<strong>Aim:</strong> To evaluate the efficacy and safety of intraluminal lithotripsy with a pneumatic lithotripter (EMS, Switzerland) and laser Holmium YAG in retrograde rigid ureteroscopy for proximal an...<strong>Aim:</strong> To evaluate the efficacy and safety of intraluminal lithotripsy with a pneumatic lithotripter (EMS, Switzerland) and laser Holmium YAG in retrograde rigid ureteroscopy for proximal and distal ureteric calculi. <strong>Materials and Methods:</strong> This was a retrospective study carried out from January 2015 to December 2019 including 175 patients with ureteric calculi who presented with ureteric colic at a mini-invasive surgical urological center in Douala, Cameroon. All the patients underwent retrograde ureteroscopy with a 7F rigid ureteroscope, and fragmentation was done with either a pneumatic lithotripter or a laser holmium YAG. Six patients who had urinary tract infection benefited from double J stent placement before retrograde ureteroscopy. The study variables included age, clinical symptoms, size and location of the stone, the type of lithotripsy, operating time, and the results of lithotripsy. <strong>Results:</strong> We included a total of 175 patients with a mean age of 40.95 ± 12.50 years. Seventy-six (43.43%) of our participants were females and all patients had at least one calculus confirmed by a CT scan. Stone sizes ranged from 5 - 26 mm (median of 12 mm). Fifteen (8.57%) stones were located in the upper ureter (pyeloureteric junction), 64 in the middle ureter, 20 in the iliac ureter, 43 in the pelvic ureter, and 33 at the vesico-ureteric orifice. The success rate was 100% for stones located in the iliac ureter, pelvic ureter and the ureteric orifice. For those in the middle and upper ureter, the success rate was 92.18% and 60%, respectively. <strong>Conclusion:</strong> Rigid ureteroscopy is an excellent treatment modality for ureteral calculi, especially those located at the distal part of the ureter. The procedure is associated with a shorter operation time and a shorter post-operative hospitalization period, in addition to its safety and effectiveness compared to open surgery.展开更多
<strong>Aim: </strong>To evaluate the efficacy of extracorporeal lithotripsy in the management of renal and ureteric calculi in a urology center in Douala, Cameroon. <strong>Materials and Methods:<...<strong>Aim: </strong>To evaluate the efficacy of extracorporeal lithotripsy in the management of renal and ureteric calculi in a urology center in Douala, Cameroon. <strong>Materials and Methods:</strong> This is a retrospective study carried out over six years, between January 2014 and December 2020. All the patients were treated using a Direx Integra lithotripter, with the number of shockwaves ranging from 1200 to 3500, without anaesthesia and were discharged a few hours after the procedure on the same day. In a majority (63.75%) of the cases, the calculi were incidental findings. A Double-J stent was indicated in two patients and preceded extracorporeal lithotripsy because of renal colic and signs of urinary tract infection. <strong>Results:</strong> We recruited a total of 122 patients with a mean age of 42.19 ± 13.08. We had 65 (53.3%) males and all patients had at least one calculus confirmed by CT scan with a mean size of 13.84 ± 4.17 mm, 85 (69.7%) patients became completely stone-free after a maximum of four sessions of extracorporeal lithotripsy (ESWL). 21 (17.2%) patients had intermediate results, being asymptomatic and/or having less than three residual fragments that measured less than 4 mm. The failure rate was 13.9%, with 17 patients still having more than three fragments measuring more than 4 mm after 4 ESWL sessions. 1 (0.8%) had septic shock as a post ESWL complication while 6 (4.9%) benefitted from a complimentary medical and/or surgical treatment (double J stent placement). <strong>Conclusion:</strong> The management of renal and ureteral calculi through extracorporeal lithotripsy in adults seems to be particularly effective for renal calculi measuring less than 20 mm and ureteral calculi measuring less than 15 mm. Extracorporeal lithotripsy, which can be performed on an outpatient basis (and without anaesthesia) is associated with minimal complications, and remains the option of choice for most upper urinary tract calculi.展开更多
