Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mo...Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mortality remains very high despite therapeutic advances. Our aim was to report on the epidemiological, diagnostic and therapeutic aspects of gangrene of the external genitalia, and to identify prognostic factors. Patients and Method: This was a 5-year retrospective descriptive study, from February 2016 to February 2021, of cases of gangrene of the external genitalia admitted to and treated in the Urology Department of Abeche University Hospital. Results: We collected 49 cases of gangrene of the external genitalia. The mean age of patients was 42 ± 16.81, with extremes of 20 and 81 years. The age group most concerned was between 20 and 29. The most frequent reasons for consultation were suppuration of the external genitalia and scrotal swelling. The average consultation time was 19.05 ± 16.02 days. The most common comorbidity was diabetes (35.9%). The most frequent pathological antecedents were urinary tract infections and endourethral maneuvers, reported in 40.5% and 38.7% respectively. Urogenital aetiology was predominant in 54.7%, and idiopathic in 35.9%. Lesions involved the scrotum in 60.6%, the scrotum and penis in 16.5%, and the penis alone in 5.7% of cases. Lesions extended to the perineum in 13.6% of cases, and to the abdomen in 3.6%. Vascular filling via the central venous line was performed in 58.6% of cases, and via the peripheral venous line in 41.4%. 3rd-generation cephalosporins and associated imidazoles were the most commonly used antibiotics. Necrosectomy was performed in 37 patients (73.4%), debridement combined with bypass cystostomy in 26.6% of cases. Colostomy was performed in 4% of cases. 90.8% of patients were cured and 9.2% died. The average hospital stay was 30 ± 75 days. Conclusion: The gangrene of the external genitalia is a medical and surgical emergency which has become rare in Europe, but which is still very common in the context of our practice in Chad. The severity of the disease is linked to delayed consultation and co-morbidity factors. Mortality remains very high despite therapeutic advances.展开更多
Trauma to the external genitalia by tearing is rare. We report the case of a 30-year-old patient, admitted to the emergency room for trauma of the external genitalia by traction following a blow and intentional injury...Trauma to the external genitalia by tearing is rare. We report the case of a 30-year-old patient, admitted to the emergency room for trauma of the external genitalia by traction following a blow and intentional injury. The authors highlight the lesions that can occur during this type of trauma and insist on the systematic search for urethral and cavernous lesions. Conclusion: Trauma to the external genitalia by intentional assault and battery is rare in our context. They occur most often in a young person and are frequently associated with damage to the corpora cavernosa and urethra.展开更多
Introduction: Ballistic traumas of the external genitalia are rare especially in civil practice. Emergency surgical exploration is the rule. Case Report: Mr. F.Y., 29 years old, a security agent, admitted to the Urolo...Introduction: Ballistic traumas of the external genitalia are rare especially in civil practice. Emergency surgical exploration is the rule. Case Report: Mr. F.Y., 29 years old, a security agent, admitted to the Urological Emergency Unit of Yalgado Ouédraogo University Hospital of Ouagadougou for trauma of the penile and left purse by firearm. The clinical examination revealed a good hemodynamic status, bladder distension. A suprapubic catheterization was performed. We noted a transfixing and bleeding wound on the penile, and on the left purse which was edematous. The patient was admitted to the operation room 07 hours after trauma. Exploration found a total destruction of the left testicle classified grade 5 of the classification of the American Association of the Surgery of Trauma (AAST). We performed a left orchiectomy. There was a partial rupture of the ventral face of the penile urethra. We performed an end-to-end anastomosis on a Foley catheter CH 18. The Foley catheter was removed after two weeks. Urination was spontaneous without dysuria. Erections were painless and without kinking of penile. Conclusion: Open traumas of the external genitalia are rare and their treatment is an extreme surgical emergency.展开更多
Aim: Report the epidemiological, clinicopathological characteristics and ensuring management of recent traumas of the external genitalia in Urology. Methods: This was a descriptive retrospective study of 47 cases of p...Aim: Report the epidemiological, clinicopathological characteristics and ensuring management of recent traumas of the external genitalia in Urology. Methods: This was a descriptive retrospective study of 47 cases of patients suffering from recent traumas of the external genitalia over a period of 5 years. The variables studied were sociodemographic, clinical, paraclinical, therapeutic and evolutionary. Results: A total of 47 patients, including 46 men, were managed. The mean age was 26.8 years, ranging from 6 to 56 years. The circumstances of occurrence were: the missteps of coitus (n = 16), traffic accidents (n = 9) and criminal injuries (n = 8). The fracture of the penis (n = 16) was the most common lesion followed by the scrotal wound (n = 11). The management was medical and surgical and varied by the type of lesion. The outcome was favorable in 91.5% of cases. Conclusion: The incidence of traumas of the external genitalia was 9.4 in urology department in N'Djamena. Penis fracture was the frequent lesion. The management is multidisciplinary, medical and surgical.展开更多
