Gangrene of the External Genitalia at Chu-Abeche

Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mortality remains very high despite therapeutic advances. Our aim was to report on the epidemiological, diagnostic and therapeutic aspects of gangrene of the external genitalia, and to identify prognostic factors. Patients and Method: This was a 5-year retrospective descriptive study, from February 2016 to February 2021, of cases of gangrene of the external genitalia admitted to and treated in the Urology Department of Abeche University Hospital. Results: We collected 49 cases of gangrene of the external genitalia. The mean age of patients was 42 ± 16.81, with extremes of 20 and 81 years. The age group most concerned was between 20 and 29. The most frequent reasons for consultation were suppuration of the external genitalia and scrotal swelling. The average consultation time was 19.05 ± 16.02 days. The most common comorbidity was diabetes (35.9%). The most frequent pathological antecedents were urinary tract infections and endourethral maneuvers, reported in 40.5% and 38.7% respectively. Urogenital aetiology was predominant in 54.7%, and idiopathic in 35.9%. Lesions involved the scrotum in 60.6%, the scrotum and penis in 16.5%, and the penis alone in 5.7% of cases. Lesions extended to the perineum in 13.6% of cases, and to the abdomen in 3.6%. Vascular filling via the central venous line was performed in 58.6% of cases, and via the peripheral venous line in 41.4%. 3rd-generation cephalosporins and associated imidazoles were the most commonly used antibiotics. Necrosectomy was performed in 37 patients (73.4%), debridement combined with bypass cystostomy in 26.6% of cases. Colostomy was performed in 4% of cases. 90.8% of patients were cured and 9.2% died. The average hospital stay was 30 ± 75 days. Conclusion: The gangrene of the external genitalia is a medical and surgical emergency which has become rare in Europe, but which is still very common in the context of our practice in Chad. The severity of the disease is linked to delayed consultation and co-morbidity factors. Mortality remains very high despite therapeutic advances.

Frequency of Monthly Ejaculation at Sexual Intercourse, DNA Fragmentation Index and Fertilization Rate among Sperm Donors and Fertility-Challenged Men in Sub-Saharan Africa: Paper 1

Introduction: In humans, the ideal ejaculation frequency depends on age, exercise and sexual potential. Natural ejaculation frequency balances the testosterone levels in the body. Materials and Methods: Semi-structured questionnaire was used to collect information from subjects. Semen samples were collected from sperm donors and sub-fertile men who presented for infertility challenges. Processing and analysis of semen samples were done according to World Health Organization guidelines. Sperm DNA fragmentation was evaluated using the Halosperm&#174;?kit. Results: A total of 114 subjects, including 19 sperm donors and 95 sub-fertile males were studied. There was a significant difference (t =?&#8722;5.96, P-value = 0.00001) in the mean [±sd] age of sperm donors (30.8 [8.1]) and that of sub-fertile men (42.3 [76]). There was a significant difference (t=?&#8722;4.10, P-value = 0.0005) in the mean monthly ejaculation during sexual intercourse (MESI) among sperm donors with DNA fragmentation index &#8722;2.20, P-value = 0.02) in MESI among sub-fertile men aged ≥40 years (8.9 [4.6]) than among those aged &#8722;0.67, SE = 0.28, t = &#8722;2.40, P-value = 0.02, 95% CI: &#8722;1.24,?&#8722;0.10). Conclusion: In men < 40 years, fewer MESI did not worsen the DFI. A higher number of professionals such as doctors, lawyers and engineers, reported lower monthly frequency of sexual ejaculations compared to entrepreneurs. Entrepreneurs and non-smokers had the highest frequencies of MESI.