Background and Objective: The optimal treatment for varicocele is still controversial. Although there are many treatment methods, none can be considered as the best therapeutic option. We present our initial laparosco...Background and Objective: The optimal treatment for varicocele is still controversial. Although there are many treatment methods, none can be considered as the best therapeutic option. We present our initial laparoscopic varicocelectomy experience by describing the clinical aspects and evaluating the outcomes of this surgical procedure at the Centre medico-chirugicale d’urologie in Douala, Cameroon. Materials and Methods: This was a retrospective study carried out between January 2015 and December 2019 on 35 patients with symptomatic varicoceles who were treated for either testicular pain or infertility. All surgical procedures were performed via laparoscopy, with ligation of the spermatic vein using a hemlock clip in the retroperitoneal space. The patients were followed up for three months after surgery, and data were collected and analyzed to obtain results. Results: The study participants were aged 16 - 55 years, with a mean age of 36.11 ± 8.45 years. Infertility was the main presenting complaint. In 65.7% of cases, varicoceles were bilateral with testicular atrophy occurring in 26 patients (74.28%). The surgery duration ranged from 14 minutes to 60 minutes, with an average duration of 34.8 minutes. There was no case of conversion to open surgery. No major complications were observed and all patients were discharged the day after surgery. Three months after surgery, all patients stopped experiencing pain and semen parameters improved in 71.42% of the study participants, with 42.82% of them impregnating their partners. Conclusion: Laparoscopic varicocelectomy is efficient, less time-consuming, with minimal postoperative complications. It can be performed easily in the outpatient department.展开更多
Aim: This study aimed to evaluate the results of the laparoscopic treatment of high and intra-abdominal undescended testes. Methods: A retrospective study was carried out from 2014 to 2021 at the Centre medico-chirugi...Aim: This study aimed to evaluate the results of the laparoscopic treatment of high and intra-abdominal undescended testes. Methods: A retrospective study was carried out from 2014 to 2021 at the Centre medico-chirugicale d’urologie in Douala. We consulted the clinical records of 27 patients aged 6 - 15 years who underwent laparoscopic orchiopexy at our hospital. We included patients with unilateral or bilateral undescended testes as detected by palpation and excluded patients with incomplete clinical records. The data collected were entered into Microsoft Excel 2016 and exported to Epi info 7 for analysis. Continuous variables were presented as mean values and standard deviations while categorical variables were presented as frequencies and percentages. The threshold for statistical significance was set at p Results: The ages of the 27 participants ranged from 6 years to 15 years, with a mean age of 10.22 ± 2.68 years. Hypospadias was an associated abnormality in 7.41% of participants. The mean duration of the surgical procedure was 80.56 ± 30.30 minutes. The overall success rate of the laparoscopic procedure was 95.83%. The mean duration of postoperative hospital stay was 26.67 ± 7.69 hours. The only postoperative complication we encountered was testicular atrophy, which occurred in 7.41% of participants. All our patients underwent single-stage laparoscopic procedures. Conclusion: Laparoscopy, which is the technique of choice for the diagnosis and management of undescended testis, is more rapid, more effective, and characterized by a shorter hospital stay and fewer postoperative complications compared to open surgery. Single-stage procedures are as effective and safe as two-stage procedures.展开更多
Background: Prostate cancer, which is the second most frequent cancer diagnosis made in men, more commonly occurs in the elderly. This disease is often diagnosed late in resource-limited settings, which results in peo...Background: Prostate cancer, which is the second most frequent cancer diagnosis made in men, more commonly occurs in the elderly. This disease is often diagnosed late in resource-limited settings, which results in people having advanced forms of the disease and a poor prognosis. This study aimed to identify factors indicative of prostate cancer aggressivity and a poor prognosis in patients with prostate cancer at a single center in Douala, Cameroon. Methods: We performed a retrospective study from 2015 to 2020 at the Centre medico-chirugical d’urologie in Douala, Cameroon, in which we included 203 patients aged 41 years to 85 years who had prostate cancer diagnosed via histopathology