Emergency Drainage of Upper Urinary Tract with a Double Catheter in the Hospital General de Grand Yoff of Dakar (HOGGY)

Goals: The goals are to assess the use of Double Jendo-prostheses in urinary obstructions in the Hospital General de Grand Yoff of Dakar (HOGGY). Patients and methods: This is a 4-year retrospective study (1st January 2009-31st December 2012). The study included all patients with obstruction of the upper urinary tract, and with a reversing type Double Jendo-prostheses. Findings: A total of 82 patients were chosen for this study, including 41 males. Patient’s average age was 45 years. Kidney failure accounted for 11.5% of the causes of consultations. Lithiasic obstacles (34.2%) and tumours (21.5%) were the most recurrent. Catheter was successfully placed in 78% of cases, and highly contributed to improve renal function in 69% of cases. The frequently complications found in patients with Double J Catheters were back pain and urinary tract infections. Four cases of catheters calcifications were reported. Catheter was replaced in 62.2% of patients within an average period of 6.9 months. Conclusion: Double J Catheters remain important in the preservation of renal function in case of obstruction. Its use requires a mastery of these indications and a rigorous follow-up.

Complications of Circumcision: A Three-Year Experience in N’Djamena Mother &Child Hospital (Chad)

Aim: This study aimed at describing the various aspects of complications of circumcision and their management in patients referred to N’Djamena Mother & Child Hospital (Chad). Material and Methods: All patients referred for complications of circumcision reported on a 3-year period (July 2011-May 2014) were included. Demographic data, circumstances of the circumcision, clinical presentation and management were computed. Results: Thirty-one cases of complications from traditionally performed circumcisions (n = 19) or circumcisions were performed by paramedics (n = 12). The average age was 7.5 ± 2 years. More than 60% of the patients were between 6 and 10 years old. The complications reported included: urethral fistula in the balano preputial sulcus in 10 cases (32%), entire amputation of the glans in 2 cases (6.5%), amputation of the penis in one case (3.5%), stenosis of the urethral meatus in 8 cases (26%), bleeding in 5 cases (16%) and infections in 5 cases (16%). A surgical treatment was performed according to clinical cases. Conclusion: Circumcision is safe when performed in hospitals. Unfortunately, serious complications may occur if it is performed by non-experts. Hence there is a necessity to raise people’s awareness on the importance of the medicalization of circumcision.

Severe External Genitalia Lesion by Firearm: A Case Report

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.