Clinicobiological Profile and Management Outcomes of Male Subfertility

Introduction: We aim to determine the epidemiology, clinical, paraclinical and etiologic aspects and to evaluate the management of male subfertility in urology. Methodology: We conducted a retrospective descriptive study of 137 patients referred to the urology department for male sub-fertility over a period of 4 years. The analyzed variables were: clinical, paraclinical characteristics and the post therapeutic evolution. Results: The mean age was 38.41 years (range: 24 to 67 years). The semen analysis was normal in 18 patients. The semen analysis showed oligoasthenozoospermia (45.3%) and total azoospermia (24.8%). Disease history was represented by: gonorrhea (27.7%), urogenital schistosomiasis (13.2%) and hernia repair (1.2%). The hormonal test showed abnormal hormone levels including: FSH (43.8%), LH (46.7%), testosterone (36.5%), prolactin (22.6%). The incriminated etiologic factors were: varicocele (5.8 %), smoking (23.7%), alcohol intake (25.4%) and sexually transmitted diseases (42.3%). The treatment was medical in 67.9% and surgical in 32.1% of cases. After a year of follow up, 13.9% of patient’s wives were pregnant. Conclusion: Male subfertility is common in Chad. The causes are numerous and diverse. The treatment is etiology based. A better management of sexually transmitted diseases and urogenital schistosomiasis is the best way to prevent it.

Symptomatic Pelvic Kidney in Women at Childbearing Potential: Diagnostic Difficulties and Management in Urology Department of N’Djamena in Chad

Introduction: We aim to report, from three observations, the diagnostic difficulties and complications, and ensure the management of pelvic kidney in women at childbearing age in the Urology Department of the National General Referral Hospital of N’Djamena. Pelvic kidney is due to an abnormality of the migration that can be associated or not with a malrotation. Its symptomatology is not specific, causing diagnostic difficulties and therapeutic errors. Observation: There were three observations of female patients aged respectively 26, 29 and 32 years who were taken care of for years in the gynecology department for pelvic inflammatory disease before being routed in urology. The diagnosis of pelvic kidney was retained on the basis of morphological examination (ultrasound, intravenous urography, CT urography). The patients have undergone nephrectomy;the postoperative aftermath was simple. Conclusion: Pelvic kidney is a rare disease. It is often discovered during autopsy. Symptoms are non-specific;nephrectomy is the treatment of choice in symptomatic cases.

Urolithiasis: Diagnostic and Therapeutic Aspects in Urology Department of N’Djamena in Chad

Introduction: To study the clinical, paraclinical, diagnostic aspects and manage patients with urolithiasis according to the available technical facilities in urology department of N’Djamena in Chad. Urolithiasis is defined as the presence of one or more stony concretions located at any level of a segment of the urinary tract: calyx, renal pelvis, ureters, bladder and urethra. Materials and Methods: This was a descriptive type of a prospective study over a period of 4 years, from January 2008 to December 2011, involving 233 patients with urolithiasis treated in the urology department. Clinical and paraclinical examinations were the basis for the selection of patients. Informed consent of patient or their parents (for minors) was obtained for the anonymous use of records and photographs for scientific aims. Results: Urolithiasis represented 5.72% (233/4072) of all urological pathologies. Male dominance was significant with a sex ratio of 4.5/1. The age group of 0 - 10 years was the most affected with a staff of 67 (28.75%). The clinic was dominated by dysuria (44.63%), renal colic (33.91%) and hematuria (9.01%). The main anatomical location was bladder (62.23%). The management was essentially medical and surgical. We recorded 7 cases of death or post-interventional hospital mortality rate of 3%. Conclusion: Urolithiasis is a real public health problem in Chad. Due to the inadequacy of the technical platform, the management was based on the open surgery. Etiological research was impossible by lack of technical laboratory platform.