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Record No. 13519 Record ID 013519 Publication type Journal Article Title Spontaneous Pregnancy Outcome after Surgical Repair of Clinically Palpable Varicocele in Young Men with Abnormal Semen Analysis Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Abdalla, A.; Amin, M.; Hamdy, A.; Nady, M. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2012 Volume and n° 17(4) Pages 115-121 Language English Descriptor Semen Analysis; Varicocele; Pregnancy Outcome Descriptor-Geographic Infertility, Male Abstract Objective: The beneficial effect of varicocele repair in male infertility remains unresolved. The aim of this study was to identify the benefit from varicocele treatment based on pregnancy rate rather than improvement of semen quality. Subjects and Methods: This study included 141 infertile men with varicocele detected by clinical examination and confirmed by venous reflux on continuous wave Doppler ultrasonography (US). Measurement of Body Mass Index (BMI) and hormonal assays were performed in all patients. A total of 233 sub-inguinal varicocele repairs were done. Couples were followed up with semen analysis and pregnancy detection for 6, 12 and 18 months. Statistical analysis was performed using the chi-square, t-test and Mann-Whitney test where appropriate (p 0.05 accepted as statistically significant). Results: The spontaneous pregnancy rate was significantly greater in men with low or normal BMI. There were statistically significant differences between postoperative mean sperm count (64.7±6.8 and 10.5±1.8 million/ml) and progressive motility (38.3±2.4 and 17.7±1.8) for spontaneous pregnancy and non-pregnancy, respectively. There were also significant changes from pre- to postoperative mean sperm concentration (21.5±2.1 and 64.7±3.8 million/ml), progressive motility (12.9±1.8 and 31.7±1.4) and normal morphology (54±1.3 and 81.3±4.6) in the spontaneous pregnancy cohort. Comparing pre- and postoperative serum hormone levels, FSH and prolactin decreased significantly in spontaneous pregnancy (6.57±0.65 to 4.6±0.53 IU/L and 166.2±11.8 to 149.3±10.4 pmol/L, respectively) and increased in non-pregnancy (9.05±0.71 IU/L and 187.8±13.3 pmol/L, respectively). Conclusion: Spontaneous pregnancy after sub-inguinal varicocelectomy is significantly affected by BMI, sperm concentration, progressive motility and morphology. The decrease of FSH may predict the spontaneous pregnancy outcome.

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Record No. 13518 Record ID 013518 Publication type Journal Article Title Aspects histo-épidémiologiques des cancers solides du rein de l'enfant en Côte d'Ivoire Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Kouyate, M.; Koffi, K.; Kouil, B.; N'guiessan, A.; Effi, A.; Ouattara, G.; D'horpock, A.; Honde, M. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(4) Pages 153-156 Language English Descriptor Tumeurs du rein; Tumeur de Wilms; Enfant Descriptor-Geographic Côte d'Ivoire Abstract Objectifs: A partir d'une étude rétrospective transversale, les auteurs rapportent 34 cas de cancer du rein histologiquement confirmés chez l'enfant de moins de 16 ans, observés dans les services d'Anatomie Pathologique des centres hospitaliers et universitaires d'Abidjan (République de Côte d'Ivoire) au cours de la période allant de janvier 1984 à décembre 2007e. Patients et méthodes: Le matériel d'étude était constitué de pièce de néphrectomie. Après fixation dans le formol à 10, les prélèvements ont été inclus en paraffine et coloré à l'hématéine éosine. Résultats: Le cancer du rein de l'enfant représentait 0.28de l'ensemble des cancers. Il y avait 18 garçons (52.94) et 16 filles (47.06). L'âge moyen était de 4.88 ans. Au plan histologique nous avons observé 31 cas de néphroblastome (91.18), 2 cas de lymphome de Burkitt (5.88) et 1 cas de carcinome à cellule rénale (2.94). Conclusion: Les cancers solides du rein de l'enfant sont dominés par le néphroblastome.