Evaluation of the Management Results of Uretero-Pelvic Junction Abnormalities

Objectives: To evaluate therapeutic and prognosis of Uretero-pelvic junction abnomalities. Methods: This article was retrospective and descriptive, covering a period of six months, running from January 1st to December 31st, 2013 and conducted?to evaluate therapeutic and prognosis of Uretero-pelvic junction abnormalities. Included criteria were all patients whose diagnosis was abnormalities of the uretero-pelvic junction and had been confirmed after para clinical explorations. The stricture of the junction after a first kidney surgery did not include. The Creatinine level has considered high from 15 mg/l. Results: The median age was 35 years old. Age groups (30 - 40) years old have predominated in 36.2%. A male predominance had been noted in 62.3% versus 37.7% women. The most affected occupation was the officials in 37.7% of cases. The main reason for consultation was lumbar pain in 97.1%. The high creatinine level has observed in 19 patients (27.5%). Sixty-one patients (88.41%) have been operated. An abstention has been observed in 7 patients (10.14%) and one patient died before the surgical issue in renal failure. The early post-operative course has been uneventful in 78.7% (48 cases) and complicated in 21.3% (21 cases). Conclusions: Open surgery tends to disappear at the expense of the endopyelotomy and laparoscopy which gives best results. However, it is still relevant.

Incidence of Sub-Clinical Prostatic Disease at Autopsy in the University College Hospital, Ibadan

This prospective study was undertaken to ascertain the incidence, histology and pathological features of different types of asymptomatic or sub clinical prostatic diseases. Prostate glands were obtained from 79 consecutive adult males aged 30 years and above who died from non-prostate related diseases at the University College Hospital Ibadan over an eighteen months period. The glands were weighed and fixed in 10% neutral buffered formalin. The sampling method of the prostate gland described by Vainer et al. (2011) was employed in this study. Paraffin-embedded sections were stained with haematoxylin and eosin and were systematically examined for focal prostate disease. The patients’ ages ranged from 30 to 86 years. The most common lesions were nodular hyperplasia (81%), followed by adenocarcinoma (6.3%). Three cases (3.8%) had schistosomiasis. Adenocarcinoma and nodular hyperplasia occurred in relatively older patients than those with normal glands or chronic prostatitis/schistosomiasis (p = 0.05). There was an increase in weight of the prostate with age (p < 0.001) and normal prostate glands weighed significantly less than diseased glands (p = 0.02). Focal prostatic atrophy was observed in 24.1% and metaplastic changes were observed in eight (10.1%) of the cases. Prostatic intraepithelial neoplasia (PIN) was not seen in any case, not even amongst the adenocarcinomas. The low frequency of prostatic adenocarcinoma and the absence of high grade prostatic intraepithelial neoplasia in this study despite the observation of increasing number of prostatic carcinoma required further investigation. Schistosomiasis was also found to be present in the adult male population.

Survival Rate and Factors Influencing It in Triptorelin-Castrated Metastatic Prostate Cancer Patients

Background: Most newly diagnosed prostate cancers in Benin are metastatic diseases and patients are reluctant to undergo orchiectomy. Still, chemical androgen deprivation therapy is not always available and not every patient can afford it. Thus, it will be interesting to evaluate the results of that therapy in the country. Objective: To analyze the survival rate and factors influencing it in metastatic prostate cancer patients who underwent triptorelin-based androgen deprivation therapy at the former Military Teaching Hospital of Cotonou from January 1, 2012, to December 31, 2022. Patients and Method: Metastatic prostate cancer patients received intragluteal injections of triptorelin 11.25 mg every 3 months. We retrospectively collected follow-up data from the patients’ medical records. By means of the software StataTM version 15, we performed a descriptive analysis of qualitative data. We used Kaplan-Meir method to estimate the overall survival rate in the whole cohort and in specific subgroups of patients. We compared survival rates by using the log-rank test. Results: 68 metastatic prostate cancer patients aged 47-86 years (mean = 69.9) with initial PSA ranging from 24.25 to 6334 ng/mL (mean = 666.1) started triptorelin-based castration. The tumor grade in 21 (33.3%), 14 (22.2%), 15 (23.8), 8 (12.7%), and 5 (7.9%) patients was respectively ISUP grade groups 5, 4, 3, 2, and 1. 15 (22.1%), 4 (5.9%), 2 (2.9%), 1 (1.5%), 11 (16.2%), and 7 (10.3%) patients respectively had hypertension, diabetes mellitus, peptic ulcer, asthma, unilateral or bilateral hydronephrosis, and paralysis. The mean nadir PSA level was 22.5 ng/mL (range: 0.01-220.25). The mean time to nadir PSA level was 8.9 months (range: 3-57). The overall survival rate was 42.6%. There was no significant survival difference between age groups (p = 0.475), relating to the presence of diabetes or hypertension (p = 0.757) or to the presence of paralysis or hydronephrosis (p = 0.090). The initial PSA level exerted no significant impact on patients’ survival (p = 0.461). Neither did the time to PSA nadir (p = 0.263). The PSA nadir less than 4 ng/mL (p = 0.005) and the PSA nadir less than 4 ng/mL achieved in 12 months or less (p = 0.002) were predictive of longer survival rate. The difference in survival rate through the ISUP grade groups was not significant (p = 0.061). Conclusion: The overall survival rate was 42.6% at 5 years. Achieving PSA nadir of less than 4 ng/mL in less than 12 months of castration was predictive of longer survival rate in triptorelin-castrated metastatic prostate cancer patients.