after either prostate biopsyor laparoscopic prostatectomy. Epi-info 7 was used for data analysis and logistic regression analyses were performed to identify factors associated with prostate cancer aggressivity and patients’ outcomes (survival or mortality). Results: The mean age of our study participants was 64.76 ± 7.48 years. Ten patients had a contributive family history of prostate cancer. The patients presented with lower urinary tract symptoms in 61.58% of cases. All patients had serum prostate-specific antigen (PSA) levels of >4 ng/ml, 100 patients were anemic, and 36 patients had aggressive forms of the disease. Eighty-eight patients had remarkable digital rectal examination (DRE) findings. The median prostate volume, as determined via transrectal ultrasonography (TRUS), was 59 [43 - 80] ml. Fifty-nine patients had abnormal prostate echostructures, and 33 patients died during follow-up. The presence of paraplegia and the practice of professions requiring unskilled labor were significantly associated with aggressive prostate cancer. The presence of lymphoedema, abnormal DRE findings, anemia, enlarged prostate glands (prostate volume >50 ml), and abnormal prostatic echostructures were significantly associated with both prostate cancer aggressivity and patients’ outcomes. Conclusion: The late diagnosis of prostate cancer is a major public health problem in Cameroon because of the complications and poor prognosis of the disease at an advanced stage. Certain clinical, biological, and imaging factors are associated with prostate cancer aggressivity and a poor prognosis, whose identification could help guide clinicians in making therapeutic choices for their patients.展开更多
Background: With the advancement of technology, prostate resection can be performed nowadays using endoscopic techniques, which include monopolar and bipolar transurethral prostate resection. This study aimed to evalu...Background: With the advancement of technology, prostate resection can be performed nowadays using endoscopic techniques, which include monopolar and bipolar transurethral prostate resection. This study aimed to evaluate the results of bipolar transurethral prostate resection in a single urology center in Cameroon. Materials and Methods: This was a retrospective study carried out over two years (2015-2017) involving 112 patients with symptomatic prostate diseases who underwent transurethral prostate resection with the help of a bipolar Olympus generator. Results: The ages of the participants ranged from 44 years to 85 years, with a mean age of 64.41 ± 9.5 years. Fifty-six (50%) patients presented with only obstructive symptoms, five (4.46%) had only irritative symptoms, twenty (17.86%) presented with both obstructive and irritative symptoms, eight (7.14%) presented with macroscopic hematuria, seven (6.25%) with urinary tract infections, and sixteen (14.29%) with acute urinary retention. Digital rectal examination was unremarkable in 74 (66.07%) findings and was positive in 38 (33.93%) patients. The median prostate diameter was 70 [59 - 86.5] mm. The mean preoperative IPSS was 24.46 ± 5.68. The mean surgery duration was 77.61 ± 23.87 minutes. The mean volume of irrigation fluid used during surgery was 24.84 ± 6.40 ml. The differences between the preoperative and postoperative mean IPPS score, maximum urine flow rate, and quality of life were statistically significant (all P Conclusion: Bipolar transurethral prostate resection is a viable alternative to open surgery or laparoscopic surgery for large prostate glands. This technique is also associated with a reduction in prostate-related morbidity.展开更多
Purpose: This study aimed to evaluate the efficacy and safety of endoscopic lithotripsy with the lithoclast (EMS, Switzerland) and laser Holmium YAG in the management of bladder calculi. Materials and methods: This wa...Purpose: This study aimed to evaluate the efficacy and safety of endoscopic lithotripsy with the lithoclast (EMS, Switzerland) and laser Holmium YAG in the management of bladder calculi. Materials and methods: This was a retrospective study carried out from January 2013 to December 2019 on 32 patients with bladder calculi. All the patients underwent either Lithoclast or Laser lithotripsy using a 22F Storz cystoscope at the Centre medico-chirugicale d’urologie in Douala, Cameroon. Data on patients’ ages, clinical symptoms, stone sizes, type of lithotripsy, surgery duration, and results of lithotripsy were collected and analyzed using Epi info 7. Results: We recruited 32 participants (24 men and 