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Record No. 13517 Record ID 013517 Publication type Journal Article Title Clinical Presentation, Pathological Pattern and Treatment Options of Prostate Cancer at Al-Azhar University Hospitals Over the Last 30 Years Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ali, M. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(4) Pages 135-140 Language English Descriptor Prostatic Neoplasms-pathology; Prostatic Neoplasms-therapy; Signs and Symptoms Hospitals, University Descriptor-Geographic Egypt Abstract Objective: To report the clinical presentation, pathological pattern and treatment options of Prostate Cancer (PCa) cases diagnosed at Al-Azhar University Hospitals, Cairo, Egypt over the last 30 years. Patients and Methods: Case sheets and hospital records of 322 consecutive cases of prostate cancer (PCa) diagnosed over 30 years period in Al-Azhar University Hospitals (between January 1980 and December 2009) were retrospectively analyzed. One fourth of cases presented during the first 15 years from 1980 to 1994 (Group I), while the remaining majority were encountered in the following 15 years from 1995 to 2009 (Group II). Assessment included Digital Rectal Examination (DRE), Pelvi-Abdominal ultrasonography, transrectal ultrasonography (TRUS) guided prostate biopsy. Serum Prostatic Acid Phosphatase (PAP) was available for the first group, while Prostate Specific Antigen (PSA) was available only in the second group. Cases with advanced disease, pelvi-abdominal Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) and bone scan were also performed to assess staging. Results: The mean age of patients was 66.2±7 years (range 52-85). At disease presentation 90of patients were 60 years or above. Organ confined disease was encountered in 17and 45in Group I and Group II respectively. Common clinical presentations included Lower Urinary Tract Symptoms (LUTS) and urine retention. Radical prostatectomy was done in 4of Group I and 21of Group II. Most of non organ confined cases were treated by castration. At the end of follow up period 28.5of cases were living, while the remaining were dead either because of tumour related causes (31) or non tumour related causes (40). The mean follow-up period of cases was 40.39 months. Conclusion: In this cohort of cases from a tertiary care referral hospital, prostatic carcinoma is usually diagnosed late. The majority of patients presented with advanced disease where available modalities of treatment are still limited. A coordinated awareness program to educate people may be needed.

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Record No. 13516 Record ID 013516 Publication type Journal Article Title Prostate Screening Practices among Male Staff of the University of Lagos, Lagos, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ebuehi, O. M.; Otumu, I. U. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(4) Pages 122-124 Language English Descriptor Prostate; Prostatic Neoplasms; Prostate-Specific Antigen; Mass Screening; Digital Rectal Examination; Men Descriptor-Geographic Nigeria-Lagos; Abstract ntroduction: Prostate cancer is the second most common male cancer and the second leading cause of cancer related death in the world. In Nigeria it is the most common male cancer constituting 11-12of all male cancers. In most developing countries, prostate cancer screening is not widespread and men's knowledge of the disease and screening methods for early detection is limited.Objective: This study assessed the knowledge, attitude and practice of prostate cancer screening among male staff of the University of Lagos, Lagos, Nigeria. Materials and Methods: A cross-sectional descriptive study using self-administered questionnaires was carried out among 250 randomly selected male staff members of the University of Lagos aged 30 to 60 years. Data analysis was done using EPI-INFO version 2007 software statistical package. Categorical variables in groups were compared using the chi-square test. The level of significance was set at p 0.05.Results: The mean age of the respondents was 47.4±6 years. Overall, 164 (66) were aware of prostate cancer and 145 (58) were aware of prostate cancer screening methods. The commonest method known by these respondents was serum Prostate Specific Antigen (PSA) testing (59.3). Only 71 (28.4) respondents had undergone prostate cancer screening and the commonest reason for screening was on the recommendation of their doctor (47.9). Of those who did not undergo testing, 32.4were not aware of the test and in 30.2of cases their doctor did not recommend it.Conclusion: This study revealed that although the respondents were aware of prostate cancer screening, few had taken the test. Because there is insufficient scientific evidence for the justification of screening in all men, the authors recommend that informed decision making should guide a decision to obtain screening for prostate cancer. This means that men should talk with their doctors to learn the nature and risks of prostate cancer, understand the benefit and risks of screening and decide whether prostate cancer screening is right for them.

