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Record No. 10657 Record ID 010658 Publication type Journal Article Title Tumeurs des deux surrénales. A propos d'un cas Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) El Baghouli, M.; Debbagh, A.; Elmessaoudi, Y.; Bennani, S.; Meziane, F. Journal Title African Journal of Urology Place of Publication Cairo Publisher Enstinet Date of publication 2009 Volume and n° 15(2) Pages 135-142, fig. Language French Descriptor Tumeurs de la surrénale; Phéochromocytome; Etudes de cas Descriptor-Geographic Maroc-Casablanca; Abstract Les tumeurs surrénaliennes bilatérales sont rares. Nous rapportons un cas de phéochromocytome surrénalien associé à un corticosurrénalome controlatéral chez une patiente de 65 ans. L'association d'une hypertension artérielle à des céphalées, sueurs, et palpitations a orienté vers le diagnostic de phéochromocytome. Le bilan biologique basé sur le dosage urinaire des dérivés méthoxylés a confirmé ce diagnostic. L'échographie et le scanner ont montré la présence de deux masses surrénaliennes bilatérales de structure tissulaire. Les deux masses sont discrètement rehaussées après injection du produit de contraste. Devant ce tableau clinique, biologique et morphologique, le diagnostic de phéochromocytome surrénalien bilatéral est retenu. Par conséquent une surrénalectomie bilatérale par voie bi-sous-costale a été réalisée. L'examen anatomopathologique a révélé la coexistence d'un phéochromocytome sur la pièce de surrénalectomie droite et d'un carcinome corticosurrénalien sur la pièce de surrénalectomie gauche, ce qui était imprévu. Les suites opératoires ont été bonnes, sans récidive, avec un recul de 4 ans. A la lumière de cette observation et d'une revue de la littérature, nous discutons les différentes caractéristiques de cette association inhabituelle.

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Record No. 10656 Record ID 010657 Publication type Journal Article Title Les traumatismes des bourses Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Odzébé, A. W.; Bouya, P. A.; Banga, M. R. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2009 Volume and n° 15(2) Pages 130-134, fig., tab. Language English Descriptor Plaies et lésions traumatiques; Testicule; Scrotum Descriptor-Geographic Congo-Brazzaville; Abstract Objectif: Evaluer les caractéristiques épidémiologiques, cliniques, paracliniques et thérapeutiques des traumatismes des bourses dans le service d'urologie - andrologie du CHU de Brazzaville Patients et méthodes: Etude rétrospective portant sur 18 patients hospitalisés pour un traumatisme des bourses entre janvier 1990 et décembre 2006. Les paramètres analysés ont été: la fréquence, l'âge, les étiologies, le motif et délai de consultation, les résultats de l'examen clinique, les données échographiques, le protocole de traitement adopté et l'évolution. Résultats: Les traumatismes des bourses représentaient 0,4des hospitalisations au CHU de Brazzaville. L'âge moyen des patients était de 34,6 ans (extrêmes 9 et 64 ans). Les traumatismes par accident de la voie publique (8 cas) et ceux du travail (5 cas) étaient les principales causes. Le délai moyen de consultation était de 3 jours pour les traumatismes fermés (12 cas) et une heure pour les traumatismes ouverts (6 cas). Le principal motif de consultation était la douleur scrotale (n=10). L'échographie réalisée chez 8 patients a mis en évidence: 4 cas de rupture de l'albuginée, 2 cas d'hématomes intra testiculaires et 2 cas d'hématocèle. Le traitement a été médical dans 6 et chirurgical dans 12 cas. Les interventions ont consisté en la résection de la pulpe extériorisée et suture de l'albuginée (n=4), une orchidopexie (n=1), une orchidectomie (n=3), une évacuation d'un hématocèle (n=2) et un drainage d'un hématome testiculaire (n=2). A long terme, des douleurs testiculaires résiduelles ont été observées chez 3 patients, une ligoasthénozoospermie chez 3 patients, une atrophie testiculaire chez 2 patients et un cas de dysfonction érectile. Conclusion: Une exploration chirurgicale doit être réalisée en cas d'hématocèle. L'échographie, entre des mains entrainées, peut faire le diagnostic de rupture de l'albuginée testiculaire cependantcet examen ne doit pas retarder la prise en charge au bloc opératoire.

