Penile Fracture at the Department of Urology and Andrology, University Hospital, Brazzaville

Objective: The objectives of this study, was to analyze epidemiological diagnosis, therapeutic option and evolutionary aspects. Materials and methods: This is a retrospective study regarding clinical data of nine penile fracture patients who have been admitted in the department of urology (university hospital, Brazzaville) from January 2006 to December 2018. The study parameters were: epidemiological, diagnosis, operative details, outcomes after treatment, and sexual disorders. Results: The mean age was 46.3 ± 14 years, ranged from 25 to 73 years. The etiology of penile fracture was coitus in 5 cases, masturbation in 3 cases and rolling of the penis on the bed in one case. 8 patients were managed surgically. The complications noticed in the postoperative period and during the follow-up visits were penile curvature in 2 cases, and erectyl dysfunction in 2 cases. Conclusion: The diagnosis of penile fracture remains clinic. Immediate surgical management is necessary for good functional result.

Epidemiological and Clinical Aspects of Male Infertility in Patients Consulting at the Urology Department of the Yaounde Central Hospital

Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and clinical aspects of male infertility in our setting. Methods: This was a cross-sectional and descriptive study, with retrospective data collection from the files of patients received for male infertility, over 5 years and 6 months (from January 1st, 2016 to April 30th, 2021) at the Urology Department of the Yaounde Central Hospital. Phone calls were made to patients with incomplete records for completion following a verbal consent. Data reported on data collection forms were entered into a data entry form designed on CSPro software version 7.2. The database was later exported for descriptive statistics using the IBM SPSS software version 23. Qualitative variables were summarized in frequencies and percentages while quantitative variables were summarized in means with their standard deviations for normally distributed data, or medians and interquartile ranges otherwise. Results: Out of 110 patients whose records were analyzed, the median age was 37.0 years, with an interquartile range of 8.3, with 55.5% in the age group 30 to 39 years. Of these 95 (86.4%) were married, 58 (52.7%) were from the West region, 76 (69.1%) were employed. Past history was dominated by mumps 40 (36.4%), varicocele surgery 25 (22.7%), alcoholism 87 (79.1%) and smoking 15 (13.6%). A disorder of spermatogenesis was found in all our patients: 37 (33.6%) azoospermia, 27 (24.6%) asthenospermia and 26 (23.7%) oligospermia patients. Paraclinical evidence of chlamydia and gonococcal infections were found respectively in 38 (34.5%) and 14 (12.7%) patients, varicocele and testicular dystrophy respectively in 95 (86.4%) and 38 (34.5%) patients. Infertility was primary in 67 (60.9%) patients. Conclusion: Most patients with infertility were in their thirties, had risky social habits and comorbidities. An early start of health promotion activities, comorbidities prevention and early detection of spermogram abnormalities would make it possible to reduce the frequency of male infertility.

Treatment of Kidney Stones by Percutaneous Nephrolithotomy: Evaluation of the Results of the First Series of Our Experience in the Urology Department of the Idrissa Pouye General Hospital in Dakar

The principle of PCNL is the extraction through a nephrostomy channel of kidney stones which are defined as the presence of crystalline concretions in the kidneys. Objectives: The objective of this work was to study the epidemiological, clinical and paraclinical aspects of patients with renal lithiasis treated by PCNL and on the other hand the different technical aspects of PCNL. Materials and Methods: This was a retrospective descriptive study, conducted in the urology department of HOGIP, covering the period from January 2015 to January 2019. We studied the demographic and clinical aspects of patients presenting renal lithiasis;we also studied the technical aspects and treatment outcomes. Statistical significance was set for α = 0.05. Results: Our series covered 82 PCNLs performed during the study period. The average age was 45.95 years, the age group [40 - 49 years] was more affected. Our study involved 44 men and 38 women, a sex ratio of 1.15. At the clinic, atypical lumbar pain was more frequent in 45.83% of cases. On URO-CT, the calculations were located more at the pyelic level (31.2%) and lower caliceal (27.2%). The size of stones measured between 15 and 20 mm in 30.52%. The stone density was between 500 and 1000 HU in 47.54% of cases. Intraoperatively, the patients were placed in lateral decubitus in 41.46% of cases. Only one access to the kidney was necessary in 87.8% of cases. The lithoclast was used in 65.85% of cases. The overall success rate (stone free) in our series was 96%. The majority of cases, 41.44%, drainage were done by natural means (totally tubeless). The average duration was 92 minutes. The complications encountered in our experience concerned 10 cases, a rate of 12.19%. Conclusion: Urinary lithiasis is more and more frequent in our regions. The development of Endo-urology offers several therapeutic options. Thus, PCNL occupies an important place in the management of kidney stones.

