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Fournier’s Gangrene in a Patient with a Bladder Cancer: A Lethal Association
Fasnewinde Aristide Kabore,
Moussa Kabore,
Boukary Kabre,
Abdoul Aziz Ouedraogo
Issue:
Volume 5, Issue 1, June 2021
Pages:
1-3
Received:
14 November 2020
Accepted:
14 December 2020
Published:
4 January 2021
Abstract: Fournier’s gangrene is a rare and life-threatening condition. It mainly affects men. Progress in resuscitation has reduced its mortality rate but it remains very high. We report a case of Fournier’s gangrene in a 30-year-old male patient admitted to our emergency room for 24 hours history of a bilateral painful scrotal swelling with fever. In his prior history the patient was followed for squamous cell carcinoma of the bladder with ureteral meatus invasion and renal failure. On physical examination we noted a severe sepsis: temperature was 39.2° Celsius, pulse rate was 115 beats per minute, respiratory rate was 26 breaths per minute, blood pressure was 80/60 mmHg. We noted a bilateral and painful scrotal swelling with snow crepitation in burses and edema of the penile. The Fournier’s Gangrene Severity Index was 17. After hydroelectrolytic resuscitation, a surgical debridement was performed. An antibiotherapy with third-generation cephalosporin and imidazole was administered. The patient died of septic shock 24 hours after the debridement. Through this clinical case we showed that Fournier's gangrene has a severe prognosis. FGSI is an interesting predictive score in the evaluation of the patient's vital prognosis. The association between FG and bladder tumor worsens the patient's vital prognosis. Bladder cancer and Fournier’s gangrene realize a lethal association.
Abstract: Fournier’s gangrene is a rare and life-threatening condition. It mainly affects men. Progress in resuscitation has reduced its mortality rate but it remains very high. We report a case of Fournier’s gangrene in a 30-year-old male patient admitted to our emergency room for 24 hours history of a bilateral painful scrotal swelling with fever. In his p...
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A Stereological (Quantitative) Study of Leydig Cell Hyperplasia in Vasectomized Rabbit and Rat Testes
Hongni He,
Zhen Tu,
Yang Guo,
Bin Peng,
Li Ma,
Yi Shang,
Yugen Li,
Xianzhong Deng,
Zhengwei Yang
Issue:
Volume 5, Issue 1, June 2021
Pages:
4-9
Received:
14 January 2021
Accepted:
21 January 2021
Published:
28 January 2021
Abstract: It was speculated that vasectomy might induce hyperplasia of Leydig cells associated with atrophy of seminiferous tubules, but estimates of the Leydig cell number were lacking in previous studies. This study aimed to test the speculation by determining the numerical change of Leydig cells and other interstitial cells after a vasectomy that induced spermatogenic damage. Twelve adult Japanese white rabbits and twelve mature Sprague-Dawley rats were subjected to a unilateral vasectomy away from the scrotum. Six months (rabbits) or thirty-seven days (rats) postoperation, testes on both sides were removed and methacrylate sections prepared. The total numbers (per testis) of all nuclei in the testicular interstitial tissue were estimated with a stereological technique – the optical disector. The results showed that marked spermatogenic damage associated seminiferous tubular atrophy on the vasectomized side occurred in 7 (rabbits) or 5 (rats) of the 12 animals. For the rabbit, the total numbers of myoid cells or leukocytes on the vasectomized side (compared with the contralateral nonvasectomized side) were unchanged but those of Leydig cells and other interstitial cells increased significantly by 41% and 52%, respectively, (a) with the increase in the testis with spermatogenic damage appearing to be larger than that in the testis without spermatogenic damage and (b) without significant increase in the total volume of the interstitium. For the rat, there were no significant differences in the total numbers of any cell type. In conclusion, hyperplasia or hyperproliferation of the interstitial cells, which might be a result of increased intra-testicular pressure for long, was possible postvasectomy, but it might not be indicative of a better function of the cells.