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Record No. 10655 Record ID 010656 Publication type Journal Article Title Traitement de l'incontinence urinaire post-opératoire de l'homme par bandelette sous urétrale: à propos de 16 cas Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Hidoussi, A.; Jaidane, M.; Slama, A.; Kalel, Y.; Sorba, N. B.; Mosbah, A. F. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2009 Volume and n° 15(2) Pages 124-129, tab. Language French Descriptor Incontinence urinaire-thérapeutique; Prostate Etudes de cas Descriptor-Local Bandelette sous urétrale Descriptor-Geographic Tunisie Abstract Objectif: Evaluer les résultats préliminaires de la mise en place d'une bandelette sous urétrale pour le traitement d'incontinence urinaire suite à une chirurgie prostatique chez l'homme selon la technique de Comiter modifiée (sans vissage osseux). Patients et méthodes: Entre janvier 2005 et décembre 2006, 16 patients ont été pris en charge pour incontinence urinaire qui apparut après chirurgie prostatique. Une bandelette de polypropylène fixée sur le périoste des branches ischio-pubiennes par des fils de nylon et comprimant l'urètre bulbaire a été mise en place. L'évaluation pré et post-opératoire a été basée sur l'examen clinique et le nombre de protections utilisées par jour. Les patients ont été revus à un mois post-opératoire, puis tous les trois mois. Résultats: Avec un recul moyen de 18 mois, 11 patients sont continents ne nécessitant pas de protection et 3 patients sont nettement améliorés. Un échec a été noté chez un patient qui avait présenté initialement une incontinence sévère. Un autre patient a développé une infection de la bandelette nécessitant son retrait et a été exclus de la série pour l'évaluation fonctionnelle. Nous n'avons pas constaté de douleurs périnéales persistantes ni d'érosion urétrale ni d'ostéite. Conclusion: Notre modification de la technique selon Comiter semble avoir des résultats satisfaisants comparables avec la technique originale. Elle présente un avantage économique certain par rapport à d'autres kits du marché

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Record No. 10654 Record ID 010655 Publication type Journal Article Title Etude rétrospective de la lithiase urinaire dans l'Hôpital Hassan II de la province de Settat (Maroc) Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Laziri, F.; Rhazifilali, F.; Amchhoud, I. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2009 Volume and n° 15(2) Pages 117-123, tab. Language English Descriptor Lithiase; Études épidémiologiques; Études rétrospectives; Service hospitalier Descriptor-Geographic Maroc-Settat; Abstract Objectif: Cette étude épidémiologique de la lithiase urinaire est la première réalisée au Maroc. Elle se propose d'étudier la fréquence et les caractéristiques de cette maladie dans notre population Matériel et méthodes: Il s'agit d'une étude rétrospective hospitalière portant sur une période de quatre ans de 1999 à 2002 dans les différents services de l'hôpital Hassan II de Settat et tenant compte de trois facteurs étudiés: sexe, âge et la saison de diagnostic. Résultats: Nous avons montré que cette maladie lithiasique a un caractère dominant chez l'homme. Elle survient le plus souvent chez des patients âgés entre 30 et 50 ans. Le nombre de sujets lithiasiques en consultation augmente en automne. Malgré les difficultés méthodologiques rencontrées dans cette étude, nous avons rapporté que le taux annuel moyen d'incidence hospitalière est estimé à 30 p 100000 (consultation et chirurgie) et que la fréquence annuelle varie selon les services de 0.01 à 0.5. Mais ces deux paramètres sont vraisemblablement sous estimés. Conclusion: La proportion des patients lithiasiques doit être connue avec plus de précision. Ceci nécessite une collaboration de la part des médecins, une coopération entre les différents services de chirurgie, de radiologie et de consultation dans les secteurs publics et privés

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Record No. 10653 Record ID 010654 Publication type Journal Article Title Pseudotumoral Malacoplakia of the Bladder Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ammani, A.; Ghadouane, M.; Janane, A.; Ameur, A.; Abbar, M.; Moufid, K. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2009 Volume and n° 15(2) Pages 107-110, fig. Language English Descriptor Malacoplakia; Urinary Bladder; Case Reports Descriptor-Geographic Morocco-Rabat; Abstract Malacoplakia is a rare inflammatory condition most often affecting the genitourinary system. We report the case of a 24-year-old man who presented with gross hematuria, nocturia, frequency, dysuria and considerable weight loss during the preceding three months. Digital rectal examination showed a solid pelvic mass. Ultrasonography and computed tomography showed calyceal dilatation on the right side and a solid bladder mass 10 cm in diameter suspicious of bladder cancer. Transurethral resection of the tumor was incomplete, due to the large volume of the bladder mass. Histological examination of the resected specimen revealed malacoplakia of the bladder. The patient was treated with fluoroquinolone and vitamin C. Follow-up at 3 months showed marked regression of the bladder mass and complete resolution of the calyceal dilatation.