Surgical Treatment of the Upper Urinary Tract Lithiasis at the Urology Department of the Hopital General Idrissa Pouye

Upper urinary tract lithiasis is a condition characterized by the presence of stones which is a stony concretion of crystallized substances in the kidney and/or ureter. Objective: The objective of this work is to study the epidemiological, clinical and therapeutic aspects of upper urinary tract stones on the one hand, then to compare the different types of surgical treatments and their results. Materials and Methods: This is a retrospective and descriptive study focusing on the surgical management of upper urinary tract stones, between January 2017 and December 2020, at the Urology department of the Hopital General Idrissa Pouye. Results: During the study period, 7.59% of surgical interventions performed were related to the treatment of upper urinary tract stones. Average age was 45.20 ± 16.4 years, the age group [41 - 60] years was more affected with 42.68%. A history of urolithiasis was present in 25.52% of cases. Lower back pain was present in 97.48% of cases. On URO-CT scan, the stone was located more at the level of the ureter (49.57%). The size between 10 to 15 mm was more frequent (30.96%) and the density greater than 1000 HU was more frequent (33.47%). The most used therapeutic procedure was ureteroscopy (52.08%), followed by PCNL (40.83%) and open surgery (7.08%). The success rate (stone free) was 93.68% for the URS, 89.36% for the PCNL. The length of hospital stay for open surgery was 6.76 ± 4.25, for PCNL 2.62 ± 2 days and for URS 1.75 ± 1.62 days. Postoperative complications were present in 23.52% for open surgery, 11.22% for PCNL and 8% for URS. Conclusion: Urolithiasis is constantly growing in our regions. Effective endourological treatment is increasingly replacing open surgery. However, global access to these new techniques in our regions is slow to be effective.

Ambulatory Uretrocystoscopy in the Urology Andrology Department of Grand Mbour Hospital

Background: Urethrocystoscopy is a method of endoscopic exploration that allows direct visualization of the urethra and bladder for diagnosis or treatment of diseases of the lower urinary tract. Purpose: To determine the epidemiological profile of patients who underwent urethrocystoscopy and to present the indications and the results of this endoscopic examination. Patients and Methods: This is a retrospective, descriptive study of all patients who underwent outpatient urethrocystoscopy in the Urology and Andrology department of Grand Mbour hospital. The epidemiological data of the patients, the indications, the results of the endoscopic exploration and the additional procedures performed were entered and analyzed with Excel 2016. We performed descriptive statistics. Results: Of the 216 patients who underwent outpatient urethrocystoscopy, we counted 179 men (82.87%) and 37 women (17.13%). The sex ratio was 4.84. The mean age of the patients was 53.71 ± 18.76 years (age range 17 to 91 years). The main indications were lower urinary tract disorders (60.18%) and hematuria (28.70%). Endoscopic exploration revealed prostatic tumor in 69 patients (31.9%), 29 cases of bladder tumors (13.4%) and 19 cases of bilharzia cystitis (8.8%). The urethrocystoscopy was normal in 32 patients (14.8%). Conclusion: Urethrostoscopy is an endoscopic exploration examination that can be performed on an outpatient basis. Lower tract urinary disorders and hematuria were the main indications.