Abstract: It was speculated that vasectomy might induce hyperplasia of Leydig cells associated with atrophy of seminiferous tubules, but estimates of the Leydig cell number were lacking in previous studies. This study aimed to test the speculation by determining the numerical change of Leydig cells and other interstitial cells after a vasectomy that induced ...
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Dynamics of Phenotypic Manifestations of Connective Tissue Dysplasia in Children with Uroandrological Pathology in the Age Aspect
Sharkov Sergey Mikhailovich,
Vasilyeva Irina Germanovna,
Safronov Boris Grigorievich
Issue:
Volume 5, Issue 1, June 2021
Pages:
10-15
Received:
19 November 2020
Accepted:
19 January 2021
Published:
28 January 2021
Abstract: Introduction. A comparative study of the phenotypic manifestations of undifferentiated connective tissue dysplasia in children of various age groups with urological and andrological pathology is carried out in the article. Materials and methods. The study included 214 children aged 1 month to 17 years with clinical manifestations of undifferentiated connective tissue dysplasia, who were treated in the pediatric uroandrological department for congenital malformations and diseases of the genitourinary system. When establishing undifferentiated connective tissue dysplasia, a generally accepted table of external phenotypic markers was used with their scores. Results. In infants, abnormalities of the auricles and skin are most often detected. In pre-school age, craniocephalic abnormalities, pathology of the osteoarticular system, and abnormalities of the auricles were detected in the largest percentage of cases. The study found that an increase in the percentage of detection of ocular abnormalities increases with age. Moreover, 2 or more eye abnormalities were most common in older children. Anomalies of the oral cavity were diagnosed in only a quarter of infants and were manifested in them by a single sign. In older age categories, anomalies of the oral cavity were observed in more than half of patients, and often they were not single. During the examination of senior schoolchildren, it was noted that all children of this age category had some kind of abnormality from the osteoarticular system, and almost always they were multiple. Conclusion. Somatic manifestations of undifferentiated connective tissue dysplasia are often multi-organ in nature and often have nonspecific clinical symptoms. Identification of the patterns of formation of uroandrological pathology in patients of various age groups against the background of connective tissue failure will provide timely prevention and correction of visceral manifestations of dysplasia in children.
Abstract: Introduction. A comparative study of the phenotypic manifestations of undifferentiated connective tissue dysplasia in children of various age groups with urological and andrological pathology is carried out in the article. Materials and methods. The study included 214 children aged 1 month to 17 years with clinical manifestations of undifferentiate...
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Measurement of Stretched Penile Length in Term Neonates at a Single Tertiary Care Centre of South India
Nitin Pingale,
Rajendra Nerli,
Shridhar Ghagane,
Manas Sharma,
Shashank Patil,
Pulkit Gupta
Issue:
Volume 5, Issue 1, June 2021
Pages:
16-20
Received:
10 September 2020
Accepted:
20 February 2021
Published:
4 March 2021
Abstract: Evidence from several studies has shown that the penile length varies among different populations of different racial/ethnic groups. Size abnormalities of the newborn external genitalia may be a pointer to some endocrine and genetic disorders. In this study we have prospectively measured the stretched penile length of all newborns at our hospital in an attempt to define normative data for full term neonates of our region. All live male neonates born at our hospital were enrolled into the study. Stretched penile length was measured from the pubic ramus to the tip of the glans penis using a digital Vernier Calliper. The measurements were taken within 48 hours of birth. Two consecutive measurements were taken and the average was recorded as the final measurement. The mean stretched penile length was 2.63±0.35 mm and the mean diameter of glans was 1.04±0.09 mm respectively. The penile length significantly varied with the length (height) of the neonate as expressed in cms. The taller the neonate, longer was the penis. Similarly, the mean penile length and the diameter of the glans was significantly different (p<0.05) for different gestational age. The stretched penile length of neonates significantly correlates with the gestational age and the length of the neonate.
Abstract: Evidence from several studies has shown that the penile length varies among different populations of different racial/ethnic groups. Size abnormalities of the newborn external genitalia may be a pointer to some endocrine and genetic disorders. In this study we have prospectively measured the stretched penile length of all newborns at our hospital i...