Objective: To describe the clinical aspects and the management of external genitalia gangrene in the Urology department of the Bobo Dioulasso CHUSS. Patients and methods: This was a retrospective and descriptive study...Objective: To describe the clinical aspects and the management of external genitalia gangrene in the Urology department of the Bobo Dioulasso CHUSS. Patients and methods: This was a retrospective and descriptive study over a period of 6 years from January 2011 to December 2016, which covered 54 patients hospitalized in the urology department of the University Hospital Souro Sanou for external genitalia gangrene. Results: The mean age of our patients was 53.8 years. The large ulcero-necrosis of scrotum was the main reason for reference. Our patients consulted on average 8.23 days after the onset of symptomatology. A risk factor was found in 44.2% of cases and a cause was identified in 65.3% of patients. A urogenital cause was present in 32.7%. Probabilistic antibiotic therapy and medical reanimation were systematic at admission. Debridement was performed on average 18 hours after admission and 10 patients had more than one debridement. We noted a mortality rate of 5.5%. Conclusion: Fournier’s gangrene is a serious infectious disease whose diagnosis is often delayed in our context. Early surgical debridement remains the essential therapeutic gesture to reduce mortality.展开更多
Gunshot wounds to external genitalia are rare either in war field and civilian setting accounting for 2% - 4% of all injuries with often a lesion to the urinary tract. We report a case of external genital injury in a ...Gunshot wounds to external genitalia are rare either in war field and civilian setting accounting for 2% - 4% of all injuries with often a lesion to the urinary tract. We report a case of external genital injury in a 27 years old man, accidentally injured by his own arm when he pressed the trigger of his gun placed in his pants. He had no past medical or surgical history, he presented to the emergency room (ER) with hemorrhagic scrotal and penile injuries with adjacent urethral tissue damage. He underwent a scrotal flap urethroplasty, and realignment of the corpus cavernosa and the tunica albugina. The patient lost his Foley catheter at post-operative day 3 and subsequently developed a urethral stenosis. Gunshot wounds to external genitalia are rare. A good reconstruction is necessary to avoid an impact on sexual and voiding function.展开更多
The Object of the Study: The author of the given paper describes an unusual combination of two diseases: extramammary Paget’s disease manifested by intraepithelial adenocarcinoma of the vulva and anus combined with i...The Object of the Study: The author of the given paper describes an unusual combination of two diseases: extramammary Paget’s disease manifested by intraepithelial adenocarcinoma of the vulva and anus combined with invasive adenocarcinoma of the ampullary part of the rectum and describes the atypical manifestations of these diseases. The Content: The content of this research paper includes a description of the patient, an analysis of the clinical picture, diagnostic methods and therapeutic interventions used, a report of the following disease, and the result of the presented case. The Result of the Research Work: The result of the research work is the analysis of a clinical case with two different tumors, where such a combination of tumors is rarely described in the literature. Moreover, no large specific sample with this combination of diseases is available. Patient Characteristics: The given case report describes a patient of the Palliative Care Unit of the Gerontology Clinic with a primary diagnosis of C20-rectal adenocarcinoma in the background of the anal canal, perineal skin Paget’s disease, stage IV. The presented complications of the patient’s primary diagnosis are multiple metastases in the liver;status post palliative chemotherapy;hepatomegaly;metastases to abdominal lymph nodes, inguinal lymph nodes;metastases at Th12, L4 level;pain syndrome. The presented above combination of diagnosed diseases is very rare. Applied Diagnostics: In October 2021, it was performed diagnostic manipulation: biopsy and the pathologist have provided a microscopic description. The first tissue fragment had a pronounced electrothermal lesion and the epithelial structures were not valuable. The second skin tissue fragment was covered with hyperplastic and acanthotic epithelium;its basal and middle layers contained multiple large cells proliferates extending into the medial epidermis, and the cytoplasm of these cells reacted positively with PAS (Periodic Acid Schiff reaction). It needs to be noted that the patient had previously had several years of biopsies from the perineal and anal epidermis, where Paget’s disease had also been diagnosed. The performed immunohistochemistry showed these cells to be CK20 positive, CK7 rare positive and p16 negative. The following pathohistological findings were made: morphological and immunohistochemical picture is consistent with Paget’s disease. According to the ICD-10, the patient was diagnosed with C51 malignant neoplasm of the female external genitalia. Using imaging diagnostics, it became clear that the patient’s rectal adenocarcinoma had progressed to metastatic stage with distant liver metastases in the background of anal canal, perineal skin Paget’s disease. Therapeutic Plan of the Patient: Based on the patient’s main diagnoses, the complications of the principal diagnosis, the patient’s overall severe condition, pain syndrome, age and comorbidities, palliative chemotherapy was approved as a therapeutic option in council of doctors. Monitoring and Outcome of the Patient: The patient’s general condition was becoming worse over time, and she was diagnosed with exitus latalis in December 2022. At that time, the patient was discharged from hospital and was on palliative care at home under the control of her family physician.展开更多