Symptomatic Urinary Lithiasis: Epidemiology and Management at Urology Department of University Hospital of Cotonou

Purpose: To study the epidemiology and treatment modalities of urolithiasis at Urology Department of University Hospital of Cotonou. Materials and Methods: It was a retrospective and descriptive study over a 10 years period ranging from January 1st, 2004 to December 31st, 2013. One hundred and two patients who were hospitalized for symptomatic urolithiasis at the Urology Department of University Hospital of Cotonou were enrolled. Results: Hospital incidence of urolithiasis was 3.7%. Patients mean age was 39.6 years (extremes: 10 years to 73 years). Male to female ratio was 2.2. The main reason for consultation was renal colic for 81 patients (79.4%). Average duration of symptoms at presentation was 5 months (range: 1 day to 10 years). A total of 173 stones were identified with an average size of 12 mm (range: 1 mm to 95 mm). Calyceal stones were seen in 32.9% of cases, renal pelvis stones in 21.4% of cases, ureteral stones in 34.1% and bladder stones in 11.5% of cases. Open surgery was the main treatment for stones that could not be managed medically. 50.8% of patients underwent surgery with extraction of 116 stones. This represented 67.1% of all stones. 9 patients (8.8%) had expelled their stone during urination. The postoperative course was uneventful in 77.5% of cases. Conclusion: Modern treatment options for urolithiasis remain rudimentary in our health facilities. Open surgery is still the main stay of treatment in our countries with limited resources.

Study of Hemorrhoid Disease in the Department of General Surgery of the Cs Ref of the Commune I Bamako

This work was a retrospective prospective study carried out in the general surgery department of the Cs ref of commune I from January 2009 to December 2012. Our study aimed to determine the hospital frequency of hemorrhoidal disease, to identify the contributing factors, describe the clinical and therapeutic aspects and analyze the surgical consequences. We collected 73 patients with an average age of 37.8 years (range: 19 years and 77 years) with a sex ratio of 2.5 in favor of men. We operated on 49 patients or 67.1% of cases. 71.2% of our patients were married and lived in Bamako. Schoolchildren and middle managers made up 39.8% of cases. 82.2% of patients were seen in ordinary consultation and 69.9% complained of progressive anal pain in 66.7% of cases. This pain was triggered by defecation in 88.2% of our patients. The contributing factors were dominated by constipation (53.4%), working in a seated position (41.1%) and a sedentary lifestyle (16.4%) of cases. Stage IV external hemorrhoids and hemorrhoidal thrombosis represented 53.8% of surgical indications. The most used surgical technique was that of Milligan-Morgan, i.e. 51.9% of cases and 45.2% of patients treated medically received a combination of transit regulator, venotonics and analgesics. The surgical aftermath was marked by hemorrhage (3 cases), delayed healing (5 cases), urinary retention (1 case) and scarring anal stenosis (1 case). The morbidity rate was 5.48% of cases and a zero mortality rate. The average length of hospitalization was 2 days with extremes of 1 and 5 days.

Transurethral Resection of the Prostate (TURP) —An Experience of the Urology Department of the University Hospital of National Reference of N’Djamena (TCHAD)

Introduction: Transurethral Resection of the Prostate (TURP) is a multi-invasive technique in the management of Benign Prostatic Hyperplasia. It constitutes a reference in developed countries;however in sub-Saharan Africa, it is prostatic adenomectomy which is mostly used. The aim was to analyze the results of the TURP carried out at the General National Reference University Hospital in N’Djamena (Chad). Patients and Methods: This is a retro-prospective study which extended over a period of 2 years, from June 2014 to May 2016. The records of all patients who had undergone TURP during this period were listed and analyzed. We did frequencies and average calculations. Results: 59 patients’ results that were treated with TURP were collected. TURP represented 33.4% of all interventions performed for prostate pathologies. The average age of our patients was 66 ± 8.06 years (50 to 92). Urinary retention was the main reason for consultation (45.7%;n = 27) followed by dysuria (27.1%;n = 16). TURP was associated with another procedure in 28.8% (n = 17). The average duration of hospitalization of our patients was 4.15 days with extremes of 2 to 9 days. Perioperative complications represented 13.6% of cases, early complications represented 15.3% of cases and late complications represented 6.8% of cases. The postoperative voiding status with an average follow-up of 6 months was judged to be good in 72.8% of cases (n = 43). Conclusion: TURP occupies an important place in the management of prostate pathologies with precise indications. It offers many advantages. It must be popularized in our countries;this will make it possible to limit morbidity and mortality rates and slow down medical evacuations abroad.

Cauda equina syndrome with urinary retention as a postoperative complication of lumbar spine surgery:A case report

BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.