Next Generation Sequencing for Microbial Analysis to Select Prophylactic Antibiotic Selection before Urologic Stone Surgery: A Culture Change

Background: This paper aims to determine if the combination of polymerase chain reaction (PCR) and next-generation sequencing (NGS) could identify bacteria in culture-negative urine that would alter prophylaxis management. Methods: We sent approximately 5 - 10 mL of a preoperative urine sample to MicrogenDx for PCR/NGS analysis performed after surgery (blind to the surgeon). The physician prescribed standard of care antibiotic prophylaxis. Cases modeling the hospital course of 3 random patients were reviewed by eight urologists after surgery to determine if NGS results would change their prophylaxis regimen. An infectious disease pharmacist reviewed the cases and provided the “ideal” regimen. Results: Urine cultures identified bacteria in 11% (2/18) of cases. Culture speciation results were consistent with NGS results. NGS detected a dominant bacteria in 56% (10/18) of negative cultures and targetable bacteria in all samples. There was a 15% (3/20) infection rate. In both cases, NGS results suggest inadequate prophylaxis. In response to the case scenarios, 100%, 88%, and 88% of the urologists reported they would change prophylaxis with NGS results. During a case scenario, physicians would tend to overprescribe antibiotics given PCR/NGS data for prophylaxis selection. Conclusion: NGS identifies a targetable bacterium in up to 80% of negative urine cultures before urologic stone surgery. Responses to case scenarios indicate that physicians would change management based on NGS results. Inter-professional (urologic and pharmacy) antibiotic selection with PCR/16S DNA testing may be helpful to improve antibiotic stewardship.

Urethral Stone: A Rare Cause of Acute Retention of Urine in Men

Urethral stones are a very rare form of urolithiasis, they most often originate from the upper urinary tract or bladder, and are rarely formed primarily in the urethra, it is formed on a urethral anatomical pathology in the majority of cases. The clinical symptomatology is very variable ranging from simple dysuria with penile pain to acute retention of urine. Smaller stones can be expelled spontaneously without intervention, but larger stones or complicated stones or those developed on an underlying urethral anatomical pathology require surgical treatment. The minimally invasive treatment should be the preferred route for the surgical treatment of this disease when feasible. We report the case of a young man with no particular pathological history who presented to the emergency department for acute retention of urine secondary to a primary fossa navicularis calculus, through this case, we discuss the different clinical aspects, etiology, pathogenesis, diagnosis and therapy of urethral stone in men.

Coccidioidomycosis of the Testis and Epididymis

This report describes an unusual presentation of a man with a testicular mass who presented in diabetic ketoacidosis to the emergency department. Initial diagnosis was a suspected testicular malignancy based on history, physical exam, and available laboratory and radiological imaging. Due to the possibility of a testicular malignancy, the patient was taken for immediate orchiectomy. Histology revealed coccidioido-mycosis of the left testicle and epididymis. Treatment with the appropriate antifungals was initiated. Despite aggressive multi-disciplinary therapy the patient continued to deteriorate and eventually expired as a result of the massive systemic infection. Literature review revealed the presentation of disseminated genitourinary coccidioidomycosis is rare and seldom reported.

Can the Rectum Balloon Minimize Rectal Toxicity During Irradiation Therapy of Prostate Cancer?