文摘Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mortality remains very high despite therapeutic advances. Our aim was to report on the epidemiological, diagnostic and therapeutic aspects of gangrene of the external genitalia, and to identify prognostic factors. Patients and Method: This was a 5-year retrospective descriptive study, from February 2016 to February 2021, of cases of gangrene of the external genitalia admitted to and treated in the Urology Department of Abeche University Hospital. Results: We collected 49 cases of gangrene of the external genitalia. The mean age of patients was 42 ± 16.81, with extremes of 20 and 81 years. The age group most concerned was between 20 and 29. The most frequent reasons for consultation were suppuration of the external genitalia and scrotal swelling. The average consultation time was 19.05 ± 16.02 days. The most common comorbidity was diabetes (35.9%). The most frequent pathological antecedents were urinary tract infections and endourethral maneuvers, reported in 40.5% and 38.7% respectively. Urogenital aetiology was predominant in 54.7%, and idiopathic in 35.9%. Lesions involved the scrotum in 60.6%, the scrotum and penis in 16.5%, and the penis alone in 5.7% of cases. Lesions extended to the perineum in 13.6% of cases, and to the abdomen in 3.6%. Vascular filling via the central venous line was performed in 58.6% of cases, and via the peripheral venous line in 41.4%. 3rd-generation cephalosporins and associated imidazoles were the most commonly used antibiotics. Necrosectomy was performed in 37 patients (73.4%), debridement combined with bypass cystostomy in 26.6% of cases. Colostomy was performed in 4% of cases. 90.8% of patients were cured and 9.2% died. The average hospital stay was 30 ± 75 days. Conclusion: The gangrene of the external genitalia is a medical and surgical emergency which has become rare in Europe, but which is still very common in the context of our practice in Chad. The severity of the disease is linked to delayed consultation and co-morbidity factors. Mortality remains very high despite therapeutic advances.
文摘Trauma to the external genitalia by tearing is rare. We report the case of a 30-year-old patient, admitted to the emergency room for trauma of the external genitalia by traction following a blow and intentional injury. The authors highlight the lesions that can occur during this type of trauma and insist on the systematic search for urethral and cavernous lesions. Conclusion: Trauma to the external genitalia by intentional assault and battery is rare in our context. They occur most often in a young person and are frequently associated with damage to the corpora cavernosa and urethra.
文摘Introduction: Ballistic traumas of the external genitalia are rare especially in civil practice. Emergency surgical exploration is the rule. Case Report: Mr. F.Y., 29 years old, a security agent, admitted to the Urological Emergency Unit of Yalgado Ouédraogo University Hospital of Ouagadougou for trauma of the penile and left purse by firearm. The clinical examination revealed a good hemodynamic status, bladder distension. A suprapubic catheterization was performed. We noted a transfixing and bleeding wound on the penile, and on the left purse which was edematous. The patient was admitted to the operation room 07 hours after trauma. Exploration found a total destruction of the left testicle classified grade 5 of the classification of the American Association of the Surgery of Trauma (AAST). We performed a left orchiectomy. There was a partial rupture of the ventral face of the penile urethra. We performed an end-to-end anastomosis on a Foley catheter CH 18. The Foley catheter was removed after two weeks. Urination was spontaneous without dysuria. Erections were painless and without kinking of penile. Conclusion: Open traumas of the external genitalia are rare and their treatment is an extreme surgical emergency.
文摘Aim: Report the epidemiological, clinicopathological characteristics and ensuring management of recent traumas of the external genitalia in Urology. Methods: This was a descriptive retrospective study of 47 cases of patients suffering from recent traumas of the external genitalia over a period of 5 years. The variables studied were sociodemographic, clinical, paraclinical, therapeutic and evolutionary. Results: A total of 47 patients, including 46 men, were managed. The mean age was 26.8 years, ranging from 6 to 56 years. The circumstances of occurrence were: the missteps of coitus (n = 16), traffic accidents (n = 9) and criminal injuries (n = 8). The fracture of the penis (n = 16) was the most common lesion followed by the scrotal wound (n = 11). The management was medical and surgical and varied by the type of lesion. The outcome was favorable in 91.5% of cases. Conclusion: The incidence of traumas of the external genitalia was 9.4 in urology department in N'Djamena. Penis fracture was the frequent lesion. The management is multidisciplinary, medical and surgical.