8 women) with a median age of 41.28 [22 - 68] years into this study. In 9 (28.12%) participants, macroscopic hematuria was the main presenting complaint, followed by lower urinary tract symptoms in 8 (25%) patients. A cystoscopy was performed in 17 (53.12%) patients to confirm the diagnosis of a bladder stone, and ultrasonography of the upper urinary tract was performed in 29 (90.6%) cases to certify the absence of another stone. Lithoclast EMS was used to manage the stones in 23 (71.87%) patients while laser lithotripsy was used in 9 (28.13%). A dormia basket was used to remove stone fragments in 10 (31.25%) patients. The mean surgery duration was 33.59 ± 14.2 minutes, and the bladder stones were successfully managed in all the participants of this study. Minor complications such as pain during micturition were found in 28 (87.37%) patients, with complete resolution occurring two weeks after surgery. Conclusion: Endoscopy with lithotripsy is a safe and effective method of management of bladder stones. This technique is also associated with short surgical procedures and postoperative hospitalization periods. We believe that it is an excellent treatment modality in the management of bladder stones.展开更多
<strong>Objective:</strong> To evaluate the role of the laparoscopic approach in the management of pelvic calculi in a urology centre in Douala, Cameroon. <strong>Materials and Methods:</strong>...<strong>Objective:</strong> To evaluate the role of the laparoscopic approach in the management of pelvic calculi in a urology centre in Douala, Cameroon. <strong>Materials and Methods:</strong> This was a retrospective study carried out from 2014 to 2019 involving 62 patients with calculi at the renal pelvis managed through laparoscopic pyelolithotomy. <strong>Results:</strong> We recruited 62 patients (38 men and 24 women) with a median age of 36 [25 - 48] years. Nephritic colic was the most frequently encountered presenting complaint (92% of cases). In 56.45% of cases, the stone was on the left side of the body. Twelve patients had kidney acute failure at the time of diagnosis. Five patients received antibiotics for urinary tract infections before the operation. Before surgery, eight double J stents were placed in 8 patients;in five because of urinary tract infection and in three because of nephritic colic. In all the cases, the definitive diagnosis was made using abdominal CT scans. The median size of the calculi was 22 [17 - 28] mm. Dilatation of the pyelocaliceal cavity was noticed in all the patients. The median surgery duration was 100 [90 - 120] minutes. Drainage of the urinary tract using a double J stent was performed in all the patients, whereas percutaneous drainage was performed only in 9.67% of cases. There was no case of conversion to open surgery. Control ultrasound performed one month after the removal of the double J stent did not reveal any residual stones in the pyelocaliceal cavities. <strong>Conclusion:</strong> Laparoscopic pyelolithotomy is a mini-invasive technique that is adequate for the management of voluminous pelvic calculi.展开更多
Background and Objective: Laparoscopy can be an alternative modality in the management of ureteral stones. We herein present our experience with laparoscopic ureterolithotomy although most ureteral stones are managed ...Background and Objective: Laparoscopy can be an alternative modality in the management of ureteral stones. We herein present our experience with laparoscopic ureterolithotomy although most ureteral stones are managed using endourologic techniques, open surgery, or shockwave lithotripsy. Materials and Methods: This retrospective study was performed from January 2014 to December 2019 on 20 patients with ureteral stones who were treated using transperitoneal laparoscopic access. We collected data on patients’ ages, genders, clinical profiles, relevant medical history, sizes of the calculi, localisation of the calculi as confirmed by imaging, and outcome of lithotripsy. Continuous data were presented as mean values and standard deviations (for normally distributed data) and medians with interquartile ranges (for skewed data). Categorical data were presented as frequencies and percentages. Results: We included 20 patients (13 males and 7 females) with a mean age of 40.40 ± 13.25 years. The mean stone size was 18.5 ± 3.05 mm and all procedures were completed laparoscopically. The mean operative time was 96 ± 22.34 minutes. The mean estimated blood loss was less than 150 ml, and none of the patients received a blood transfusion. There was no intraoperative complication or postoperative complications, except for leakage of urine in the suture area. The mean hospital stay was 2.05 ± 0.69 days and the double J stent was removed after an average of 20 days post-operatively. The stone-free rate was 100% and after a mean follow-up period of 3 months, there was no stone recurrence. Conclusion: Laparoscopic ureterolithotomy is an effective and safe technique in the management of ureteric stones. The benefits of this technique include minimal postoperative morbidity, short postoperative hospitalization, a short convalescence period, and remarkable cosmetic results.展开更多
