cystostomy seemed to be at a higher risk of operative complications. These results suggest that M-TURP without suprapubic cystostomy is a safe and effective method, even among patients with larger prostates, heavier estimated resection weights, and longer surgical times.

Surgical Excision of Placenta with Lower Uterine Segment as a Conservative Management in a Case of Placenta Accreta: A Case Report

Introduction: Placenta accreta is due to invasive placental implantation. It is diagnosed when there is failure of delivery of a retained placenta. This is usually complicated by massive intrapartum hemorrhage that ends by hysterectomy. Case: We report a case of conservative management in a case of placenta accreta involving an elliptical shape incision of the lower segment with removal of placenta with underlying lower uterine segment in a stable patient desiring future fertility. Conclusion: Conservative management may be valid in carefully selected cases of placenta accreta diagnosed pre-operatively in tertiary hospitals with availability of blood-bank and multi-disciplinary approach.

Epidemiology of Urological Emergencies at the Regional University Hospital Center of Ouahigouya, Burkina Faso

Introduction: Urological emergencies are less frequent compared to other emergencies, particularly traumatological and digestive emergencies. The objective of this study was to determine the epidemiological profile of urological emergencies in a regional hospital in Burkina Faso. Patients and methods: This was a cross-sectional study of urological emergencies admitted to the Surgical Department of the Ouahigouya Regional University Hospital in Burkina Faso over a period of 41 months. The study covered a 41-month period from March 2015 to July 2018. Ethical clearance was taken from the institutional ethics committee. Results: Urological emergencies accounted for 3.7% of all emergencies. The mean age of the patients was 56.59 ± 25.93 years (range 1 year - 95 years). The sex ratio was 12.05. Bladder urinary retention was the main urological emergency in 48.28% of cases. Suprapubic cystostomy was the most performed surgical procedure (56.25%) followed by debridement of external genitalia gangrene (27.68%). Conclusion: Urological emergencies occupy a significant place in our work context. An increase in the number of urologists would improve their management.

Glass ampoule in urinary bladder as a foreign body

A wide range of objects have been inserted into the urinary bladder and urethra.Most foreign bodies in the lower genitourinary tract are self-inserted via the urethra as the result of erotic impulses,psychometric problems,sexual curiosity,or sexual practice while intoxicated.Here we report the case of a 32-year-old female with alleged history of insertion of glass ampoule in the urethra by the husband in eroticism which was removed with open surgery.This is the first case of its kind as per the literature available.

RESEARCH AND CLINICAL APPLICATION OF A NEW SURFACE MODIFICATION LARGE DIAMETER FOLEY CATHETER

-The surface of the large diameter three-way foley catheter we design and produce has been modified with the hydrophilic polyurethane,which makes the inner &.outer cavity very smooth.Observed from the canning electron microscope,the cracks of the catheter are closed up,and its surface is much smoother than that of the natural latex catheter. Besides these, we also give the catheter very strict physical,chemical & biological tests.And it matches all the technical targets with those of concerning stipulations.Through the clinical observations on 40 patients,the surface modiried large di-ameter three-way foley catheter is much better tban the emulsion catheter and catheter with mushroom-like tip.This catheter has many advantages,such as surface smooth, diameter large, easy for urinating and irrigating or bladder & pelvis, no urine salt sedimentation arter a long Period,stable, good biocompatibility,easy for operation changing,long period for the use of one catheter,and so on.