Molecular mechanism and research progress of traditional Chinese medicine in the treatment of prostate cancer

Prostate cancer(PCa)is one of the most common malignant tumors in the male genitourinary system,ranking second in incidence worldwide.Traditional Chinese medicine(TCM),as an important component of complementary and alternative medicine,shows unique advantages in cancer treatment.Chinese herbal medicine is usually composed of multiple ingredients and involves multiple signaling pathways,which showed function of inducing apoptosis of cancer cells,arresting the cell cycle,inhibiting invasion and metastasis,reducing drug resistance,and regulating immune function.Physical therapy is also an important treatment of TCM.Currently,Physical therapy such as acupuncture or Tai Chi and Qigong are gaining increased recognition in the management of PCa,particularly in addressing issues like urinary incontinence and bone metastasis-related pain.This article reviews the TCM treatment and therapy of PCa,in order to provide new research avenues and treatment options for the treatment of PCa with TCM and improve the quality of life of patients.

Clinical value of combining epirubicin with mindfulness intervention in patients with urinary system tumors and depression

BACKGROUND Urinary system tumors often cause negative psychological symptoms,such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis.While epirubicin(EPI)is recommended by the European Association of Urology and can improve prognosis,its long-term use can cause toxic side effects,reduce treatment compliance,and increase psycho-logical burden.Therefore,an appropriate intervention mode is necessary.METHODS This was a retrospective study including 110 patients with urinary system tumors and depression admitted to Zhumadian Central Hospital between March 2021 and July 2023.Patients were divided into conventional(n=55)and joint inter-vention(n=55)groups.The conventional group received mitomycin and routine nursing,while the joint intervention group received EPI and mindfulness intervention.Both groups underwent three cycles of chemotherapy.Immune function(CD4+cells,CD8+cells,CD4+/CD8+ratio),tumor marker levels[urinary bladder cancer antigen(UBC),bladder tumor antigen(BTA)and nuclear matrix protein 22(NMP22)],quality of life questionnaire-core 30(QLQ-C30),17-item Hamilton depression scale(HAMD-17),and cancer-related fatigue[cancer fatigue scale(CFS)]were assessed.Adverse reactions and nursing satisfaction were recorded and evaluated.RESULTS Post-intervention,CD4+,CD8+,and CD4+/CD8+levels increased in both groups,with the joint intervention group showing more significant improvement(P<0.05).Tumor marker levels(NMP22,BTA,and UBC)were lower in the joint intervention group compared to the conventional group(P<0.05).The joint intervention group also showed a greater reduction in HAMD-17 scores(9.38±3.12 vs 15.45±4.86,P<0.05),higher QLQ-C30 scores,and lower CFS scores(both P<0.05).Additionally,the joint intervention group had a lower incidence of adverse reactions and higher nursing satisfaction(P<0.05).CONCLUSION EPI combined with mindfulness intervention significantly improved clinical outcomes in patients with urinary system tumors and depression and is worthy of clinical application.

Epidemiological and Clinical Aspects of Bladder Tumours at the Nianankoro Fomba Hospital in Segou in the Urology Department

Objectives: To study the epidemiological, diagnostic and prognostic aspects of bladder tumours in Segou Hospital. Patients and Methods: We conducted a descriptive cross-sectional study of bladder tumours over the period from 1 April 2012 to 1 April 2017, in the urology department of the Nianankoro Fomba Hospital in Segou. The first three years were used for patient recruitment, and the last two years for follow-up of the patients in the series. Results: Over a period of three years, we collected 165 cases of bladder tumours hospitalised out of 1308 hospitalisations from 7007 consultations, i.e. 12.6% of hospitalisations and 2.3% of consultations. The sex ratio was 1.2 in favour of men. A history of treated bilharzia was reported in 78.8% of cases and untreated bilharzia in 9.1% of cases. Haematuria was the most common reason for consultation. The majority of our patients were at stage T4 and T3 at the time of diagnosis, i.e. 53.3% and 44.3% respectively. Most patients consulted within 13 to 24 months after the first sign, i.e. 44.8%. Conclusion: The prognosis is still clouded by the delay in management. All the patients diagnosed had a bladder tumour infiltrating the muscle.