文摘<strong>Aim:</strong> To evaluate the efficacy and safety of intraluminal lithotripsy with a pneumatic lithotripter (EMS, Switzerland) and laser Holmium YAG in retrograde rigid ureteroscopy for proximal and distal ureteric calculi. <strong>Materials and Methods:</strong> This was a retrospective study carried out from January 2015 to December 2019 including 175 patients with ureteric calculi who presented with ureteric colic at a mini-invasive surgical urological center in Douala, Cameroon. All the patients underwent retrograde ureteroscopy with a 7F rigid ureteroscope, and fragmentation was done with either a pneumatic lithotripter or a laser holmium YAG. Six patients who had urinary tract infection benefited from double J stent placement before retrograde ureteroscopy. The study variables included age, clinical symptoms, size and location of the stone, the type of lithotripsy, operating time, and the results of lithotripsy. <strong>Results:</strong> We included a total of 175 patients with a mean age of 40.95 ± 12.50 years. Seventy-six (43.43%) of our participants were females and all patients had at least one calculus confirmed by a CT scan. Stone sizes ranged from 5 - 26 mm (median of 12 mm). Fifteen (8.57%) stones were located in the upper ureter (pyeloureteric junction), 64 in the middle ureter, 20 in the iliac ureter, 43 in the pelvic ureter, and 33 at the vesico-ureteric orifice. The success rate was 100% for stones located in the iliac ureter, pelvic ureter and the ureteric orifice. For those in the middle and upper ureter, the success rate was 92.18% and 60%, respectively. <strong>Conclusion:</strong> Rigid ureteroscopy is an excellent treatment modality for ureteral calculi, especially those located at the distal part of the ureter. The procedure is associated with a shorter operation time and a shorter post-operative hospitalization period, in addition to its safety and effectiveness compared to open surgery.
文摘<strong>Aim: </strong>To evaluate the efficacy of extracorporeal lithotripsy in the management of renal and ureteric calculi in a urology center in Douala, Cameroon. <strong>Materials and Methods:</strong> This is a retrospective study carried out over six years, between January 2014 and December 2020. All the patients were treated using a Direx Integra lithotripter, with the number of shockwaves ranging from 1200 to 3500, without anaesthesia and were discharged a few hours after the procedure on the same day. In a majority (63.75%) of the cases, the calculi were incidental findings. A Double-J stent was indicated in two patients and preceded extracorporeal lithotripsy because of renal colic and signs of urinary tract infection. <strong>Results:</strong> We recruited a total of 122 patients with a mean age of 42.19 ± 13.08. We had 65 (53.3%) males and all patients had at least one calculus confirmed by CT scan with a mean size of 13.84 ± 4.17 mm, 85 (69.7%) patients became completely stone-free after a maximum of four sessions of extracorporeal lithotripsy (ESWL). 21 (17.2%) patients had intermediate results, being asymptomatic and/or having less than three residual fragments that measured less than 4 mm. The failure rate was 13.9%, with 17 patients still having more than three fragments measuring more than 4 mm after 4 ESWL sessions. 1 (0.8%) had septic shock as a post ESWL complication while 6 (4.9%) benefitted from a complimentary medical and/or surgical treatment (double J stent placement). <strong>Conclusion:</strong> The management of renal and ureteral calculi through extracorporeal lithotripsy in adults seems to be particularly effective for renal calculi measuring less than 20 mm and ureteral calculi measuring less than 15 mm. Extracorporeal lithotripsy, which can be performed on an outpatient basis (and without anaesthesia) is associated with minimal complications, and remains the option of choice for most upper urinary tract calculi.