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Record No. 12746 Record ID 012746 Publication type Journal Article Title L'uréthrorraphie terminoterminale dans le traitement des retrécissements de l' urètre bulbaire et membraneux Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) El-Ammari, J.; El-Yazami, O.; El-Fassi, M.; Farih, M. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(2) Pages 66-71 Language French Descriptor Sténose de l'urètre-étiologie; Sténose de l'urètre-thérapie; Descriptor-Geographic Egypte Abstract Objectifs: Evaluer les résultats de d'urétrorraphie termino-terminale dans le traitement des sténoses de l'urètre bulbaire et membraneux à travers l'étude de la série de notre service et une revue récente de la littératurePatients et méthodes: Il s'agit d'une étude rétrospective basée sur la revue des dossiers médicaux des patients ayant bénéficiés d'une Urétrorraphie Termino-Terminale (UTT) dans notre formation entre Février 2006 et Février 2010. La moyenne d'âge des patients était de38, 3 ans. L'étiologie du rétrécissement urétral était infectieuse et traumatique respectivement dans 40et 60des cas. Chez 68d'entre eux, le rétrécissement urétral était localisé au niveau bulbaire et chez 32au niveau membraneux. Tous les patients avaient une sténoseunique inférieure à 2 cm à l'urétro-cystographie rétrograde et mictionnelle.Résultats: La durée moyenne de suivi était de 28 mois. Le taux de succès de l'urétrorraphie termino-terminale dans notre étude était de 88. 12des patients avaient présenté une récidive de la sténose. Tow patients (8) ayant une sténose bulbaire avaient rapporté des troubles éjaculatoires. Aucun de nos patients (0) n'avait présenté ni dysfonction érectile ni incontinence suite à cette intervention.Conclusion: L'urétroplastie anastomotique termino-terminale permet des taux élevés de reperméabilisation urétrale après une première procédure. Le taux de récidive de la sténose reste faible comparativement aux autres techniques chirurgicales. Les troubles éjaculatoires peuvent être prévenus par une dissection minutieuse et une restitution anatomique des muscles bulbo-caverneux.

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Record No. 12745 Record ID 012745 Publication type Journal Article Title Comparison of Pelvic Plexus Blockade to Other Conventional Techniques of Analgesia in Transrectal Ultrasound Guided Prostate Biopsy Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Sahay, S.; Gupta, N.; Singh, P. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(2) Pages 48-55 Language English Descriptor Hypogastric Plexus; Analgesia; Ultrasonography; Biopsy; Prostate Descriptor-Geographic Egypt Abstract Objectives: To compare the degree of pain, efficacy and safety of pelvic plexus block to other conventional techniques of analgesia in 12 core transrectal ultrasound guided biopsy of prostate. Materials and Methods: The study included 160 consecutive cases of prostate biopsy, prospectively randomized into four groups of 40 each -Men in group 1 (control arm) received lignocaine gel (2) only; Group 2 received lignocaine gel with basal periprostatic nerve block (BPNB) with 2lignocaine; Group 3 received lignocaine gel (2) with apical periprostatic block (APNB) with 2lignocaine and Group 4 received lignocaine gel with pelvic plexus block. Pain was recorded on a 10 point visual analogue scale by a nurse. Results: Patients in pelvic plexus block group had lowest pain score (1.25±0.43) while lignocaine injection than BPNB (1.53±0.45) and APNB (1.58±0.50, P value = 0.008). The mean pain score among 4 groups while taking the biopsy cores were 4.85, 2.67, 2.48 and 1.95, respectively. Patients who received pelvic plexus block experienced least pain than BPNB and APNB groups (p value 0.001 and 0.002, respectively). Perineal pain persisted longer in pelvic plexus block group than apical and periprostatic groups. Duration of dysuria was less in pelvic plexus nerve block group. Hematuria and rectal bleed complications were comparable in all groups. Conclusion: Prostate biopsy should be performed with either periprostatic nerve block (basal or apical) or pelvic plexus block under Doppler ultrasonography guidance. Pelvic plexus block provides superior analgesia to basal and apical periprostatic block. Electronic Access :  Full Text-1