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Peno-Scrotal Elephantiasis: An Observation and Literature Review
Mohammed Mzyiene,
Mustapha Ahsaini,
Ziba Ouima Justin Dieudonne,
Somuah Tenkorang,
Mellas Soufiane,
Jalal Eddine Elammari,
Mohammed Fadl Tazi,
Mohammed Jamal Elfassi,
Moulay Hassan Farih
Issue:
Volume 5, Issue 1, June 2021
Pages:
21-24
Received:
18 March 2021
Accepted:
1 April 2021
Published:
13 April 2021
Abstract: Scrotal elephantiasis is a rare pathology Peno-scrotal elephantiasis (scrotal lymphedema) is most common in endemic filarian areas. Outside these areas this pathology remains quite rare. We report a case of primitive peno-scrotal elephantiasis. A 60-year-old patient with no significant pathological history, who had a significant increase of the bursa volume that had been evolving for years. The clinical examination found a bursary 46 cm in diameter with thickened skin and a penis buried in a glove finger. Exploration of the vascular axis of the lower limbs was normal. Peri-scrotal MRI noted significant infiltration of inflammatory-looking scrotal tunics, but found no obstructive cause. The patient was treated by a complete surgical resection of the pathological tissue and a peno-scrotal reconstruction. The evolution was marked by a progressive healing of the surgical wound, the patient was reviewed several times to assess the benefit of the treatment, he noted a satisfaction of the surgery allowing a good functional and aesthetic result. The aim of this case report is to present a specific management of a peno-scrotal elephantiasis in our hospital and to compare it with the review of literature on surgical management of this pathology. This condition is uncommon and challenging to manage for most urologists.
Abstract: Scrotal elephantiasis is a rare pathology Peno-scrotal elephantiasis (scrotal lymphedema) is most common in endemic filarian areas. Outside these areas this pathology remains quite rare. We report a case of primitive peno-scrotal elephantiasis. A 60-year-old patient with no significant pathological history, who had a significant increase of the bur...
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Transurethral Resection of the Prostate at the Urology Department of Ignace Deen Hospital, Conakry, Guinea
Mamadou II Barry,
Amadou Camara,
Thierno Mamadou Oury Diallo,
Mamadou Bissiriou Bah,
Mamadou Diawo Bah,
Lahoumbo Ricardo Gnammi,
Thierno Oumar Diallo,
Demba Cissé,
Daouda Kanté,
Ibrahima Bah,
Abdoulaye Bobo Diallo,
Oumar Raphiou Bah
Issue:
Volume 5, Issue 1, June 2021
Pages:
25-29
Received:
4 April 2021
Accepted:
22 April 2021
Published:
30 April 2021
Abstract: Transurethral resection of the prostate (TURP) remains the gold standard treatment for benign prostatic hyperplasia (BPH). Objective: To report the results of TURP to the Urology Department of Ignace Deen National hospital Patients and methods: This was a prospective, descriptive study of 2 years 5 months (January 1, 2015 to May 31, 2017), carried out in the urology department of the Ignace Deen National Hospital. We included 86 patients who benefited from an isolated TURP or associated with another surgical procedure. Results: TURP accounted for 51.19% of endoscopic surgery and 20.18% of prostate surgery. The mean age was 69.21 years (48 and 89). The mean total PSA level was 17.7ng / ml. The mean prostate volume was 54, 22 cm3 (27 and 107). The indication for surgery was dominated by chronic retention of bladder urine (93.02%). The mean duration of TURP was 41.84 min (28 and 58). Postoperative complications were dominated by orchi-epididymitis (5.81%) and UVR (4.66%). The mean length of stay was 5.63 days. The histologic types were: benign prostatic hyperplasia (69.77%), prostatic adenocarcinoma (29.07%) and high grade intraepithelial prostate neoplasia (1.16%). After a mean follow-up of 2.21 months, the result was good in 95.35% of cases. Conclusion: It offers low morbidity and a good result in almost all cases.