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Record No. 10652 Record ID 010653 Publication type Journal Article Title Challenges of Surgical Repair of Hypospadias in Ile-Ife, Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Olajide, A. O.; Sowande, A. O.; Salako, A. A.; Olajide, F. O.; Adejuyigbe, O. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2009 Volume and n° 15(2) Pages 96-102, tab., fig. Language English Descriptor Hypospadias; Urogenital Surgical Procedures; Cryptorchidism Descriptor-Geographic Nigeria-Ile-Ife; Abstract Objective: To document the presentation, outcome and challenges of management of hypospadias in a resource-limited setting. Patients and Methods: For this retrospective study we analyzed the files of all patients with hypospadias managed at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria between 1996 and 2006. The parameters studied were the patients' bio-data, clinical presentation, treatment and outcome. Results: During the 10-year period under review 51 cases of hypospadias were managed. The majority of the patients (n=39, 76.5) presented within the first year of life with a mean age at presentation of 1 year and 8 months, though most of the repairs were done in the 2nd, 3rd and 4th years of life. Of the 51 patients 46 (90.2) came from rural and semi-urban areas and 18 (35.3) had been circumcised before presentation. Surgical repair consisted of preputial island flap in 22 patients (43.1) followed by a peri-meatal based flap (Mathieu procedure) in 16 patients (31.4). The MAGPI procedure was used in 5 patients (9.8) and the Snodgrass procedure in 1 (2). Staged repair was necessary in 7 patients (13.7). Post-operative complications were encountered in 15 patients with urethrocutaneous fistula being the commonest one (11 patients, 21.6). Conclusion: Our results show that hypospadias can be successfully managed in a low- resource setting.

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Record No. 10651 Record ID 010652 Publication type Journal Article Title Non-Tensile Tunica Albuginea Plication for the Correction of Penile Curvature Source of Record WHO Regional Office for Africa, WR/Guinea Author(s) Ismail, H. R.; Youssef, M.; Sakr, M.; Hussein, T.; Zahran, A. M. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2009 Volume and n° 15(2) Pages 88-95 Language English Descriptor Penile Induration; Urologic Surgical Procedures; Postoperative Complications Descriptor-Local Tunica Albuginea Plication Descriptor-Geographic Egypt Abstract Objective: To evaluate the efficacy of non-tensile tunica albuginea plication (NTTAP) using nonabsorbable sutures for the correction of congenital and acquired penile curvature and to determine the key points for a successful outcome of this procedure. Patients and Methods: From June 2004 to July 2007, 43 patients with penile curvature (35 congenital and 8 secondary to Peyronie's disease) underwent surgical correction by NTTAP. The indications were difficult or impossible vaginal penetration, and a cosmetically unacceptable penis. For tunica albuginea plication (TAP) we applied the 16 dot procedure using non-absorbable sutures (Tycronr 2/0 polyester fiber). Results: After a mean follow-up period of 18 months, successful results with respect to penile straightening, normal erection, penetration and sensation, confirmed both subjectively and objectively, were achieved in all patients. Post-operative penile shortening of less than 1.5 cm was present in 50of the cases, but did not affect intercourse. Post-operative complications were mild and reversible; they consisted of penile skin necrosis after circumcising incisions and post-operative pain upon nocturnal erection that subsided after a few weeks with the frequent use of ice compresses. The overall satisfaction rate was nearly 100(35/43 very satisfied and 8/43 satisfied). Conclusion:NTTAP is a simple and effective method for the correction of congenital and acquired penile curvature. The key points for successful appropriate expectations, and careful discussion of the location of the suture sites. There is no need for mobilization of the urethra or neurovascular bundle, which adds a great advantage to this easy and simple technique. Cutting through the tunica albuginea, which may prevent postoperative erectile dysfunction, is not necessary. A disadvantage of this procedure is that it cannot correct hour-glass deformity.

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Record No. 10650 Record ID 010651 Publication type Journal Article Title The Pattern of Urological Cancers in Zambia Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Bowa, K.; Kachimba, J. S.; Labib, M. A.; Mudenda, V.; Chikwenya, M. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2009 Volume and n° 15(2) Pages 84-87 Language English Descriptor Urologic Neoplasms; Prostatic Neoplasms; Carcinoma, Squamous Cell Descriptor-Geographic Zambia Abstract Objective: To examine the pattern of urological malignancies, particularly cancer of the bladder, seen at the University Teaching Hospital (UTH) in Lusaka and to compare the findings with previous studies on the same parameters done at UTH. Material and Methods: A retrospective study of urological cancers in Zambia was performed, based on histopathology reports of specimens reviewed at the UTH Pathology Laboratory in Lusaka, Zambia, between January 1990 and December 2005. The parameters studied were the histological type of the cancer, patient age and trends over a 15-year period. Results: In total, 8829 cancers were diagnosed during the study period, of which 749 (8.5) were urological malignancies affecting the kidney, bladder, prostate, testis or penis. The maleto- female ratio of the urological cancers was 10.7 to 1. Cancer of the prostate was the most common urological malignancy (54.6), followed by bladder cancer (21.1) and penile cancer (18.6). The histological type of bladder cancer was mainly squamous cell carcinoma (46.2), transitional cell carcinoma (23.4) and adenocarcinoma (22.2); other types (8.2) included rhabdomyosarcoma, small cell carcinoma and lymphoma. The majority of patients (79) with bladder cancer were between 56 and 65 years of age. Whereas 20 years ago prostate cancer comprised only 26of urological malignancies, it accounted for 55of urological cancers diagnosed in Zambia between 1990 and 2005. In contrast, cancer of the penis, kidney and testis have shown no change in frequency distribution compared to 20 years ago. Conclusion:Over the last 15 years there has been an increasing proportion of cancer of the prostate and squamous cell carcinoma of the bladder. This is associated with high levels of schistosomiasis, cystitis (some of which is HIV-related) and bladder stones. It may also be due to the extension of urological services and the diagnostic armamentarium (PSA, cystoscopy and histological diagnosis) to indigent rural populations, where the incidence of squamous cell carcinoma is likely to be higher than in affluent urban populations.