文摘Background and Objective: The optimal treatment for varicocele is still controversial. Although there are many treatment methods, none can be considered as the best therapeutic option. We present our initial laparoscopic varicocelectomy experience by describing the clinical aspects and evaluating the outcomes of this surgical procedure at the Centre medico-chirugicale d’urologie in Douala, Cameroon. Materials and Methods: This was a retrospective study carried out between January 2015 and December 2019 on 35 patients with symptomatic varicoceles who were treated for either testicular pain or infertility. All surgical procedures were performed via laparoscopy, with ligation of the spermatic vein using a hemlock clip in the retroperitoneal space. The patients were followed up for three months after surgery, and data were collected and analyzed to obtain results. Results: The study participants were aged 16 - 55 years, with a mean age of 36.11 ± 8.45 years. Infertility was the main presenting complaint. In 65.7% of cases, varicoceles were bilateral with testicular atrophy occurring in 26 patients (74.28%). The surgery duration ranged from 14 minutes to 60 minutes, with an average duration of 34.8 minutes. There was no case of conversion to open surgery. No major complications were observed and all patients were discharged the day after surgery. Three months after surgery, all patients stopped experiencing pain and semen parameters improved in 71.42% of the study participants, with 42.82% of them impregnating their partners. Conclusion: Laparoscopic varicocelectomy is efficient, less time-consuming, with minimal postoperative complications. It can be performed easily in the outpatient department.
文摘Aim: This study aimed to evaluate the results of the laparoscopic treatment of high and intra-abdominal undescended testes. Methods: A retrospective study was carried out from 2014 to 2021 at the Centre medico-chirugicale d’urologie in Douala. We consulted the clinical records of 27 patients aged 6 - 15 years who underwent laparoscopic orchiopexy at our hospital. We included patients with unilateral or bilateral undescended testes as detected by palpation and excluded patients with incomplete clinical records. The data collected were entered into Microsoft Excel 2016 and exported to Epi info 7 for analysis. Continuous variables were presented as mean values and standard deviations while categorical variables were presented as frequencies and percentages. The threshold for statistical significance was set at p Results: The ages of the 27 participants ranged from 6 years to 15 years, with a mean age of 10.22 ± 2.68 years. Hypospadias was an associated abnormality in 7.41% of participants. The mean duration of the surgical procedure was 80.56 ± 30.30 minutes. The overall success rate of the laparoscopic procedure was 95.83%. The mean duration of postoperative hospital stay was 26.67 ± 7.69 hours. The only postoperative complication we encountered was testicular atrophy, which occurred in 7.41% of participants. All our patients underwent single-stage laparoscopic procedures. Conclusion: Laparoscopy, which is the technique of choice for the diagnosis and management of undescended testis, is more rapid, more effective, and characterized by a shorter hospital stay and fewer postoperative complications compared to open surgery. Single-stage procedures are as effective and safe as two-stage procedures.