文摘Objective: To describe the clinical aspects and the management of external genitalia gangrene in the Urology department of the Bobo Dioulasso CHUSS. Patients and methods: This was a retrospective and descriptive study over a period of 6 years from January 2011 to December 2016, which covered 54 patients hospitalized in the urology department of the University Hospital Souro Sanou for external genitalia gangrene. Results: The mean age of our patients was 53.8 years. The large ulcero-necrosis of scrotum was the main reason for reference. Our patients consulted on average 8.23 days after the onset of symptomatology. A risk factor was found in 44.2% of cases and a cause was identified in 65.3% of patients. A urogenital cause was present in 32.7%. Probabilistic antibiotic therapy and medical reanimation were systematic at admission. Debridement was performed on average 18 hours after admission and 10 patients had more than one debridement. We noted a mortality rate of 5.5%. Conclusion: Fournier’s gangrene is a serious infectious disease whose diagnosis is often delayed in our context. Early surgical debridement remains the essential therapeutic gesture to reduce mortality.
文摘Gunshot wounds to external genitalia are rare either in war field and civilian setting accounting for 2% - 4% of all injuries with often a lesion to the urinary tract. We report a case of external genital injury in a 27 years old man, accidentally injured by his own arm when he pressed the trigger of his gun placed in his pants. He had no past medical or surgical history, he presented to the emergency room (ER) with hemorrhagic scrotal and penile injuries with adjacent urethral tissue damage. He underwent a scrotal flap urethroplasty, and realignment of the corpus cavernosa and the tunica albugina. The patient lost his Foley catheter at post-operative day 3 and subsequently developed a urethral stenosis. Gunshot wounds to external genitalia are rare. A good reconstruction is necessary to avoid an impact on sexual and voiding function.
文摘The Object of the Study: The author of the given paper describes an unusual combination of two diseases: extramammary Paget’s disease manifested by intraepithelial adenocarcinoma of the vulva and anus combined with invasive adenocarcinoma of the ampullary part of the rectum and describes the atypical manifestations of these diseases. The Content: The content of this research paper includes a description of the patient, an analysis of the clinical picture, diagnostic methods and therapeutic interventions used, a report of the following disease, and the result of the presented case. The Result of the Research Work: The result of the research work is the analysis of a clinical case with two different tumors, where such a combination of tumors is rarely described in the literature. Moreover, no large specific sample with this combination of diseases is available. Patient Characteristics: The given case report describes a patient of the Palliative Care Unit of the Gerontology Clinic with a primary diagnosis of C20-rectal adenocarcinoma in the background of the anal canal, perineal skin Paget’s disease, stage IV. The presented complications of the patient’s primary diagnosis are multiple metastases in the liver;status post palliative chemotherapy;hepatomegaly;metastases to abdominal lymph nodes, inguinal lymph nodes;metastases at Th12, L4 level;pain syndrome. The presented above combination of diagnosed diseases is very rare. Applied Diagnostics: In October 2021, it was performed diagnostic manipulation: biopsy and the pathologist have provided a microscopic description. The first tissue fragment had a pronounced electrothermal lesion and the epithelial structures were not valuable. The second skin tissue fragment was covered with hyperplastic and acanthotic epithelium;its basal and middle layers contained multiple large cells proliferates extending into the medial epidermis, and the cytoplasm of these cells reacted positively with PAS (Periodic Acid Schiff reaction). It needs to be noted that the patient had previously had several years of biopsies from the perineal and anal epidermis, where Paget’s disease had also been diagnosed. The performed immunohistochemistry showed these cells to be CK20 positive, CK7 rare positive and p16 negative. The following pathohistological findings were made: morphological and immunohistochemical picture is consistent with Paget’s disease. According to the ICD-10, the patient was diagnosed with C51 malignant neoplasm of the female external genitalia. Using imaging diagnostics, it became clear that the patient’s rectal adenocarcinoma had progressed to metastatic stage with distant liver metastases in the background of anal canal, perineal skin Paget’s disease. Therapeutic Plan of the Patient: Based on the patient’s main diagnoses, the complications of the principal diagnosis, the patient’s overall severe condition, pain syndrome, age and comorbidities, palliative chemotherapy was approved as a therapeutic option in council of doctors. Monitoring and Outcome of the Patient: The patient’s general condition was becoming worse over time, and she was diagnosed with exitus latalis in December 2022. At that time, the patient was discharged from hospital and was on palliative care at home under the control of her family physician.