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Record No. 9608 Record ID 009608 Publication type Journal Article Title Les traumatismes de l'appareil génito-urinaire : aspects épidémiologiques et lésionnels Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Dekou, A.; Konan, P. G.; Kouame, B.; Vodi, C.; Ouegnin, G. A.; Kouame, N.; Manzan, K.; Djedje, M. A. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2008 Volume and n° 14(2) Pages 105-113, fig., tab. Language French Descriptor Appareil urogénital Plaies et lésions traumatiques-épidémiologie; Accidents de la circulation Descriptor-Geographic Côte d'Ivoire-Abidjan; Abstract Objectif: Analyser la fréquence, les étiologies et les types de lésions observées lors des traumatismes de l'appareil urinaire et génital. Patients et méthodes: Etude rétrospective portant sur 38 victimes de traumatisme de l'appareil génito-urinaire traités entre avril 2000 et décembre 2006 au CHU de Cocody, Abidjan, Côte d'Ivoire. Les paramètres étudiés ont été: l'âge, le sexe, la profession, les causes des traumatismes, le type de lésions constatées, les interventions chirurgicales réalisées l'ensemble répertorié sur des fiches de recueil. Résultats: 38 victimes de traumatisme de l'appareil génito-urinaire ont été enregistrées sur l'ensemble des 16425 traumatisés, soit une prévalence de 0,2. Il s'agissait de 37 hommes et d'une femme avec un âge moyen de 26,9 ans (extrêmes: 5-63 ans). Les patients étaient pour la plupart victimes d'accidents de la voie publique (AVP) (16 cas; 42,1), ensuite 11 patients (28,9) ont eu un accident de travail. Les agressions étaient responsables de 9 victimes soit 23,7des traumatisés urogénitaux. Chez 2 patients (5,3) le traumatisme a été engendré par un accident de sport. L'urètre et la vessie étaient le plus souvent atteints (81,6des cas), pendant que les traumatismes du rein et des organes génitaux externes ont été observés respectivement dans 7,9et 10,5des cas. 25 cas (65,8) ont eu des fractures de bassin associées. Tous les traumatismes étaient directs dont 29 fermés (76,3) et 9 pénétrants (23,78). Les gestes chirurgicaux réalisés étaient en particulier les urétrorraphies termino-terminales (20 cas; 52,6). Conclusion : les traumatismes de l'appareil uro-génital sont rares, surviennent surtout chez les hommes jeunes victimes d'accidents de la voie publique et de travail. Ces traumatismes peuvent être responsables de séquelles fonctionnelles invalidantes

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Record No. 9607 Record ID 009607 Publication type Journal Article Title Management of Complex Urogenital Fistulae in the Female Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Al Rifaei, M. A.; Al Rifaei, A. M.; El Salmy, S. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication 14(2)Cairo Publisher 90-97, fig., tab.Enstinet Date of publication 2008 Language English Descriptor Female Urogenital Diseases; Urinary Fistula; Hysterectomy Descriptor-Geographic Egypt Abstract Objective: To present our experience in the management of complex genitourinary fistulae in the female. Patients and Methods: Between 1995 and 2004, 12 female patients with a mean age of 30 (range 6 - 40) years were managed in our department for various types of complex genitourinary fistulae caused by difficult labor in 6 cases, abdominal hysterectomy in 5 cases and car accident in one case. All patients were subjected to clinical, radiological and endoscopic examination. The fistulae were managed by open surgery. The procedures were individualized according to the existing pathology and included bladder augmentation and construction of a bladder tube. Results: The fistulae were repaired successfully and socially acceptable continence was achieved in all patients. Conclusion: Through urological evaluation of complex urinary fistulae is recommen- ded. The treatment should be individualized based on the existing pathology and may include bladder augmentation and construction of a bladder tube

