Epidemiological, Clinical and Management of Benign Prostatic Hypertrophia in Urologie Department in N’Djamena, Chad

Aim: To determine the epidemiological, clinical, paraclinical characteristics and assess the result of surgical treatment of benign prostatic hyperplasia (BPH) in the urological department. Patients and Method: It is a retrospective descriptive study of 757 patient samples whose BPH diagnosis was pronounced and have benefited of the open surgery in urology department from January 2006 to December 2010. The variables studied were sociodemographical, clinical, paraclinical, therapeutical and the follow up. Those variables were: arterial tension, sonography, consultation reasons and hospitalization, the data provided rectal touch, the comorbidity, the prostatic specific antigen (PSA), other blood tests, urinary tests, medical management surgical treatment, the causes of death and the complications. Results: during the study period, 2406 patients were hospitalized, from them 1472 (61.18%) for low urinary tract diseases where 757 for BPH. The mean age was 64.18 years. The acute urine retention was the main cause of hospitalizations and consultations (51.51%). The rectal touch Helped in diagnosing 96.43% of cases. PSA in 74.10%, the sonography evaluated the volume of the prostate and the complications on the upper urinary tract, kidney dilatation and stones. An urgent evacuation of acute retention of urine in the bladder was done in 74.10%, a medical treatment was done in 33.47%. The open surgery was done in 66.47%. The evolution was good for 703 (92.86%), 54 died (7.14%) and the causes were various (anemia, hyperglycemia, HIV…). Conclusion: The BHP was the first reason of consultation and hospitalization in urology department in N’Djamena. Its diagnosis was done after the analysis of a beam clinical and paraclinical arguments. In the absence of an endoscopic resection column, open surgery was the only surgical treatment.

Etiology and Management of Complete Acute Urinary Retention in Urology Department in N’Djamena, Chad

Goal: To study the epidemiological, clinical, etiological, characteristics and ensure earlier management of complete acute urine retention (CAUR) in the urology department of N’Djamena in Chad. Patient and Method: It was a retrospective descriptive study of a sample of 606 patients during the period ranging from November 2008 to December 2010. The patients were consulted first in urology or referred by a colleague for a CAUR. The diagnosis was confirmed by an earlier clinical examination. The patients have benefited from a urine evacuation before looking for the etiologies. Results: We managed a sample of 606 patients suffering from CAUR. Average age was 60 years old with extremes of 1 month and 100 years. There were more patients in the ranks of 60 years and more (n = 436;71.94%). Men were more than women in the proportion of 583/25, and 63.20% of the patients lived In N’Djamena. The benign prostatic hypertrophia was the first cause of CAUR, followed by urethral stricture, urinary infection, lithiasis of the lower urinary tract, adenocarcinoma of the bladder, hymen imperforation in young girls, bilharzias, paraphimosis and ovenbird necrosis. The bladder catheterization was the most urgent gesture done in 61.71%, followed by open cystostomy. In the second case, etiological treatment was done as: open prostatic surgery (n = 306), urethral reconstitution (n = 58), cystololithotomia (n = 54), dilatation of urethral conduct (n = 54), hymenostomia (n = 6). Conclusion: CAUR was the first symptom which motivated the consultation in the department of urology in N’Djamena the main problem of public health in Chad.

100 Cases of Clinical and Etiological Aspects of Cardiac Insufficiency in N’Djamena, Chad

Introduction: Cardiac Insufficiency is progressively taking over as the leading cause of morbidity and mortality in the world and a major public health problem in Chad. Our study was to contribute and provide a deeper understanding of the clinical and etiological aspects concerning the etiology and management of Cardiac Insufficiency in N’Djamena, Chad. Due to having no published data to distinctly understand this pathology in this part of the world, we represent here a summary of available data which could be used to describe the clinical and etiological aspects of Cardiac Insufficiency and to help in changing practices for an optimal management as a baseline for comparison in future studies. Patients and Methods: This was a prospective, descriptive study conducted from November 30th 2011 to May 30th 2013 at the Good Samaritan Hospital of N’Djamena. Results: 100 hospitalized patients were included consecutively. The sex ratio was 1.08 with an average age of 40.21 ± 21.30 years. The main cardiovascular risk factors were high blood pressure (15%), obesity (12%) and diabetes (11%). Clinically, exertional dyspnea was found in 95% of cases, and signs of congestive heart failure in 61% of cases. The etiologies were 50% of Rheumatic valvulopathy, 22% of Dilated cardiomyopathy, 13% of Hypertensive cardiomyopathy and 12% of Congenital heart disease. Conclusion: The most common etiologies were Rheumatic valvulopathy, Congenital heart disease, Dilated cardiomyopathy and Hypertensive cardiomyopathy.