5 research outputs found
Genitourinary complications of pelvic traumaLes complications uro-génitales des traumatismes du bassin: a propos de 41 cas
Objective: To analyse the epidemiological features, diagnostic criteria and therapeutic aspects of 41 genitourinary lesions due to pelvic fracture. Patients and Methods : This is a retrospective analysis of 41 consecutive cases of pelvic trauma associated with urinary or genital complications seen over a 5-year period at the University Hospital of Treichville, Abidjan, CĂŽte d'Ivoire. The patients had a mean age of 27.8 years (range: 14 â 48 years) with a male-to-female ratio of 9.25 to 1. Results: Traffic accidents were the prevailing cause of trauma accounting for 75.6%. The commonest type of fracture was anterior arc fracture encountered in 26.9% of the patients. The commonest presenting symptoms were chronic urinary retention (16.7%), bleeding per urethram (10.4%) and hematuria (29.1%). Urethral lesions were encountered in 50%, bladder lesions in 38.5%, lesions of the external genitalia in 9.6% and prostatic lesions in 1.9% of patients. In the majority of the patients (51.2%) urethral repair was attempted by the spatulated anastomotic technique. In cases of disruption of the membranous urethra, urethral repair was delayed by 3 months. The functional results of treatment were good in 66%, while satisfactory erectile function could be achieved in 73% of the patients. Mortality was 4.9%. Conclusion: The prognosis of patients with pelvic trauma can be improved by a fast diagnosis and by resorting to a multidisciplinary team taking care of the multiple visceral injuries in association with the urogenital ones. RĂ©sumĂ© Objectifs: Analyser les donnĂ©es Ă©pidĂ©miologiques, diagnostiques et thĂ©rapeutiques des complications uro-gĂ©nitales de 41 cas de traumatismes du bassin. Patients et mĂ©thode: Il s'agit d'une Ă©tude rĂ©trospective effectuĂ©e Ă partir de 41 cas de traumatismes du bassin avec complication urinaire et/ou gĂ©nitale colligĂ©s dans le service d'urologie du CHU de Treichville sur une pĂ©riode de cinq ans. L'Ăąge moyen des patients est de 27,8 ans (extrĂȘmes: 14 Ă 48 ans), avec un sexe ratio de 9,25 hommes pour une femme. RĂ©sultats: Les accidents de la voie publique sont les plus grands pourvoyeurs de traumatisme reprĂ©sentant 75,6% des cas. Les fractures de l'arc antĂ©rieur sont les plus incriminĂ©es (26,9%). Les signes cliniques les plus Ă©vocateurs sont: la rĂ©tention aiguĂ« d'urines (16,7%), l'urĂ©trorragie (10,4%) et l'hĂ©maturie (29,1%). Nous avons observĂ© 50% de lĂ©sions urĂ©trales, 38,5% de lĂ©sions vĂ©sicales, 9,6% d'atteintes des organes gĂ©nitaux externes et 1,9% de lĂ©sions prostatiques. Nous avons optĂ© pour une rĂ©paration Ă distance du traumatisme causal (3 mois) pour les ruptures de l'urĂštre membraneux en faisant une large part Ă la rĂ©section-anastomose avec spatulation (51,16%). Nous avons obtenu 66% de bons rĂ©sultats sur le plan urinaire et 73% de conservation d'une fonction Ă©rectile satisfaisante tandis qu'une mortalitĂ© de 4,9% assombrit le pronostic.Conclusion: Le pronostic peut ĂȘtre amĂ©liorĂ© par la cĂ©lĂ©ritĂ© du diagnostic et la prise en charge des lĂ©sions qui sont squelettiques et souvent poly-viscĂ©rales chez les patients prĂ©sentant des lĂ©sions uro-gĂ©nitales consĂ©cutifs aux traumatismes du bassin, câest Ă dire la nĂ©cessitĂ© d'une prise en charge spĂ©cialisĂ©e pluridisciplinaire. African Journal of Urology Vol. 12(1) 2006: 37-4
Valeur de lâartĂšre testiculaire : approche histofonctionnelle et comparative chez le raton et le rat
The structure and innervation of the male urethra: histological and immunohistochemical studies with three-dimensional reconstruction
The structure of the striated urethral sphincter, the so-called rhabdosphincter, remains the subject of controversy. There are two main concepts regarding its structure: either it is a part of the urogenital diaphragm, or it extends from the base of the bladder up to the urogenital diaphragm and is an integral part of the urethra. It is also uncertain whether it possesses a somatic innervation or a mixed innervation (i.e. autonomic and somatic). The purpose of this study was to show the precise location of the nerves running to the urethra, and to try to determine their exact nature. Histology and immunohistochemistry were performed in the external urethral sphincter of ten male fetuses (114â342 mm crownârump length, or between 14 and 40 weeks of gestation). A three-dimensional (3D) reconstruction of the urethral structure and its innervation was made from serial sections. The 3D reconstruction of the same section levels with different strains allowed us to identify the precise structure of the muscle layers (smooth and striated muscle fibres) and the nature of the nerve elements (myelinated and unmyelinated), their distributions and their relationship to the urethral wall, the prostate and the seminal vesicles. Histological and immunohistochemical 3D reconstruction of the anatomical elements of the urethral sphincter helps us to understand the 3D arrangement of the sphincter muscle layers. It also provides a better understanding of the origin and nature of the nerve elements that play a role in urinary continence