Abstract: Transurethral resection of the prostate (TURP) remains the gold standard treatment for benign prostatic hyperplasia (BPH). Objective: To report the results of TURP to the Urology Department of Ignace Deen National hospital Patients and methods: This was a prospective, descriptive study of 2 years 5 months (January 1, 2015 to May 31, 2017), carried ...
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A Rare Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE3 Gene Fusion: Case Report of 8 Cases and Review of the Literature
Mohammad Arman Hossain,
Jannatul Maoya Bashanti,
Xiaoyong Dong,
Shun Gao,
Hang Tong,
Xinyuan Li,
Hubin Yin,
Xin Gou,
Weiyang He
Issue:
Volume 5, Issue 1, June 2021
Pages:
30-37
Received:
4 April 2021
Accepted:
26 April 2021
Published:
8 May 2021
Abstract: XP11.2 translocation TFE3 gene fusion renal cell carcinoma (RCC) is enlisted as a rare subtype of RCC by WHO in 2004. This type of Tumor was previously considered a pediatric tumor predominantly but is now invariably found in adult and older patients. The article investigates the clinical manifestation, pathological features, diagnosis criteria, and treatment of this rare subtype of RCC. We collected the clinical data of eight patients confirmed as XP11.2 TFE3 RCC admitted in the First affiliated hospital of Chongqing Medical University from August 2015 to November 2018, and a retrospective analysis of these data was conducted. There were three male, five female patients, the average age of 33.25 years old, ranging from 5 years old to 62. Six patients were asymptomatic and diagnosed incidentally, one of them complained of hematuria and back pain for three months, and another patient complained just back pain for four months. After hospital admission, transabdominal ultrasonography, CT scan, and MRI imaging were done on all the patients. The tumor sizes of 2 patients were more than 7cm; 3 patients were 5-6 cm, and the rest three patients were below 4cm. One Patient got an Open Radical Nephrectomy for the right kidney and Right Ureterectomy. Four patients went through a Radical nephrectomy, and partial nephrectomies were done in the rest three patients. All the removed tumor samples were analyzed using pathology and immunohistochemistry assays. The results showed that all samples had renal carcinoma cells, with positive CD10 and TFE3 staining. Other parameters varied from each other. One postoperative Patient got both chemotherapies and targeted therapy; 3 patients were treated with Interferon but changed to thymopentin due to adverse effects. Only one Patient got thymopentin, and the rest three patients did not need any adjuvant therapy. Follow-up was done on all patients from 6 months to 40 months. Except for one patient who died of lung metastasis at 16 months after surgery, no disease progression occurred in those patients. The imaging findings are atypical, constantly varying among different patients with various tumor morphologies. So far, the golden standard of diagnosis is postoperative pathology and immune histochemistry. Radical or partial nephrectomy combining with renal lymph node clearance should be performed if metastasis of lymph nodes occurs. Proper adjuvant therapy, including chemotherapies, targeted therapy, and immune therapy, should be applied when needed. To maintain a risk-free life, follow-up must be done every 3 to 6 months.
Abstract: XP11.2 translocation TFE3 gene fusion renal cell carcinoma (RCC) is enlisted as a rare subtype of RCC by WHO in 2004. This type of Tumor was previously considered a pediatric tumor predominantly but is now invariably found in adult and older patients. The article investigates the clinical manifestation, pathological features, diagnosis criteria, an...