The irradiation of the rectum cancer occurs in many institutes by using a rectum balloon in order to reduce the mobility of the target organ and to distance the rectum from the target organ. The objective is to reduce side effects quantitatively as well as qualitatively. On the basis of two hospitals using identical techniques for the prostate irradiation with the sole difference of the rectum balloon the toxicity has been evaluated with the result of no significant difference between the cohorts concerning diarrhea, rectal pain symptoms and rectal bleedings. Therefore the authors consider the use of the rectum balloon prior to each irradiation not necessary for the reduction of toxicity particularly due to the fact that the application is often very painful, especially for patients with hemorrhoids. The rectum balloon as a tool for the reduction of the prostate mobility was not objective of this study.

Mucinous Carcinoma of the Scrotum about a Case in Yaounde

Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in the management of urogenital cancers in developing countries. Case presentation: This was a 62-year-old patient who had consulted for fistulized lesions of the scrotum associated with urinary disorders. Physical examination found budding lesions in the scrotum from which mucus was leaking. The diagnostic assessment carried out consisted of a biopsy sample of the scrotal lesions, a blood analysis and medical imaging, which led to the diagnosis. The mutilating nature of the surgery proposed to the patient after multidisciplinary consultation meeting and the expensive cost of chemotherapy drugs constituted the limits of the patient’s therapeutic management. Conclusion: Mucinous carcinoma of the scrotum is rare and primary lesion should always be sought. The presence of budding lesions of the scrotum with discharge of mucus should suggest the diagnosis.

Primary Prostatic Tuberculosis: A Rare Entity

Objectives: To clarify the clinical, histological and therapeutic features of prostatic tuberculosis. Methods: We conducted a single-centre retrospective descriptive study of all patients presenting with prostatic tuberculosis between January 2002 and December 2020. Patients who were lost to follow-up, could not be reached by telephone or whose records were not usable were excluded from this study. Results: 240 patients were treated for urogenital tuberculosis, including 13 for isolated prostatic tuberculosis. The average age of the patients was 75 years. None of our patients had a history of tuberculosis. The average of international prostate symptom score (IPSS) was 27. Lower urinary tract symptoms in the filling phase were predominant. The digital rectal examination was suspicious in only one patient. The mean preoperative PSA was 9.24 ng/ml. 46.15% of patients underwent transurethral resection of the prostate and 53.85% underwent ultrasound-guided prostate biopsy. Histological examination showed epithelioid gigantocellular granuloma with isolated caseous necrosis in 61.53% of patients and associated adenomyomatous hyperplasia in 38.47% of patients. Antituberculosis treatment was given for 6 months. The average of follow up was 15 months. All patients reported an improvement in clinical signs with a mean post operative IPSS score of 17 and a normalisation of PSA levels. Conclusion: Isolated prostatic tuberculosis is a rare entity, it can simulate a cancer. In front of the symptoms of the lower urinary tract, the clinicians must think of it especially in the developing countries where tuberculosis still prevails in an endemic state.

Application of Circulating Tumor Cells in Peripheral Blood in Judging the Prognosis of Patients with Renal Cancer and Related Indexes of Blood Coagulation

Objective: To investigate the value of the number of circulating tumor cells (CTC) in peripheral blood in the prognosis and coagulation-related indicators of patients with renal cancer. Methods: 65 patients with renal cell carcinoma (RCC) confirmed pathologically were divided into CTC positive group and CTC negative group according to the CTC count (5 pcs/3.5 ml). Compare the age, gender, tumor location, TNM (clinical stage), pathological grade, tissue type, lymph node metastasis, distant metastasis, prognosis and prothrombin time (PT), fibrinogen (FIB), partial coagulation of the two groups of patients The correlation between the results of zymogen time (APTT) and D-dimer (DD) and the number of CTC. Results: There were significant differences in TNM, lymph node metastasis, and distant metastasis between the two groups (P < 0.05). The number of CTC in patients was correlated with FIB and D-D levels (P < 0.05). Conclusion: The number of CTC in patients with renal cell carcinoma is correlated with some clinical phenotypes (TNM, lymph node metastasis, distant metastasis) and some coagulation indexes (FIB, D-D), and can jointly predict the prognosis of renal cancer.