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Record No. 12744 Record ID 012744 Publication type Journal Article Title Paratesticular Liposarcoma: what is the best Therapeutic Strategy? Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Makni, A.; Rebai, W.; Azzouz, H.; Nouira, Y.; Magherbi, H.; Jouini, M.; Kacem, M.; Safta, Z. B. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(2) Pages 56-58 Language English Descriptor Testicular Neoplasms Liposarcoma, Myxoid-diagnosis; Liposarcoma, Myxoid-therapy; Middle Aged Descriptor-Geographic Egypt Abstract Introduction: Liposarcomas are neoplasms of mesodermal origin derived from adipose tissue and correspond to 10-14of all soft tissue sarcomas. Paratesticular liposarcoma is very rare. Case report: We report a 60-year old man who presented with a left testicular tumor 20 cm in diameter. Initial incisional biopsy was reported as fibromatosis. Chest and abdominal CT scan did not show distant metastases. Through an inguinal incision orchidectomy with homolateral inguinal node dissection was performed. Histopathological examination showed a paratesticular myxoid liposarcoma. Adjuvant radiotherapy without chemotherapy was administered. The patient remains well at 11 months followup, with no evidence of recurrence. Conclusion: Complete surgical extirpation reduces the risk of local recurrence. Neoadjuvant chemotherapy or radiotherapy may reduce the tumor size, thus facilitating complete excision.

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Record No. 12743 Record ID 012743 Publication type Journal Article Title Predicting the Fragility of Renal Calculi in Response to Shock Wave Lithotripsy through their Radiographic Appearance Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Elkoushy, M. A.; Nady, M.; Abdel Hafez, A.; Salah, E. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(2) Pages 37-42 Language English Descriptor Kidney Calculi; Lithotripsy, Laser; Radiography; Ureter; Urinary Bladder Descriptor-Geographic Egypt Abstract Objectives To evaluate the radiological characteristics of renal stones on plain X-ray film of the kidneys, ureters and bladder (KUB) area as predictors of stone fragility during shock wave lithotripsy (SWL). Patients and Methods This prospective study included 336 patients who had a single renal pelvic stone =20 mm and were managed by SWL at 3 different centers. The patients were classified according to the radiological appearance of the stone on KUB film in terms of homogeneity, smoothness of the outline, and radiodensity in comparison to the last rib. The primary endpoint was the stone-free rate (SFR) within 3 months post-SWL. Multivariate regression analysis was used to compare the results. Results The overall SFR was 71.43. SFR was significantly higher in heterogeneous compared with homogenous stones (86vs. 53; p0.01) and in rough compared with smooth surface calculi (77vs. 61, p0.01). SFRs for stones with density less than, similar to or higher than that of the last rib were 82, 69and 56, respectively (p0.01). Multivariate analysis showed a positive proportional relationship between stone fragility (SWL outcome) and one or more favorable radiological criteria. Conclusion The radiological characteristics of renal calculi could predict their fragility after SWL. Stones which were heterogeneous, rough, or less dense than the last rib on KUB film were more likely to disintegrate during SWL. Electronic Access :  Full Text-1

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Record No. 12742 Record ID 012742 Publication type Journal Article Title Prise en charge du priapisme chez l'enfant, au CHU de Treichville Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Nandiolo-Anelone, K. R.; Djè, K.; Bankolé, S. R.; Mobiot, M. L. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(2) Pages 59-65 Language French Descriptor Priapisme-étiologie; Priapisme-thérapie; Évolution de maladie Gestion de la maladie Enfant Centres hospitaliers universitaires Descriptor-Geographic Côte d'Ivoire-Treichville; Abstract Objectif: Le but de cette étude est d'évaluer la prise en charge du priapisme dans notre service en vue de proposer une conduite à tenir à partir d'une revue de la littérature.Patients et méthodes: Il s'agit d'une étude rétrospective portant sur 7 dossiers de patients suivis pour priapisme dans le service de chirurgie pédiatrique du CHU de Treichville, de Janvier 2006 à Octobre 2010. Nous avons analysé: l'âge, les antecedents, le délai de prise en charge, l'étiologie, les aspects cliniques, le traitement, et l'évolution.Résultats: Il s'agissait de 7 enfants de race noire, de sexe masculin, âgés de 3 ans à 14 ans. Nous avons observé : un priapisme aigu chez 4 enfants (85.71) drépanocytaires SSFA2, un priapisme intermittent chez 2 enfants hétérozygotes AS et 1 cas de priapisme intermittent idiopathique. Le priapisme aigu a été traité chirurgicalement par shunt caverno-balanique unilatérale sans excision d'albuginée selon le procédé de Falandry. Le priapisme intermittent a été traité par l'administration orale d'étiléfrine. Après la chirurgie, nous avons observé 3 bons résultats immédiats (75) et 1 bon résultat 24 heures après. Aucune récidive ni aucun trouble de l'érection n'ont été observés après un recul moyen de 14 mois. Conclusion: Le priapisme est une complication fréquente de la drépanocytose qui doit être recherchée et traitée de façon concomitante. Nous préconisons l'injection intracaverneuse précoce d'étiléfrine suivie, en cas d'échec, par la chirurgie selon la technique de Al-gorhab modifiée Falandry. Des études doivent être effectuées afin d'apprécier le résultat à long terme, de cette technique, sur la fonction érectile. L'accent doit être mis sur la sensibilisation afin de prévenir la survenue d'une impuissance sexuelle irréversible. Electronic Access :  Full Text-1