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Record No. 9606 Record ID 009606 Publication type Journal Article Title Pathologic Pattern of Invasive Bladder Carcinoma: Impact of Bilharziasis Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Khalaf, I.; El-Mallah, E.; Elsotouhi, I.; Abu-Zeid, H.; Elmeligy, A. Journal Title African Journal of Urology ISSN 1110-5704 Date of publication 2008 Volume and n° 14(2) Pages 90-97, fig., tab. Language English Descriptor Urinary Bladder; Carcinoma, Squamous Cell; Carcinoma, Transitional Cell; Schistosomiasis; Cystectomy Descriptor-Geographic Egypt-Cairo; Abstract Objective: To describe the pathologic pattern of invasive bladder carcinoma in cystectomy specimens in relation to bilharziasis. Patients and Methods: Between April 2002 and October 2006, 148 consecutive patients with invasive bladder cancer were subjected to radical cystectomy and orthotopic sigmoid bladder substitution at Al-Azhar Urology Department, Cairo, Egypt. A retrospective computerized data- base analysis of the pathologic features of the cystectomy specimens was done focusing on the impact of bilharziasis on the pathology of bladder carcinoma. The tumor cell type, stage, grade and gross features in addition to lymph node involvement were particularly noted. Results: Bilharzial bladder pathology (lesions or ova) was present in 105 (70.9) of 148 cystectomy specimens. Tumor histology included transitional cell carcinoma (TCC) in 84 (56.7), squamous cell carcinoma (SCC) in 51 (34.5), adenocarcinoma in 9 (6.1) and anaplastic tumor in 4 (2.7) of these specimens. Most tumors associated with bilharziasis were bulky and appeared fungating or ulcerative. The pathologic tumor stage was pT2 in 23, pT3 in 70.9and pT4a involving the prostate or seminal vesicles in 6.1. None of these pT4a tumors were SCC. The tumor grade was described as low grade in 72 (48.6) and high grade in 76 (51.4) specimens. Regional lymph node involvement was detected in 31 (20.9) specimens irrespective of bilharzial infestation. Conclusion: Invasive bladder carcinoma associated with bilharzial pathology is mainly stage pT3, low-grade SCC and commonly appears as an ulcerative, bulky, fungating or verrucous mass. On the other hand, bladder carcinoma not associated with bilharziasis is mainly high-grade TCC and commonly appears as nodular or fungating lesions. Positive surgical margin and lymph node involvement are unrelated to bilharzial infestation.

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Record No. 9605 Record ID 009605 Publication type Journal Article Title Comparison of Prostatic Volume Measured with Abdominal Ultrasound and Prostatic Weight Determined after Open Enucleation Performed in Gondar University Hospital, Ethiopia Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Getahun, G. M.; Kebede, A. G. Journal Title African Journal of Urology ISSN 1110-5704 Date of publication 2008 Volume and n° 14(2) Pages 90-97, fig., tab. Language English Descriptor Prostatic Hyperplasia; Ultrasonography; Research Design Descriptor-Geographic Ethiopia-Gondar; Abstract Objective: To describe the pathologic pattern of invasive bladder carcinoma in cystectomy specimens in relation to bilharziasis. Patients and Methods: Between April 2002 and October 2006, 148 consecutive patients with invasive bladder cancer were subjected to radical cystectomy and orthotopic sigmoid bladder substitution at Al-Azhar Urology Department, Cairo, Egypt. A retrospective computerized data- base analysis of the pathologic features of the cystectomy specimens was done focusing on the impact of bilharziasis on the pathology of bladder carcinoma. The tumor cell type, stage, grade and gross features in addition to lymph node involvement were particularly noted. Results: Bilharzial bladder pathology (lesions or ova) was present in 105 (70.9) of 148 cystectomy specimens. Tumor histology included transitional cell carcinoma (TCC) in 84 (56.7), squamous cell carcinoma (SCC) in 51 (34.5), adenocarcinoma in 9 (6.1) and anaplastic tumor in 4 (2.7) of these specimens. Most tumors associated with bilharziasis were bulky and appeared fungating or ulcerative. The pathologic tumor stage was pT2 in 23, pT3 in 70.9and pT4a involving the prostate or seminal vesicles in 6.1. None of these pT4a tumors were SCC. The tumor grade was described as low grade in 72 (48.6) and high grade in 76 (51.4) specimens. Regional lymph node involvement was detected in 31 (20.9) specimens irrespective of bilharzial infestation. Conclusion: Invasive bladder carcinoma associated with bilharzial pathology is mainly stage pT3, low-grade SCC and commonly appears as an ulcerative, bulky, fungating or verrucous mass. On the other hand, bladder carcinoma not associated with bilharziasis is mainly high-grade TCC and commonly appears as nodular or fungating lesions. Positive surgical margin and lymph node involvement are unrelated to bilharzial infestation