Ureteric Stone Containing Gas: First Case Report with Review of Cases of Urolithiasis with Gas within the Stone and Its Clinical Implications

We report the first case of a ureteric stone containing gas. This rare stone with gas within it was found during the management of a diabetic patient with urosepsis as the initial presentation. Literature review of cases of renal stone containing gas, mechanisms of gas within the stone, and clinical implications of stone containing gas are discussed. Also, a new terminology is proposed to describe this phenomenon.

Medical Expulsive Therapy (MET) for Large Distal Ureteral Stones: A Prospective Study Comparing Three Drugs

Introduction: One of the most common disorders of the urinary tract is Urolithiasis. Twenty percent of lithiasis are located in the ureter of which 68% are seen in the distal ureter. The concept of medical expulsive therapy (MET) has been developed with enough knowledge of the ureter physiology in order to make easier the spontaneous expulsion of the stone. The aim of this study was to evaluate the efficacy and safety of three different drugs for the treatment of pelvic ureteral stones. Materiel and Methods: Between October 2017 and November 2018, 90 adult patients presenting with low or non-obstructive pelvic ureteral stones sized 8 to 10 mm were included. They were prospectively randomized, using computer-based randomization charts, into three equal groups: treatment with ketoprofen 100 mg once daily (Group I), silodosin 8 mg once daily (Group II) and tadalafil 5 mg once daily (Group III). The aim was to compare spontaneous expulsion of stone between those drugs Results: The mean expulsion time from the start of MET was 11.5 ± 3.27 days for ketoprofen group, 10.71 ± 3.98 days for silodosin group and 10.57 ± 3.40 days for tadalafil group. But these differences were also not significant (P = 0.79). The use of analgesics (grade II) was higher in groups II and III compared to group I, but without significant difference (23.33% in group I, 33.33% in group II and 40% in group III, p = 0.38). Discussion: The overall chance of spontaneous passage is low when the stone diameter is sized more than 7 mm. A wide range of spontaneous passage rates have been reported in the literature, varying from 71% to 98% for distal ureteral stones less than 5 mm and 25% - 53% for stone sized 5 to 10 mm with a mean expulsion time of more than 10 days. Conclusion: The three drugs have a low expulsion rate for 8, 9 and 10 mm pelvic ureteral stones with a higher adverse event rate for the NSAID group.

Prospective Clinical Study of ¹²⁵I Particle Permanent Implantation for Prostate Cancer

Objective: To investigate the clinical effect of 125I radioactive seed implantation and the treatment of prostate cancer with radical resection of prostate cancer. Methods: Within the period of the second phase, 62 cases of prostate cancer patients, aged from 46 to 87 years old, average 69 years old. In the treatment group, 30 cases were implanted with 125I radioactive particles via the rectum with the guidance of the rectum. 32 cases in the control group underwent radical prostatectomy. Results: All patients were operated successfully, the patients were followed up for 12 to 36 months. In the treatment group, the average particle size was 38 + 15. No serious complications caused by rectal puncture. 2 patients occurred 6 months after PSA increased significantly, systemic examination revealed bone metastases, and underwent endocrine therapy. In the control group, there were 2 cases of patients with PSA significantly increased in 5 months after surgery, and the external irradiation plus endocrine therapy. During the observation period, the survival rate of the patients who were implanted with 125I particles in the treatment group without progression was 93.3%. Control group, the cumulative PSA progression free survival rate was 93.7%. Conclusion: Patients with prostate cancer during the second phase, the clinical curative effect of the treatment of prostate cancer with the treatment of 125I of prostate cancer and the treatment of prostate cancer by using radical resection of prostate cancer are quite. This technology has the advantages of small trauma, quick recovery, low damage to normal tissue.

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.

Pubo-Penile Testicular Ectopia (ETPP) of the Infant of 4 Months about a Case

Pubo-penile testicular ectopia is a rare congenital malformation whose etiopathogenesis remains poorly understood. It represents other testicular ectopias less than 1% of all testicular migration disorders. We report a clinical observation of a 4-month-old infant who consulted for swelling at the root of the penis associated with vacuity of the right hemi scrotum. An inguinal ultrasound was performed which confirmed the presence of the right testicle. An orchidopexy was performed at 4 months of life by an inguinal approach, the postoperative course was simple with a follow-up of 6 months.