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Record No. 12741 Record ID 012741 Publication type Journal Article Title Rectus Fascia Sling for the Treatment of Total Urethral Incontinence in Males Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Shoukry, M.; Hassouna, M.; El-Kerim, A. A.; El-Salmy, S. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(2) Pages 43-47 Language English Descriptor Urinary Incontinence-therapy; Nervous System Autoimmune Disease, Experimental Male Descriptor-Geographic Egypt Abstract Objectives: Urinary incontinence in patients with neurological disease is a major health problem. A modified rectus fascial sling has been assessed in incontinent male patients. Patients and Methods: Fourteen adult male patients with total incontinence due to neurogenic or post-traumatic and etiology were included in this study. A rectangular rectus sheath flap was harvested and defatted.The flap was placed around the bulbar urethra and sutures were passed both in front of and behindthe pubic bone. Both sutures on each side were tied to each other over the pubic bone. Results: Of the 14 patients, 9 (64.3) were completely dry, 3 (21.4) reported improved continence, while 2 (14.3) were a failure. In total, 71.4of the patients showed significant improvement using the Incontinence Quality of Life (IQoL) questionnaire. A significant decrease in the number of pads used per day of 61.3(p

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Record No. 12740 Record ID 012740 Publication type Journal Article Title Localisation intravésicale d'une broche d'ostéosynthèse (à propos d'un cas) Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Makhloufi, M.; Lahyani, M.; Karmouni, T.; El Khader, K.; Koutani, A.; Ibnattya, A.; Hachimi, M. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(1) Pages 24-27 Language French Descriptor Ostéosynthèse; Corps étranger; Administration par voie vésicale Descriptor-Geographic Egypte Abstract La variété de corps étrangers introduits dans l'appareil génito- urinaire défie l'imagination et peut confronter l'urologue aux difficultés de leur extraction. Si leur présence relève souvent d'une pratique douteuse d'origine psychiatrique, il faut noter la possibilité d'une migration à partir des espaces perivésicaux lors d'une chirurgie de voisinage ainsi qu'une introduction accidentelle durant une intervention transvésicale. Les symptômes du bas appareil urinaire, non spécifiques, sont les circonstances fortuites de découverte de corps étrangers intravésicaux. Bien que le pronostic vital ne soit pas engagé, l'extraction chirurgicale ou endoscopique s'avère nécessaire du fait de l'inflammation sévère associée aux dommages vésicaux secondaires à ce corps étranger.Nous rapportons le cas d'un jeune patient admis aux urgences chez qui on trouve une broche d'ostéosynthèse compliquée d'une lithiase située dans la vessie.

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Record No. 12739 Record ID 012739 Publication type Journal Article Title Séminome spermatocytaire: à propos d'un cas et revue de la littérature spermatocytic seminom Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Andaloussi, M. B.; Rais, G.; Raissouni, S.; Barki, A.; Sayegh, E.; Iken, A.; Nouini, Y.; Lachkar, A.; Benslimane, L.; Mrabti, H.; Errihani, H.; Faik, M. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(1) Pages 18-23 Language French Descriptor Tumeurs du testicule; Séminome; Adulte d'âge moyen; Article de revue Abstract Le séminome spermatocytaire est une tumeur rare, représentant moins de 2des cancers du testicule, survenant essentiellement chez le sujet âgé. Nous rapportons une nouvelle observation d'un patient âgé de 48 ans. La tumeur se présentait comme une prolifération de cellules en nappes compactes, avec 3 types cellulaires, des cellules de petite taille, des cellules intermédiaires et des grandes cellules. Il n'a été retrouvé ni contingent sarcomateux, ni séminome classique. L'analyse en immun histochimie n'a retrouvé aucune expression des cellules tumorales pour les anticorps classiques testés, notamment l'Ac anti PLAP et les marqueurs lymphoïdes. Le séminome spermatocytaire doit être reconnu, car son évolution est très favorable et ne nécessite qu'une simple orchidectomie, en l'absence d'un exceptionnel contingent sarcomateux ou de métastase où une chimiothérapie s'impose.