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Record No. 9604 Record ID 009604 Publication type Journal Article Title Experience with Penile Circular Fasciocutaneous Flap in the Treatment of Long Anterior Urethral Strictures Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Abdalla, M. A. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2008 Volume and n° 14(2) Pages 81-85, fig., tab. Language English Descriptor Urethral Stricture; Surgical Flaps; Penile Disease Descriptor-Local Fasciocutaneous Flap Descriptor-Geographic Egypt-Assuit; Abstract Objective: To evaluate our experience with penile circular fasciocutaneous flap urethroplasty for the repair of long penile and bulbar strictures. Patients and Methods: Between February 2003 and April 2005, a total of 21 circumcised patients with a mean age of 39 (range 11 - 79) years underwent penile circular fasciocutaneous flap urethroplasty for urethral strictures involving the penile and bulbar tracts. The average stricture length was 7 cm. Follow-up included retrograde urethrography at 3 weeks, 3 months and 12 to 18 months, and thereafter when needed, and evaluation of the urinary flow. The mean follow-up was 25.6 months (range 7 to 44 months). The clinical outcome was defined as success when the patient had a good urinary stream, a post void residual urine 50 cc, a peak urinary flow speed 20 ml/sec, a normal and smooth caliber of the urethra as shown on retrograde urethrography and no urinary tract infection. Results: Our initial success rate was 86(18/21 patients). An immediate successful outcome was achieved in 15/21 (71) patients. Three patients had an unsatisfactory urinary stream in the immediate post-operative period which resolved after a single dilation or optical urethrotomy. With a mean follow-up of 26 months 2 patients developed a stricture at the proximal site of the repaired urethra necessitating resection and re-anastomosis. One patient with lichen sclerosus developed recurrence of the stricture and was subjected to suprapubic cystostomy, then further staged reconstruction was done. Immediate post-operative complications were encountered in 4 patients in the form of secondary hemorrhage, ischemia and sloughing of the penile skin, urethrocutaneous fistula which closed sponta-neously and a decreased sensation at the lower limb in one patient each. Conclusion: Circular fasciocutaneous flap urethroplasty is a highly effective single-stage method of reconstructing long urethral strictures. It provides ample tissue for urethral substitution.

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Record No. 9603 Record ID 009603 Publication type Journal Article Title Hinged Transpubic Approach to Delayed Repair of Posterior Urethral Distraction Defects Complicating Pelvic Fractures - Preliminary Experience Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Essiet, A.; Ekwere, P. D.; Ikpeme, I. A. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2008 Volume and n° 14(2) Pages 75-80 Language English Descriptor Urethra; Urethral Stricture; Pelvis; Wounds and Injuries; Rupture Abstract Objective: To present our experience with a transpubic approach to the management of one of the most challenging injuries of the lower urinary tract. Patients and Methods: Between January 2003 and December 2005, 7 patients presenting to our unit with complex urethral distraction defects due to type 2 or 3 posterior urethral disruption injuries complicating pelvic fracture were included in an ongoing evaluation of the transpubic approach to the repair of such defects. The patients had a mean age of 37.7 (range 22 - 56) years and were followed up for 1 - 4 years. Results: After the follow-up period 4 patients had a very successful outcome with trouble-free voiding. Three developed stric-tures, two of which were successfully managed with regular dilatation, while the third patient became catheter-dependent following dilatation and inadvertent creation of a false passage. This patient underwent a successful re-operation with full recovery. Conclusion: The transpubic approach to delayed repair of urethral distraction defects complicating pelvic fracture is feasible. It allows an effective dissection of the dense hematoma-fibrosis that commonly complicates these injuries at a later stage. The approach is particularly useful in complex long-standing defects where such dissection is made relatively easy by the ample working space provided. The successful outcome of treatment by this approach in 4 and ultimately 5 out of 7 patients offers a reasonable degree of salvage for patients with an otherwise poor prognosis. Further studies are warranted to confirm our positive results.

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Record No. 9602 Record ID 009602 Publication type Journal Article Title Is Prostate Cancer more Common and more Aggressive in African Men? Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Heyns, C. F. Journal Title African Journal of Urology ISSN 1110-5704 Place of Publication Cairo Publisher Enstinet Date of publication 2008 Volume and n° 14(2) Pages 66-74, tab. Language English Descriptor Prostatic Neoplasms-epidemiology; Prostatic Neoplasms-diagnosis; Prostatic Neoplasms-therapy; Men African Continental Ancestry Group Descriptor-Geographic Africa Abstract The highest prostate cancer incidence and mortality rates in the world have been reported among Black African-American men (AAM) living in the United States of America. These rates are significantly higher for AAM compared to White (Caucasian) American men (CAM). However, prostate cancer is not the only malignancy which is more common in AAM compared to White American men or women. Although prostate cancer has the highest Black/White mortality ratio, it is not the only malignancy which has a higher mortality in AAM compared to CAM. Numerous reports have shown that AAM present with higher grade and stage tumors, higher serum PSA levels, and that they are less likely to receive definitive or curative treatment and have a worse prognosis compared with CAM. It has been suggested that prostate cancer is not only more common, but also more biologically aggressive in AAM compared with CAM. Hypotheses attempting to explain this include genetic differences, dietary factors, higher testosterone levels or increased androgen receptor activity. However, the majority of reports from the USA indicate that, when controlled for major prognostic factors, the outcome for clinically localized as well as advanced prostate cancer does not depend on race. Several studies have indicated that socio- economic factors, decreased awareness of prostate cancer and limited access or decreased utilization of health care contribute to the poorer outcomes in AAM. Earlier studies have suggested that prostate cancer is relatively rare among indigenous Black men living in Africa. However, cancer incidence data in Africa are likely to underestimate the true rates because of underdiagnosis and underreporting. The frequency distribution of cancers in African countries, as well as more recent data indicate that prostate cancer is not rare among Black men living in Africa and that the incidence is probably similar to that of White men, although not as high as that reported for Black men living outside Africa. It is well documented that African men with prostate cancer present with more advanced disease and that palliative rather than curative treatment is used in the majority of patients. There are no reliable age-adjusted prostate cancer mortality rates available for African countries. However, there is as yet no evidence that prostate cancer in Black men living inside Africa is biologically more aggressive than in other populations.