Pyeloplasty According to Küss-Anderson-Hynes: Results and Complications at the Urology-Andrology Department of the Sino-Guinean Friendship Hospital

Objective: Evaluate pyeloplasty according to Küss-Anderson-Hynes at the urology-andrology department of the Sino-Guinean Friendship Hospital. Patient and Method: This is a 3-year prospective descriptive study from January 1, 2018 to December 31, 2020. It focused on a sample of 21 patients, who had undergone pyeloplasty according to Küss-Anderson-Hynes. Results: The averages age of the patients was 24.24 years. Lumbar pain was the main reason for consultation in 71.43% of cases. pyeloplasty according to Küss-Anderson-Hynes alone was performed in 76.20% of cases. It was associated with lower pole vessel uncrossing in 14.29% of cases and in 9.52% of cases with pyelolithotomy. The main Postoperative complications consisted of surgical site infections (23.81%) and fistula of the pyelo-ureteral junction (9.52%). The result of the pyeloplasty evaluated after three years, was qualified as good in 13 patients (86.67%), conversely the result was declared bad in 2 patients or 13.33%. During the follow-up period, postoperatively, we had lost sight of 6 patients. Conclusion: Pyeloplasty according to Küss-Anderson-Hynes in addition to its excellent results reported by the literature was the only therapeutic alternative performed during this study. However, its indications are considerably reduced with the advancement of laparoscopy.

Robotic nurse duties in the urology operative room:11 years of experience

The robotic nurse plays an essential role in a successful robotic surgery.As part of the robotic surgical team,the robotic nurse must demonstrate a high level of professional knowledge,and be an expert in robotic technology and dealing with robotic malfunctions.Each one of the robotic nursing team“nurse coordinator,scrub-nurse and circulating-nurse”has a certain job description to ensure maximum patient’s safety and robotic surgical efficiency.Well-structured training programs should be offered to the robotic nurse to be well prepared,feel confident,and maintain high-quality of care.

Education and training evolution in urolithiasis:A perspective from European School of Urology

Objective:With the worldwide increase in urolithiasis prevalence,the present study aimed to delineate and summarise recent evolutions in training for the management of urolithiasis.Methods:A PubMed search using the key words“simulation”,“training”,“ureteroscopy”,“RIRS”,“URS”,“percutaneous nephrolithotomy”,“PCNL”,“virtual reality”,“augmented reality”,“artificial intelligence”,“healthcare”,“curriculum”,and“assessment”was used to examine how education and training in urolithiasis have adapted over recent years.Focus was placed on the role of high-and low-fidelity simulation models,virtual reality and artificial intelligence,and standardised assessment and curriculum.Results:This review supports the necessity to incorporate technology,simulation,and other skill enhancement training modalities into surgical training.However,these cannot solely replace mentored training with an experienced professional supervisor.Whilst technological and simulation advancements are likely to prove increasingly important in urolithiasis training,it is just as important for stratification of robust curricula with validated assessment.We also propose a pathway for future training.Conclusion:Endourology subspeciality training programmes have successfully incorporated simulation model-based training for skill acquisition,refinement,and improving operative outcomes.Success is achieved by maintaining a delicate balance between machine and in person mentor-based training.A trainee-centred model that follows the proposed curriculum could aid this balance for the future generation of trainees.

Beyond prostate, beyond surgery and beyond urology: The “3Bs” of managing non-neurogenic male lower urinary tract symptoms

Lower urinary tract symptoms(LUTS),consisting storage,voiding and postmicturition symptoms,is a comprehensive definition involving symptoms that may occur due to several causes.Instead of simply focusing on the enlarged prostate,more attention has to be paid to the entire urinary tract as well as multiple system comorbidities.Therefore,prostate surgery alone does not necessarily provide adequate management and cross-disciplinary collaborations are sometimes required.Based on current literature,this paper proposes the“3Bs”concept for managing non-neurogenic male LUTS,namely,“beyond prostate”,“beyond surgery”and“beyond urology”.The clinical application of the“3Bs”enables urologists to carry out integrated,individualized and precise medical care for each non-neurogenic male LUTS patient.