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Record No. 12738 Record ID 012738 Publication type Journal Article Title Primary Renal Leiomyosarcoma: Case Report and Literature Review Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Bhat, G. S.; Nelivigi, G. G.; Shivalingaiah, M.; Ratkal, C. S. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(1) Pages 15-17 Language English Descriptor Leiomyosarcoma; Kidney; Aged; Case Reports; Review Descriptor-Geographic Egypt Abstract Primary leimyosarcoma of the kidney is extremely rare. The management is unclear due to the limited literature on the subject. The diagnosis should be considered when imaging shows a relatively hypovascular tumor involving one renal pole, with atypical features on microscopy. We report a renal leiomyosarcoma in a 68 year old man, who underwent right radical nephrectomy. A tumor-free surgical margin is the most important prognostic factor. Although various modalities of adjuvant treatment have been tried, the overall prognosis is poor as the tumor is highly aggressive.

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Record No. 12737 Record ID 012737 Publication type Journal Article Title Retrospective Analysis of Mathieu's Urethroplasty for Anterior Hypospadias Repair in Circumcised Children: a Single Center Experience Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Salako, A. A.; Olajide, A. O.; Sowande, A. O.; Olajide, F. O. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(1) Pages 11-14 Language English Descriptor Hypospadias; Circumcision, Male; Child; Retrospective Studies; Hospitals, Teaching Descriptor-Geographic Nigeria-Ile-Ife; Abstract Introduction: Mathieu's technique (peri-meatal based flap) makes use of the urethral plate in the repair of anterior hypospadias, thereby creating an almost natural neo-urethra. In a circumcised baby or after previous unsuccessful repair, Mathieu's flap may be one of the few options left to repair anterior hypospadias. Objectives: To evaluate the result of Mathieu's flap repair for anterior hypospadias in a resource poor setting.Materials and Method: This is a retrospective review of post-circumcision anterior hypospadias managed by Mathieu's flap repair between January 1996 and December 2006 in the paediatric surgical unit of the Obafemi Awolowo University Teaching Hospital, a tertiary hospital in the South Western Nigeria. Results: Mathieu's flap repair was performed in 16 patients with isolated anterior hypospadias; 15 (93.8) were circumcised before presentation. The complications were urethrocutaneous fistula in 3 (18.8), wound infection in 2 (12.5) and flap necrosis in 1 patient (6.3). Final outcome was satisfactory in all patients. Conclusion: Mathieu's flap remains a viable option in the repair of anterior hypospadias even after circumcision.

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Record No. 12736 Record ID 012736 Publication type Journal Article Title Semiquantitative Smoothelin Expression in Detection of Muscle Invasion in Transurethral Resection and Cystectomy Specimens in Cases of Urinary Bladder Carcinoma Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Refaiy, A.; Muhammad, E.; ElGanainy, E. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(1) Pages 6-10 Language English Descriptor Smoothelin protein, mouse; Neoplasm Invasiveness; Cystectomy; Urinary Bladder Neoplasms Descriptor-Geographic Egypt Abstract Objectives: To examine the usefulness of smoothelin - a new immunohistochemical (IHC) marker that is expressed predominantly in visceral smooth muscle - in recognizing muscularis propria (MP) in transurethral resection (TUR) and matched cystectomy specimens and to compare thepattern of its expression in muscularis mucosae (MM) and MP in radical cystectomy specimens. Methods: IHC staining for smoothelin was performed in 49 cases of urothelial carcinoma removed by radical cystectomy (16 had undergone TUR before the cystectomy). Results: In cystectomy specimens, smoothelin staining in the MP was strong (+3), moderate (+2) and weak (+1) in 49, 44.9and 6.1of cases, respectively, whereas smoothelin positivity in the MM was absent and weak in 77.6and 22.4of cases, respectively. In TUR specimens, smoothelin immunoreactivity was moderate to strong in 68.8and weak in 6.3of cases and all of them proved to have MP invasion in cystectomy specimens. Conclusion: Smoothelin is a useful marker for the detection of MP in TUR specimens. Moderate to strong smoothelin staining of the muscles included in TUR specimens and split by the tumor is a sign of MP invasion. It may be useful in cancer staging and treatment decision making.

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Record No. 12735 Record ID 012735 Publication type Journal Article Title Rolled Vaginal Wall Flap for the Treatment of Stress Urinary Incontinence Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Shoukry, M.; Hassouna, M.; AbdEl-Kerim, A.; El-Salmy, S. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2011 Volume and n° 17(1) Pages 1-5 Language English Descriptor Urinary Incontinence, Stress-therapy; Suburethral Slings Descriptor-Geographic Egypt Abstract Objectives: Anterior vaginal wall slings (AVWS) have been used for decades in the treatment of female stress urinary incontinence (SUI). The main drawback of using the vaginal wall as a sling is its tendency to weaken and stretch over the course of years. The use of synthetic tapes for the treatment of SUI is effective but costly. For patients who cannot afford synthetic tapes, we describe the preliminary results of a modified AVWS technique for the treatment of SUI types II and III. Patients and Methods: In this series, a modification of the AVWS was applied in 35 female patients with SUI. A fortified and rolled flap is used to provide compression and support of the urethra. The vaginal mucosal surface of the flap is cauterized and two diagonal sutures are placed across it. The flap is then rolled on itself with a running 2/0 vicryl suture. Two sutures attached to both ends are passed retropubically to the anterior abdominal wall and tied over the rectus sheath. Results: All 35 female patients had type II/III SUI. After a median follow up of 43 months, 91of the patients were dry or used 0-1 pad per day. Only one patient suffered from transient retention for one week post-operatively. Conclusion: This is a simple method to reinforce vaginal wall flaps. It could offer a durable and effective option for the treatment of SUI in patients who can not afford synthetic tapes. Long-term follow up is required to evaluate the durability of the procedure.

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Record No. 12374 Record ID 012374 Publication type Journal Article Title Migration intravésicale du dispositif intra-utérin à propos de cinq cas Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Barki, A.; Ait Sakel, A.; Benazzouz, M. H.; Mazdar, A.; Essatara, Y. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2010 Volume and n° 16(2) Pages 60-64 Language French Descriptor Migration de dispositif intra-utérin; Lithotritie; Calculs de la vessie; Etudes de cas Descriptor-Geographic Egypte Abstract La migration intravésicale du dispositif intra-utérin (DIU) par perforation utérine est une complication rare. Dans cette étude rétrospective monocentrique, nous présentons notre expérience de 5 cas colligés au sein de notre établissement entre 2004 et 2009. L'âge moyen de nos patientes est de 39 ans (32-48 ans). La symptomatologie clinique révélatrice était dominée par le syndrome irritatif vésical. Le diagnostic a été évoqué sur le couple écho/AUSP, puis confirmé par la cystoscopie. Le traitement a consisté en une lithotritie balistique du calcul avec extraction du stérilet par voie endoscopique chez 4 patientes et extraction chirurgicale chez une seule.

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Record No. 12373 Record ID 012373 Publication type Journal Article Title Adult Patients Presenting with Undescended Testis in Awareness-Poor Region Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Osifo, O. D.; Osaigbovo, E. O. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2010 Volume and n° 16(2) Pages 39-45 Language English Descriptor Cryptorchidism; Awareness; Adult; Patients; Poverty Areas; Adult Descriptor-Geographic Nigeria-Evbuomore; Abstract Objectives The majority of patients with undescended testis present during childhood with minimal complications owing to straightforward treatment with excellent postoperative outcome. This paper reports the mode of presentation, challenges and outcome of management of adult patients with undescended testis. Methods. This prospective study included consecutive cases of adult patients managed with undescended testis from January 2004 to December 2008 in Evbuomore, Nigeria. Results Eighteen adults with a mean age of 38.3 years (range 19-61) were managed during the period. Ten (55.5) had bilateral, 5 (27.8) right and 3 (16.7) left lesions. Awareness was poor as they presented due to infertility in 8 (44.4), associated hernia 5 (27.8), wife/self discovery 4 (22.2) and accidental discovery by a health worker 1 (5.6), with 9 men (50) presenting between 30 and 40 years of age. On inguinal exploration, only 3 (10.7) patients had viable but significantly reduced testicular volume, 17 (60.7) were atrophic/fibrotic while in 8 (28.6) the vas deferens ended blindly in the inguinal canal with no viable testicular tissue. Apart from three patients who had children before presentation, infertility persisted even after treatment despite adequate hormone profiles and satisfactory sexual performance. Counseling of spouses was a major challenge, with 8 couples adopting children and three marriages ending in separation. conclusion: Management of adults with undescended testis was challenging due to irreversible complications, psychological effects and poor outcome of treatment which shows the importance of awareness programs that will result in childhood presentation.