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Record No. 8633 Record ID 008633 Publication type Journal Article Title Kyste hydatique du rein : à propos de 49 cas Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Fredj, N.; Touffahi, M.; Mbarek, I. H.; Saidi, R.; Farhane, S.; Hafsa, C.; Golliet, M.; Saad, H. Journal Title African Journal of Urology ISSN 1595-8272 Date of publication 2007 Volume and n° 13(2) Pages 157-164, tab., fig. Language French Descriptor Échinococcose-diagnostic; Échinococcose-thérapeutique; Rein Descriptor-Geographic Tunisie Abstract Objectif : L'hydatidose rénale est relativement rare par rapport à celle du foie et du poumon. A travers notre expérience dans la prise en charge de 53 kystes hydatiques du rein (KHR) dans 49 patients, nous discutons les modalités diagnostiques et les indications thérapeutiques actuelles de cette affection.Patients et méthodes : Les dossiers de 27 femmes et 22 hommes opérés pour des KHR entre 1986 et 2005 ont été revus afin d'étudier les principales circonstances de découverte, les données radiologiques, les tests sérologiques et les résultats de la chirurgie. L'âge moyen des patients était de 41 ans avec des extrêmes allant de 20 à 73 ans. Tous les patients ont été traités chirurgicalement à l'exception de 2 kystes de type V. Le traitement percutané et le traitement médical antiparasitaire ont été utilisés seulement dans les récidives hydatiques.Résultats: La symptomatologie clinique était dominée par la douleur du flanc (79,6) des cas) et une masse lombaire ou abdominale (59,2des cas). Le diagnostic préopératoire a été basé sur les données de l'échographie et la sérologie. La tomodensitométrie s'avérait nécessaire chaque fois que le diagnostic demeurait incertain (36,8des cas). Le traitement de choix était la chirurgie ouverte conservatrice, réalisée dans 96,2des cas. Les suites opératoires étaient généralement simples .Conclusion : Le KHR est rare. Son diagnostic est basé sur des arguments épidémiologiques, cliniques, radiologiques et biologiques. Le traitement percutané constitue une bonne alternative à la chirurgie et doit être considéré, si disponible, comme le traitement de première intention des KHR.

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Record No. 8632 Record ID 008632 Publication type Journal Article Title Traumatismes des bourses : à propos de 14 Observations Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Diao, B.; Ndoye, A. K.; Fall, P. A.; Berthe, H.; Ondo, Z. N.; Niang, L.; Ba, M.; Diagne, B. A. Journal Title African Journal of Urology ISSN 1110-5704 Date of publication 2007 Volume and n° 13 2) Pages 151-156 Language French Descriptor Scrotum-traumatismes; Scrotum-échographie; Descriptor-Geographic Sénégal Abstract Objectif : Le but de ce travail est de rapporter les aspects épidémiologiques, cliniques, paracliniques et thérapeutiques des traumatismes des bourses à partir d'une série observée au service d'Urologie-Andrologie de l'hôpital A. Le Dantec de Dakar. Patients et méthodes: Il s'agit d'une étude rétrospective, allant de Juillet 1986 à Juillet 2002, de 14 patients pris en charge au service d'Urologie-Andrologie de l'hôpital A. Le Dantec de Dakar pour traumatisme des bourses. L'âge moyen de nos patients était de 28 ans. La cause principale était les accidents de la voie publique.Résultats: Le motif de consultation le plus fréquent était la grosse bourse douloureuse (n=10). Le délai moyen de consultation était court pour les traumatismes ouverts (45 minutes). Le traumatisme était ouvert dans 4 cas et fermé dans 10 cas. Le traitement chirurgical a consisté en une orchidectomie (n=2), un parage suivi d'une suture des lésions (n=2), une évacuation d'hématocèle avec réparation des lésions (n=6) et une cure d'hydrocèle (n=1). Un traitement conservateur a été réalisé chez trois patients. Le suivi à long terme n'a pas montré de complications chez onze patients. Deux cas d'atrophie testiculaire et trois cas d'oligo-asthénozoospermie ont été rapportés. Conclusion : La précocité de la consultation, la systématisation de l'échographie des bourses dans les traumatismes fermés sans hématocèle permettent une meilleure prise en charge et constituent le gage de la sauvegarde de la fonction gonadique.