Application of DDG-3300K Liver Reserve Function Analyzer and Relevant Nursing Procedures at the Department of Infectious Diseases

Objective: To discuss some key points about nursing in the use of DDG-3300K liver reserve function analyzer in patients at the department of infectious diseases. Method: DDG-3300K liver reserve function analyzer was applied to 5464 patients at the department of infectious diseases. The reasons for failed detection and complications related to the detection were analyzed, and the measures for improving the nursing procedures were proposed. Result: Among the 5464 patients, the detections were successful at the first attempt in 5458 patients;2 patients had leakage of liquid;2 patients were poorly prepared, and 1 case failed because of mistaken selection of CO mode, which led to adverse drug reactions;1 case did not finish the detection due to anaphylactic shock;8 patients had nausea and 6 patients had skin rash on the four limbs and torso during the detection. Conclusion: It is necessary to formulate the nursing procedures for the use of DDG-3300K liver reserve function analyzer. Moreover, preparatory work, health education, refined nursing procedures and skillful operations are closely related to the success rate and accuracy of the detection.

Marker Ki-67 is a potential biomarker for the diagnosis and prognosis of prostate cancer based on two cohorts

BACKGROUND Prostate cancer(PCa)is a widespread malignancy,predominantly affecting elderly males,and current methods for diagnosis and treatment of this disease continue to fall short.The marker Ki-67(MKI67)has been previously demonstrated to correlate with the proliferation and metastasis of various cancer cells,including those of PCa.Hence,verifying the association between MKI67 and the diagnosis and prognosis of PCa,using bioinformatics databases and clinical data analysis,carries significant clinical implications.AIM To explore the diagnostic and prognostic efficacy of antigens identified by MKI67 expression in PCa.METHODS For cohort 1,the efficacy of MKI67 diagnosis was evaluated using data from The Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)databases.For cohort 2,the diagnostic and prognostic power of MKI67 expression was further validated using data from 271 patients with clinical PCa.RESULTS In cohort 1,MKI67 expression was correlated with prostate-specific antigen(PSA),Gleason Score,T stage,and N stage.The receiver operating characteristic(ROC)curve showed a strong diagnostic ability,and the Kaplan-Meier method demonstrated that MKI67 expression was negatively associated with the progression-free interval(PFI).The time-ROC curve displayed a weak prognostic capability for MKI67 expression in PCa.In cohort 2,MKI67 expression was significantly related to the Gleason Score,T stage,and N stage;however,it was negatively associated with the PFI.The time-ROC curve revealed the stronger prognostic capability of MKI67 in patients with PCa.Multivariate COX regression analysis was performed to select risk factors,including PSA level,N stage,and MKI67 expression.A nomogram was established to predict the 3-year PFI.CONCLUSION MKI67 expression was positively associated with the Gleason Score,T stage,and N stage and showed a strong diagnostic and prognostic ability in PCa.

Summarizing the evidence for robotic-assisted bladder neck reconstruction: Systematic review of patency and incontinence outcomes

Objective:Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically,and open repair is associated with high rates of incontinence.In recent years,there have been increasing reports of robotic-assisted bladder neck reconstruction in the literature.However,existing studies are small,heterogeneous case series.The objective of this study was to perform a systematic review of robotic-assisted bladder neck reconstruction to better evaluate patency and incontinence outcomes.Methods:We performed a systematic review of PubMed from first available date to May 2023 for all studies evaluating robotic-assisted reconstructive surgery of the bladder neck in adult men.Articles in non-English,author replies,editorials,pediatric-based studies,and reviews were excluded.Outcomes of interest were patency and incontinence rates,which were pooled when appropriate.Results:After identifying 158 articles on initial search,we included only ten studies that fit all aforementioned criteria for robotic-assisted bladder neck reconstruction.All were case series published from March 2018 to March 2022 ranging from six to 32 men,with the median follow-up of 5e23 months.A total of 119 patients were included in our analysis.A variety of etiologies and surgical techniques were described.Patency rates ranged from 50%to 100%,and pooled patency was 80%(95/119).De novo incontinence rates ranged from 0%to 33%,and pooled incontinence was 17%(8/47).Our findings were limited by small sample sizes,relatively short follow-ups,and heterogeneity between studies.

Etiology and management of urethral calculi:A systematic review of contemporary series

Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology.