Bipolar Transurethral Resection of the Prostate (B-TURP) Including Large Prostate Glands in Kinshasa, DR Congo

Context: In DR Congo, prostate adenoma was treated solely by open surgery till the practice of minimally invasive surgery in 2012. Surgical management of large prostate glands has greatly improved over the last years. Even if open adenomectomy is indicated for prostate glands > 80 ml, TURP is currently the gold standard. We report the resection time of TURP procedure, quality of life of the patients, the postoperative complications and outcomes of 152 patients with large prostate glands who went under Bipolar TURP from 2021 to 2022. Patients and Methods: This is a prospective and evaluative study of 152 patients who underwent surgery for benign prostatic hyperplasia (BPH) from January 2021 to December 2022 using bipolar transurethral resection of the prostate (TURP). The study variables were age, low urinary tract symptoms (LUTS), paraclinical parameters, prostate volume, resection time, length of hospital stay, results of histopathological analysis of resected tissues (prostate chips), complications and postoperative outcomes of the patients. All the patients underwent saline bipolar TURP. Results: The mean age of the patients was 66.5 ± 9.3 years. Dysuria and acute urinary retention were the most predominant symptoms, 46.1% and 23.03% respectively. Arterial hypertension was the most common medical history (29.7%), or associated with diabetes mellitus (18.4%). The most frequent surgical history was the repair of the inguinal hernia in 21.7% of cases. Most of the patients had a prostate volume ≥ 80 ml (n = 91) in a relative frequency of 60% of cases. The mean prostate volume was 104.8 ± 60.4 ml. The volume of the prostate was correlated with the age of the patients (r = 0.321;p 15 ml/s (96%) postoperatively. The post-void residual (PVR) was significant in the group of patients with prostate volume ≥ 80 ml (p Conclusion: Although conventional surgery (open adenomectomy) has been a standard treatment for large prostate adenomas, progress in minimally invasive techniques, mainly Bipolar TURP, seems to confer more advantages such as the low rate of complications, reduced length of hospital stay and improved quality of life for the patients.

Evolution of Androgenic Deprivation in Treatment of Prostate Cancer in Kinshasa

Context and Objective: Prostate cancer (PCa) is hormone-dependent cancer. In our area, most patients often arrive at the locally advanced stage or the metastatic stage. This justifies the choice of androgen deprivation as the mode of treatment. The objective of this study was to describe the socio-demographic characteristics of patients with PCa. Identifying the period during which the disease remains susceptible to androgen deprivation. Assessing the patient’s prognosis in terms of survival. Methods: This is a retrospective observational study of the course of patients managed for PCa. It involved 51 cases and was conducted at the Pointe à Pitre clinic (CPAP) in Matete Township during a period of 4 years (from March 2014 to June 2018). Results: The mean age of patients was 69.4 ± 9.7 years (40 - 92 years);39.2% of patients with PCa were aged between 70 - 79 years;45.1% had consulted for dysuria and 25.5% were hypertensive. All had performed the prostate biopsy, 47.1% were diagnosed at the metastatic stage, with PSA ≥ 100 ng/ml, Gleason scores 8 - 10, and clinical-stage TNM 3 - 4. About 51% were subjected to androcure, 23.5% had been surgically cased and 3.9% had undergone radical prostatectomy. 41.1% had resisted castration within a median of 1.4 years of response to treatment. The median survival was 30 months, with a mean survival of 26.6 months. Conclusion: Prostate cancer involved most of the patients in the age bracket of 70 to 79 years. The diagnosis was performed lately with a high resistance rate of castration and median survival of 30 months.

Can Necrosis and Ovarian Vein Thrombus Be a Serious Complication in Morbidly Adherent Placenta?

We report a case of a 40-year-old woman, second pregnancy, previous cesarean section due to intrauterine growth restriction and placenta accreta spectrum disorders. She was 25 weeks gestational age, admitted to the hospital 25 weeks gestational age, diagnosed with fetal death. Initial conservative management attempt with uterine preservation progresses to complications requiring total hysterectomy followed by a rare outcome: pelvic thrombi with uterine necrosis, with its associated clinical complications.