Scrotal Trauma in a Motorcycle Accident Leading to a Partial Orchidectomy: Case Report

Scrotal trauma in motorcycle accidents (STMA) is a rare entity in the literature. In general, trauma to the genitals is not life-threatening. However, STMA can cause rupture of the testis with consequences that can lead to alteration of sexuality and reproduction. We present an STMA case managed in a rural hospital where various types of injuries arise from motorcycle accidents. A 20-year-old man without any previous pathology presented in our hospital with a swollen painful scrotum. One week prior to presentation, the patient with a speeding motorbike drove over a speed bump, and the frame of his motorcycle broke into two halves, violently striking his genitals and causing scrotal trauma. After examination and investigation, patient has consented to scrotal exploration which was carried out. A partial left orchidectomy was performed and the right testicle was healthy. The evolution was favorable and the patient was discharged on the 5th postoperative day. Prognosis at 6 months was good. It is possible that genital trauma related to motorcycle accidents will become more frequent in the future. This underscores the importance of educating motorcyclists to respect the Highway Code;and making practitioners aware of the risk of serious injury in the event of acute scrotal trauma.

Epidemiology of Urological Emergencies at the Regional University Hospital Center of Ouahigouya, Burkina Faso

Introduction: Urological emergencies are less frequent compared to other emergencies, particularly traumatological and digestive emergencies. The objective of this study was to determine the epidemiological profile of urological emergencies in a regional hospital in Burkina Faso. Patients and methods: This was a cross-sectional study of urological emergencies admitted to the Surgical Department of the Ouahigouya Regional University Hospital in Burkina Faso over a period of 41 months. The study covered a 41-month period from March 2015 to July 2018. Ethical clearance was taken from the institutional ethics committee. Results: Urological emergencies accounted for 3.7% of all emergencies. The mean age of the patients was 56.59 ± 25.93 years (range 1 year - 95 years). The sex ratio was 12.05. Bladder urinary retention was the main urological emergency in 48.28% of cases. Suprapubic cystostomy was the most performed surgical procedure (56.25%) followed by debridement of external genitalia gangrene (27.68%). Conclusion: Urological emergencies occupy a significant place in our work context. An increase in the number of urologists would improve their management.

The Outcome of Transvesical Prostatectomy—A Multicenter Retrospective Study

Background: Benign Prostatic Hyperplasia (BPH) is one of the commonest causes of lower obstructive uropathy and usually presents with lower urinary tract symptoms. However, in developing nations, the presentation is late often large prostate and associated complications of bladder outlet obstruction (diverticulae, stones, impaired renal function etc.) warranting open prostatectomy. Objective: The objective of this study is to share our experience of perioperative outcomes of open transvesical prostatectomy over a year involving two referral centers in Monrovia Liberia. Methodology: This was a retrospective study performed at The John F. Kennedy Medical Center and the Saint Joseph Catholic Hospital involving a total of 31 patients. Results: The mean age was 64.6 years (SD = 9.03) with a range 52 - 85 years. The study showed that 54.8% (17/31) of patients had preoperative catheter. The maximum duration of Catheter was greater than 4 weeks with a mean duration of 3.17 weeks. The mean hemoglobin was 11.30 g/dl. The commonest presenting complication was urinary retention at 25.8% (8/31) followed by hematuria 16.1% (5/31). Hypertension 41.9% (13/31) and diabetes 6.5% (/31) were the commonest comorbidity. The rate of postoperative complication was 38.7% with the commonest being surgical site infection 16.1% (5/31) and clot retentions 9.7% (3/31). There was a high rate of transfusion was 77.4% (24/31) patients. Up to about 13% (4/32) patients had coexisting stricture with 6.5% (2/31) patients treated with urethroplasty and 6.5% (2/31) patients treated by dilatation. The mortality rate was 6.5% (2/31) from renal impairment and severe sepsis. Conclusion: BPH is a common cause of lower obstructive uropathy. Most patients present with complications of the disease such as refractory symptoms, bladder stones or diverticulae necessitating surgery. However, due to the absence of endourological equipments in most parts of Africa and the large prostate at presentation, most settings consider open transvesical prostatectomy as a viable option. The perioperative morbidity is relatively higher, but the outcome remains acceptable.