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Comparison of Minimally Invasive Surgical Approaches in the Management of Small Renal Masses at a Safety Net Hospital
Liz Wang,
Michel Apoj,
Remington Lim,
Shaun Wason,
Mark Katz,
David Wang
Issue:
Volume 5, Issue 1, June 2021
Pages:
38-42
Received:
21 April 2021
Accepted:
3 May 2021
Published:
14 May 2021
Abstract: Partial nephrectomy can be performed with traditional straight laparoscopy (SL), hand- assisted laparoscopic (HAL) and robotic-assisted laparoscopic (RAL) techniques. The purpose of this study is to analyze trends in surgical technique and compare the intra- and post-operative outcomes at a safety net hospital. We performed a single-institution retrospective review of intra- and post-operative outcomes in partial nephrectomy cases between 2012 and 2018. We analyzed the impact of patient demographics, tumor characteristics, and RENAL nephrometry score on surgical outcomes and post-operative complications among the three surgical approaches to partial nephrectomy. Of the 164 partial nephrectomies, 36 were SL, 65 HAL, and 63 RAL. Most SL was performed in the early years, whereas most RAL was performed in the later years, and HA was evenly distributed throughout the years. There was no difference in demographics, intra-operative complications, estimated blood loss, or positive margin rates between SL, HAL, and RAL. HAL partial nephrectomies had a higher RENAL nephrometry score and had statistically significant less warm ischemia and operative times when compared to RAL. HAL is a worthwhile technique in larger and more complex masses and especially in settings where robotic surgery is unable to be performed.
Abstract: Partial nephrectomy can be performed with traditional straight laparoscopy (SL), hand- assisted laparoscopic (HAL) and robotic-assisted laparoscopic (RAL) techniques. The purpose of this study is to analyze trends in surgical technique and compare the intra- and post-operative outcomes at a safety net hospital. We performed a single-institution ret...
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Redo Hypospadias Repair: Our Experience in a Tertiary Care Centre
Shoubhik Chandra,
Priyeshkumar Patel,
Rajendra Nerli,
Shridhar Ghagane,
Neeraj Dixit
Issue:
Volume 5, Issue 1, June 2021
Pages:
43-46
Received:
16 February 2021
Accepted:
8 May 2021
Published:
31 May 2021
Abstract: Introduction: Treating children following a failed hypospadias repair can be challenging. Complications include urethrocutaneous fistulas, glans dehiscence, meatal stenosis and urethral strictures. Glans dehiscence remains the most common indication for re-operative urethroplasty. The repair can be challenging because of several factors including significant scarring and paucity of genital skin. We report our experience in the management of failed hypospadias repairs at our centre. Materials & Methods: We retrospectively reviewed and analysed the inpatient and outpatient records of children/adolescents undergoing redo-hypospadias repairs during the period Jan 2010 to Dec 2019. Results: A total of 37 children with a mean age of 8.62±3.76 (2 – 17) years underwent a redo repair of hypospadias. Twenty children underwent two stage buccal mucosa urethroplasty, 11 underwent tubularized incised plate (TIP) urethroplasty, 5 dorsal inlay graft urethroplasty and 1 onlay flap urethroplasty. A total of three (8.10%) children developed an urethrocutaneous fistula needing an additional stage for repair. Uroflowmetry done in all children showed adequate maximum flow rates, with minimal to nil residuals. Conclusions: The majority of hypospadias failures can be salvaged with one stage surgery including Mathieu flip flap Urethroplasty, Tubularized incised plate urethroplasty and dorsal inlay graft urethroplasty. A two stage buccal mucosa urethroplasty may be necessary in cases wherein the urethral plate or skin substitute is grossly scarred, or the ventral curvature greater than 30 degrees. Complications do occur following redo procedures but eventually excellent functional and cosmetic results can be achieved.
Abstract: Introduction: Treating children following a failed hypospadias repair can be challenging. Complications include urethrocutaneous fistulas, glans dehiscence, meatal stenosis and urethral strictures. Glans dehiscence remains the most common indication for re-operative urethroplasty. The repair can be challenging because of several factors including s...