文摘Background: Prostate cancer, which is the second most frequent cancer diagnosis made in men, more commonly occurs in the elderly. This disease is often diagnosed late in resource-limited settings, which results in people having advanced forms of the disease and a poor prognosis. This study aimed to identify factors indicative of prostate cancer aggressivity and a poor prognosis in patients with prostate cancer at a single center in Douala, Cameroon. Methods: We performed a retrospective study from 2015 to 2020 at the Centre medico-chirugical d’urologie in Douala, Cameroon, in which we included 203 patients aged 41 years to 85 years who had prostate cancer diagnosed via histopathology after either prostate biopsyor laparoscopic prostatectomy. Epi-info 7 was used for data analysis and logistic regression analyses were performed to identify factors associated with prostate cancer aggressivity and patients’ outcomes (survival or mortality). Results: The mean age of our study participants was 64.76 ± 7.48 years. Ten patients had a contributive family history of prostate cancer. The patients presented with lower urinary tract symptoms in 61.58% of cases. All patients had serum prostate-specific antigen (PSA) levels of >4 ng/ml, 100 patients were anemic, and 36 patients had aggressive forms of the disease. Eighty-eight patients had remarkable digital rectal examination (DRE) findings. The median prostate volume, as determined via transrectal ultrasonography (TRUS), was 59 [43 - 80] ml. Fifty-nine patients had abnormal prostate echostructures, and 33 patients died during follow-up. The presence of paraplegia and the practice of professions requiring unskilled labor were significantly associated with aggressive prostate cancer. The presence of lymphoedema, abnormal DRE findings, anemia, enlarged prostate glands (prostate volume >50 ml), and abnormal prostatic echostructures were significantly associated with both prostate cancer aggressivity and patients’ outcomes. Conclusion: The late diagnosis of prostate cancer is a major public health problem in Cameroon because of the complications and poor prognosis of the disease at an advanced stage. Certain clinical, biological, and imaging factors are associated with prostate cancer aggressivity and a poor prognosis, whose identification could help guide clinicians in making therapeutic choices for their patients.
文摘Background: With the advancement of technology, prostate resection can be performed nowadays using endoscopic techniques, which include monopolar and bipolar transurethral prostate resection. This study aimed to evaluate the results of bipolar transurethral prostate resection in a single urology center in Cameroon. Materials and Methods: This was a retrospective study carried out over two years (2015-2017) involving 112 patients with symptomatic prostate diseases who underwent transurethral prostate resection with the help of a bipolar Olympus generator. Results: The ages of the participants ranged from 44 years to 85 years, with a mean age of 64.41 ± 9.5 years. Fifty-six (50%) patients presented with only obstructive symptoms, five (4.46%) had only irritative symptoms, twenty (17.86%) presented with both obstructive and irritative symptoms, eight (7.14%) presented with macroscopic hematuria, seven (6.25%) with urinary tract infections, and sixteen (14.29%) with acute urinary retention. Digital rectal examination was unremarkable in 74 (66.07%) findings and was positive in 38 (33.93%) patients. The median prostate diameter was 70 [59 - 86.5] mm. The mean preoperative IPSS was 24.46 ± 5.68. The mean surgery duration was 77.61 ± 23.87 minutes. The mean volume of irrigation fluid used during surgery was 24.84 ± 6.40 ml. The differences between the preoperative and postoperative mean IPPS score, maximum urine flow rate, and quality of life were statistically significant (all P Conclusion: Bipolar transurethral prostate resection is a viable alternative to open surgery or laparoscopic surgery for large prostate glands. This technique is also associated with a reduction in prostate-related morbidity.
文摘Purpose: This study aimed to evaluate the efficacy and safety of endoscopic lithotripsy with the lithoclast (EMS, Switzerland) and laser Holmium YAG in the management of bladder calculi. Materials and methods: This was a retrospective study carried out from January 2013 to December 2019 on 32 patients with bladder calculi. All the patients underwent either Lithoclast or Laser lithotripsy using a 22F Storz cystoscope at the Centre medico-chirugicale d’urologie in Douala, Cameroon. Data on patients’ ages, clinical symptoms, stone sizes, type of lithotripsy, surgery duration, and results of lithotripsy were collected and analyzed using Epi info 7. Results: We recruited 32 participants (24 men and 8 women) with a median age of 41.28 [22 - 68] years into this study. In 9 (28.12%) participants, macroscopic hematuria was the main presenting complaint, followed by lower urinary tract symptoms in 8 (25%) patients. A cystoscopy was performed in 17 (53.12%) patients to confirm the diagnosis of a bladder stone, and ultrasonography of the upper urinary tract was performed in 29 (90.6%) cases to certify the absence of another stone. Lithoclast EMS was used to manage the stones in 23 (71.87%) patients while laser lithotripsy was used in 9 (28.13%). A dormia basket was used to remove stone fragments in 10 (31.25%) patients. The mean surgery duration was 33.59 ± 14.2 minutes, and the bladder stones were successfully managed in all the participants of this study. Minor complications such as pain during micturition were found in 28 (87.37%) patients, with complete resolution occurring two weeks after surgery. Conclusion: Endoscopy with lithotripsy is a safe and effective method of management of bladder stones. This technique is also associated with short surgical procedures and postoperative hospitalization periods. We believe that it is an excellent treatment modality in the management of bladder stones.