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Record No. 12372 Record ID 012372 Publication type Journal Article Title Inner Preputial Flap as Tunica Albuginea Replacement in the Management of Previously Untreated Fracture of the Penis Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Bhat, A.; Sharma, B.; Dawan, M.; Saxena, G. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2010 Volume and n° 16(2) Pages 33-38 Language English Descriptor Penile Induration-therapy; Foreskin Surgical Flaps Disease Management Descriptor-Geographic Egypt Abstract To assess the efficacy of an inner preputial skin flap as replacement for the tunica albuginea of the corpus cavernosum after excision of fibrous plaque. Patients and Methods In this retrospective study we evaluated 5 men who presented with impotence, chordee, painful erection and/or painful coitus after previously undiagnosed or untreated penile fracture. In two patients soft tissue X-rays suggested calcification of the plaque, while ultrasonography revealed extension of fibrosis in four cases. In all patients the plaque was excised and the defect in the tunica albuginea was closed with an inner preputial pedicle skin flap. Results The flaps had taken well in all cases at 3 months follow-up and all patients reported having normal sexual intercourse. Conclusion Surgical excision is the treatment of choice for management of symptomatic fibrous plaques occurring in undiagnosed, untreated or conservatively managed penile fracture. A defect of more than 1.5 cm after excision of the plaque requires tunica replacement, and an inner preputial flap is a good replacement.

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Record No. 12371 Record ID 012371 Publication type Journal Article Title Le kyste hydatique du rein fistulisé dans les voies urinaires, prise en charge diagnostique et thérapeutique à propos de 14 cas Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Soufiane, M.; Mustapha, A.; Youness, A.; Mohamed Fadl, T.; Mohamed El Jamal, fassi Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2010 Volume and n° 16(1) Pages 27-32 Language French Descriptor Échinococcose-diagnostic; Rein Voies urinaires Prise en charge personnalisée du patient Descriptor-Geographic Maroc Abstract Objectif l'hydatidose est une pathologie fréquente au Maroc et constitue un problème majeur de santé publique. La localisation rénale de cette parasitose est rare. Les formes s'accompagnant de plus d'une fistulisation dans les voies excrétrices présentent des particularités diagnostiques et thérapeutiques qui seront décrites dans cet article. Patients et méthodes 14 patients présentant un kyste hydatique du rein fistulisé dans la voie excrétrice urinaire ont été inclus dans l'étude de 2002 à 2008. Les variables étudiées ont été: l'âge moyen, les antécédents, la symptomatologie clinique, l'imagerie, le traitement et l'évolution. Résultats L'âge moyen était de 38 ans (21-54). La douleur lombaire a été retrouvée chez tous les patients et l'hydaturie chez 8 patients. L'échographie réalisée chez tous les patients a montré 6 cas de kyste hydatique de type III et 8 cas de type IV selon la classification de GHARBI. L'uroscanner a confirmé la nature hydatique de la masse et deux cas de rein non fonctionnel. L'hydaturie et la dilatation des cavités excrétrices ont été les principaux éléments orientant vers le diagnostic. Le traitement a consisté en une résection du dôme saillant et la fermeture de la fistule chez 12 patients; huit d'entre eux ont eu une néphrostomie per-opératoire après cure de la fistule et deux patients une montée de sonde urétérale double crosse en pré-opératoire, les deux autres n'ont pas été drainés. Les deux patients restant ont eu une néphrectomie. Les suites ont été marquées par une fistule stercorale colique chez un patient et deux cas d'infection de paroi. Conclusion Tout kyste hydatique du rein doit avoir un bilan d'imagerie comportant un uroscanner avec des clichés tardifs à la recherche d'une fistulisation dans la voie excrétrice urinaire. Il est conseillé de mettre en place une sonde urétérale en préopératoire à visée diagnostique et thérapeutique.

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