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Correlation Between Bone Metastases and PSA Among Prostate Cancer Patients at Kilimanjaro Christian Medical Centre from June 2018 to May 2019
Samuel Kibona,
Orgeness Mbwambo,
Nicholaus Ngowi,
Frank Bright,
Jasper Mbwambo,
Alfred Mteta,
Mbarouk Mohammed
Issue:
Volume 5, Issue 1, June 2021
Pages:
47-50
Received:
21 November 2020
Accepted:
9 December 2020
Published:
9 June 2021
Abstract: Prostate cancer is a leading cause of cancer death in men, second only to lung cancer. Bone metastasis is a common complication in prostate cancer patients that can cause bone pain and pathological fracture. PSA, Gleasons score, clinical T stage have been developed to integrate multiple clinical metastatic disease in prostate cancer patients. Bone radiography is used to rule out bone metastasis. It’s common to have bone metastasis when PSA level is high and histology of poorly differentiated adenocarcinoma. Aim: To determine the prevalence of osteoblastic lesions and analyze the correlation of PSA levels, on lumbar sacral radiography in patients diagnosed with prostate cancer. Methods: This was a hospital based cross-sectional retrospective study, conducted at KCMC urology institute from June 2108 to May 2019 and all prostate cancer patients diagnosed at KCMC during the study period both inpatients and outpatients attending urology department within the study period. The structural data sheet was used to collect information from patient file. Study parameters include Age, Gleason’s score, PSA level used to assess the correlation with osteoblastic lesion on lumbar sacral x-ray. Results: A total of 97 patients included in the study, with mean age was 74.5 (SD) 8.97.6 yrs. Patients with Gleason score of 8-10 were 56 (57.8%) and the median PSA level was 126ng/mL with IQR (58.9-402.2) and The prevalence of bone metastases was 57.7%. There were 56 (49.5%) patient had osteoblastic lesions on lumbar sacral x-ray with PSA >100. Conclusion: The prevalence of bone metastasis is 57.7% with 49.5% of the patients had total serum PSA of >100ng/ mL. So lumbar sacral X ray can be used as a diagnostic tool when PSA is more than 100ng/ml. There is a need to avoid unnecessary lumbar sacral X rays in patients with carcinoma of the prostate who have no symptoms and sign metastatic disease and has PSA of less than 100ng/ml.
Abstract: Prostate cancer is a leading cause of cancer death in men, second only to lung cancer. Bone metastasis is a common complication in prostate cancer patients that can cause bone pain and pathological fracture. PSA, Gleasons score, clinical T stage have been developed to integrate multiple clinical metastatic disease in prostate cancer patients. Bone ...
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Supine Versus Prone Percutaneous Nephrolithotomy – A Randomised Comparative Study
Mohan Keshavamurthy,
Niramya Pathak,
Karthik Rao,
Sreeharsha Harinatha,
Shakir Tabrez,
Premakumar Krishnappa,
Basavaraja Neelagar,
Santosh Kumar Subudhi
Issue:
Volume 5, Issue 1, June 2021
Pages:
51-57
Received:
22 April 2021
Accepted:
31 May 2021
Published:
9 June 2021
Abstract: Percutaneous Nephrolithotomy (PCNL) is the standard procedure for large renal stones. This study was conducted to compare the conventional Prone position PCNL with the newer concept of Supine PCNL. A prospective, randomised controlled, double blind study was conducted in 100 patients planned for PCNL. They were randomised into 2 groups with 50 patients each and PCNL was performed either in the prone or supine position. The patient groups were compared for the length of hospital stay, duration of surgery, postoperative and intra operative complications, postoperative stone free status, and requirement of adjunctive procedures. Stone free rates were significantly better for the supine PCNL group. Post operative complications such as fever was more for Prone PCNL group. The other parameters that were not statistically significant were mean operating time which was less for the supine group and duration of hospital stay which was less for the supine group. There was no difference in the other complication rates between the two procedures. The requirement of additional procedures for stone clearance were also same between both the groups. To conclude, Our study demonstrates that supine PCNL is a better technique than prone PCNL in terms of stone free rates, post-operative complications such as fever, lesser number of punctures required for stone clearance and more tubeless procedures.
Abstract: Percutaneous Nephrolithotomy (PCNL) is the standard procedure for large renal stones. This study was conducted to compare the conventional Prone position PCNL with the newer concept of Supine PCNL. A prospective, randomised controlled, double blind study was conducted in 100 patients planned for PCNL. They were randomised into 2 groups with 50 pati...
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