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Record No. 8631 Record ID 008631 Publication type Journal Article Title La tuberculose génitale masculine : à propos de 22 cas Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Bensouda, A.; Reffad, J.; Kabbaj, M. M.; Karmouni, T.; Tazi, K.; El Khader, K.; Koutani, A.; Andaloussi, A.; Hachimi, M. Journal Title African Journal of Urology ISSN 1110-5704 Date of publication 2007 Volume and n° 13(2) Pages 145-150 Language French Descriptor Tuberculose urogénitale-épidémiologie; Tuberculose urogénitale-anatomie pathologique; Tuberculose urogénitale-thérapeutique; Épididymite Prostatite Antituberculeux Descriptor-Geographic Maroc Abstract Objectif : Rapporter les particularités épidémiologiques, anatomo-cliniques, pronostiques et thérapeutiques de l'atteinte génitale masculine de la tuberculose avec revue de la littérature. Patients et méthodes : Il s'agit d'une étude rétrospective portant sur 22 cas de lésions génitales de tuberculose confirmées. Le diagnostic a été posé sur un faisceau d'arguments cliniques, bactériologiques, radiologiques et histologiques. Un traitement anti-tuberculeuse a été instaurée systématiquement. La surveillance a été clinique, biologique et radiologique. Résultats: Les motifs de consultation ont été par ordre de fréquence décroissant : l'épididymite chronique (11 cas), une fistule scrotale (6 cas), une hydrocèle (6 cas), une rétention d'urine (3 cas) et une stérilité (1 cas). L'examen clinique a retrouvé un nodule épididymaire dans 11 cas et une hydrocèle dans 10 cas. Une leucocyturie sans germe a été retrouvée dans un cas. L'échographie scrotale réalisée a mis en évidence des lésions épididymaires dans 8 cas. Le diagnostic de certitude a été posé sur l'examen anatomopathologique des pièces opératoires (13 cas), de fragments biopsiques (8 cas), et par la découverte du bacille de Koch dans les urines (1 cas). L'urographie intraveineuse réalisée systématiquement a retrouvé des lésions urinaires associées dans 5 cas. L'évolution a été favorable dans tous les cas.Conclusion: L'atteinte tuberculeuse isolée des organes génitaux masculins est de diagnostic difficile en dehors d'un contexte endémique tuberculeux. Une étiologie tuberculeuse doit être suspectée devant toute orchiépidydimite traînante, particulièrement sur terrain débilité ou devant une notion d'hypofertilité. Le traitement médical reste efficace en cas de diagnostic précoce, alors que la chirurgie est réservée aux cas résistants ou compliqués

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Record No. 8630 Record ID 008630 Publication type Journal Article Title Temps de doublement du PSA : méthodes de calcul et intêret Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ghezala, W.; Mounir, M.; Touffahi, M.; Dagdagui, N.; Saidi, R.; Saad, H. Journal Title African Journal of Urology ISSN 1110-5704 Date of publication 2007 Volume and n° 13(2) Pages 139-144 Language French Descriptor Antigène spécifique prostate; Tumeurs de la prostate; Évaluation résultats traitement Descriptor-Local Méthode de calcul Descriptor-Geographic Tunisie Abstract Le temps de doublement du PSA est un outil mathématique qui donne une valeur dynamique au PSA (antigène spécifique prostatique). La diversité des méthodes de son calcul pose des difficultés pour les urologues. Nous allons essayer à travers une revue de la littérature de proposer deux méthodes simples pour son calcul, et détailler son intérêt en pratique courante.

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Record No. 8628 Record ID 008628 Publication type Journal Article Title Successful Treatment of Homozygous Cystinuria with Captopril Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Ketata, S.; Karra, H.; Ketata, H.; Sahnoun, A; Fakhfakh, H.; Bahloul, A.; Mhiri, M. N. Journal Title African Journal of Urology ISSN 1110-5704 Date of publication 2007 Volume and n° 13(2) Pages 119-123, tab., fig. Language English Descriptor Cystinuria-therapy; Lithiasis Calculi Captopril Descriptor-Geographic Nigeria Abstract Objective : Cystinuria is an autosomal recessive hereditary disorder associated with nephrolithiasis and its attendant complications. Traditional management using oral alkali, D-penicillamine, or mercaptopropionyglycine in an attempt to increase urinary cystine solubility is often unsuccessful due to intolerable side-effects. The aim of this study was to determine, if captopril could reduce urinary cystine excretion in homozygous cystinuric patients. Patients and methods : Three cystinuric patients with a history of multiple cystine stones despite previous traditional therapy were treated with 150 mg captopril daily for 3 years after determination of their baseline 24-hour urine cystine excretion. Cystine excretion studies were repeated subsequently at 6-month intervals. Results : The baseline 24-hour urine cystine excretion was within the expected limits for homozygous cystinuria in all patients (1072, 862 and 959 mg cystine per gm creatinine per 24 hours). After institution of captopril treatment, all patients had a significant decrease in urinary cystine levels (374, 313 and 451 mg cystine per gm creatinine per 24 hours). No patient experienced recurrent nephrolithiasis or adverse drug effects. Conclusion : We conclude that captopril can significantly decrease urinary cystine excretion in patients with homozygous cystinuria. Captopril should be considered an alternative to traditional drug management of cystinuria.

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