文摘<strong>Objective:</strong> To evaluate the role of the laparoscopic approach in the management of pelvic calculi in a urology centre in Douala, Cameroon. <strong>Materials and Methods:</strong> This was a retrospective study carried out from 2014 to 2019 involving 62 patients with calculi at the renal pelvis managed through laparoscopic pyelolithotomy. <strong>Results:</strong> We recruited 62 patients (38 men and 24 women) with a median age of 36 [25 - 48] years. Nephritic colic was the most frequently encountered presenting complaint (92% of cases). In 56.45% of cases, the stone was on the left side of the body. Twelve patients had kidney acute failure at the time of diagnosis. Five patients received antibiotics for urinary tract infections before the operation. Before surgery, eight double J stents were placed in 8 patients;in five because of urinary tract infection and in three because of nephritic colic. In all the cases, the definitive diagnosis was made using abdominal CT scans. The median size of the calculi was 22 [17 - 28] mm. Dilatation of the pyelocaliceal cavity was noticed in all the patients. The median surgery duration was 100 [90 - 120] minutes. Drainage of the urinary tract using a double J stent was performed in all the patients, whereas percutaneous drainage was performed only in 9.67% of cases. There was no case of conversion to open surgery. Control ultrasound performed one month after the removal of the double J stent did not reveal any residual stones in the pyelocaliceal cavities. <strong>Conclusion:</strong> Laparoscopic pyelolithotomy is a mini-invasive technique that is adequate for the management of voluminous pelvic calculi.
文摘Background and Objective: Laparoscopy can be an alternative modality in the management of ureteral stones. We herein present our experience with laparoscopic ureterolithotomy although most ureteral stones are managed using endourologic techniques, open surgery, or shockwave lithotripsy. Materials and Methods: This retrospective study was performed from January 2014 to December 2019 on 20 patients with ureteral stones who were treated using transperitoneal laparoscopic access. We collected data on patients’ ages, genders, clinical profiles, relevant medical history, sizes of the calculi, localisation of the calculi as confirmed by imaging, and outcome of lithotripsy. Continuous data were presented as mean values and standard deviations (for normally distributed data) and medians with interquartile ranges (for skewed data). Categorical data were presented as frequencies and percentages. Results: We included 20 patients (13 males and 7 females) with a mean age of 40.40 ± 13.25 years. The mean stone size was 18.5 ± 3.05 mm and all procedures were completed laparoscopically. The mean operative time was 96 ± 22.34 minutes. The mean estimated blood loss was less than 150 ml, and none of the patients received a blood transfusion. There was no intraoperative complication or postoperative complications, except for leakage of urine in the suture area. The mean hospital stay was 2.05 ± 0.69 days and the double J stent was removed after an average of 20 days post-operatively. The stone-free rate was 100% and after a mean follow-up period of 3 months, there was no stone recurrence. Conclusion: Laparoscopic ureterolithotomy is an effective and safe technique in the management of ureteric stones. The benefits of this technique include minimal postoperative morbidity, short postoperative hospitalization, a short convalescence period, and remarkable cosmetic results.
