Penile Gangrene: An Unusual Complication of Priapism in a Patient with Bladder Carcinoma

A 40-year-old, apparently healthy farmer presented with a 4-day history of progressively painful penile erection with no known predisposing or precipitating factor. He had an emergency El-Ghorab shunt which resulted in almost complete detumescence. He was noticed to have developed ischemic changes of the distal part of the penile skin which progressed to gangrene of the distal part of the penis on the 4th day post intervention. Abdomino-pelvic ultrasound revealed an intravesical mass and urine and corpus cavernosa aspiration cytology were positive for malignant cell. The patient, however, declined further treatment and was discharged against medical advice

“Non-functioning” Kidneys in Excretory Urography: Caution is the word!

Significant loss of renal function is objectively diagnosed with radioisotope renal scintigraphy. In many developing countries radioisotope study is notreadily available and the diagnosis of non-functioning kidney is often based on intravenous urography. We retrospectively reviewed the case notes of three patients that were diagnosed with ‘non-functioning’ kidneys based on intravenous contrast renal imaging but had salvage procedure for the renalmoiety. In the absence of radioisotope study, some restrain is advocated for nephrectomy, for ‘non-functioning kidney’, based solely on the result ofintravenous urography

Knowledge of human immunodeficiency virus post-exposure prophylaxis among doctors in a Nigerian tertiary hospital

Background: The mainstay of prevention of occupationally-acquired HIV infection is compliance with universal precautions. Appropriate post-exposure prophylaxis is an integral part of prevention, control and workplace safety. This study was undertaken to assess the level of knowledge of post-exposure prophylaxis (PEP) against human immunodeficiency virus (HIV) among doctors in Federal Medical Centre, Gombe, Nigeria.Materials and Methods: Ethical committee approval for the conduct of the study was obtained. Questionnaires were served to all cadres of doctors from house officers to consultants; it was completed and returned on anonymous basis.Results: Sixty six (88.0%) of the 75 distributed questionnaires were returned completed and formed the basis of further analysis. The overall knowledge level of post-exposure prophylaxis against human immunodeficiency virus infection was very low. About 62.1% are aware of the existence of PEP policy in the hospital. The level of knowledge concerning the high-risk fluid and three drugs used in PEP is high. Over 90% are not aware of the risk of sero-conversion following significant needle-sticks injury and mucous membrane exposure. The study also revealed poor knowledge concerning actions to be taken, how soon to commence the PEP treatment and the duration of medication following needle stick injury. More than 50% of the surveyed doctors had experienced significant exposure to potentially infective materials and none reported or sought PEP advice.Conclusion: There is the need to educate the doctors and other health workers about the PEP guideline policy, what to do in the event of injury, whom to contact and the importance of seeking urgent advice following injury or exposure

An Unusual Lymphatic Metastasis of Cancer of the Prostate: A Report of 3 Cases

No Abstract

Survey of urologists on clients’ demand for screening for prostate cancer in Nigeria

Objective: The aim of this article is to document the experience of urologists on clients’ demand for prostate cancer screening among Nigerians.Materials and Methods: The study is a cross-sectional evaluation of the urologists that attended the Fourteenth Annual Meeting and the Scientific Conference of the Nigerian Association of Urological Surgeons. A structured questionnaire was used to assess the estimated workload of the respondents, with reference to prostate cancer management, the stage proportion at the time of diagnosis, and the proportion of patients requesting for CaP screening. The data was analyzed using the SPSS version 15 statistical software.Results: Twenty-two respondents completed and returned the questionnaire and formed the basis of further analysis. About 76.9% of the consultant urologists were also lecturers in their respective universities. They were all actively practicing and a majority of them, 76.9%, had up to 10 years experience as practicing urologists. The majority of the respondents managed between one and fifteen new patients with CaP every month, with 36.4% of them managing more than 15 new patients on an average every month. About 95.4% of all the patients seen by the respondents were diagnosed with advanced stages of the disease, while the remaining ones were incidental findings. About one half of the respondents attended to clients seeking for advice on CaP ‘often’ or ‘very often,’ while 40.9% attended to them ‘occasionally,’ with a mean of 4.67 clients seeking advice per month. The majority of respondents, 20 (22); 90.9%, were ‘not aware’ of any national guideline on CaP screening.Conclusions: A majority of practitioners affirmed that patients with prostate cancer present late. The mean number of patients requesting for screening for prostate cancer per month, per respondent, for CaP, is still low. It is the authors’ belief that the trend may not change until there is an appropriate effort at health education, to enlighten the populace

Spontaneous Intra-Peritoneal Urinary Bladder Rupture Complicating Benign Prostate Hyperplasia: Case Report

A case of a rare atraumatic spontaneous rupture of the urinary bladder in a 62-year-old man with benign prostate hyperplasia who presented with anuria, abdominal pain and abdominal distension is reported. He had declined prostatectomy for two and a half years on financial ground. In addition to the presenting history, the presence of free intraperitoneal fluid and abdominal rigidity heightened the clinical suspicion of the diagnosis. This was confirmed by the laboratory demonstration of uroperitoneum and ultrasonographic demonstration of rent in the urinary bladder wall. About 6 litres of urine, mixed with blood, was drained following a moderately difficult trans-urethral bladder catheterization. This led to the spontaneous disappearance of the abdominal distension and healing of the bladder rupture as confirmed by ultrasonography and cystography on the eighth day of presentation. He had urethro-cystoscopy and retropubic prostatectomy electively two months later and has remained well on follow up

Review of prostate cancer research in Nigeria

Prostate cancer (CaP) disparities in the black man calls for concerted research efforts. This review explores the trend and focus of CaP research activities in Nigeria, one of the ancestral nations for black men. It seeks to locate the place of the Nigerian research environment in the global progress on CaP disparities. Literature was reviewed mainly through a Pubmed search with the terms “prostate cancer”and “Nigeria”, as well as from internet and hard copies of journal pages

Prostate cancer outcome in Burkina Faso

<p>Abstract</p> <p>Introduction</p> <p>African-American black men race is one of non-modifiable risk factors confirmed for prostate cancer. Many studies have been done in USA among African- American population to evaluate prostate cancer disparities. Compared to the USA very few data are available for prostate cancer in Sub-Saharan African countries. The objective of this study was to describe incident prostate cancer (PC) diagnosis characteristics in Burkina Faso (West Africa).</p> <p>Methods</p> <p>We performed a prospective non randomized patient’s cohort study of new prostate cancer cases diagnosed by histological analysis of transrectal prostate biopsies in Burkina Faso. Study participants included 166 patients recruited at the urology division of the university hospital of Ouagadougou. Age of the patients, clinical symptoms, digital rectal examination (DRE) result, serum prostate-specific antigen (PSA) level, histological characteristics and TNM classification were taking in account in this study.</p> <p>Results</p> <p>166 transrectal prostate biopsies (TRPB) were performed based on high PSA level or abnormal DRE. The prostate cancer rate on those TRPB was 63, 8 % (n=106). The mean age of the patients was 71, 5 years (52 to 86). Urinary retention was the first clinical patterns of reference in our institution (55, 7 %, n = 59). Most patients, 56, 6 % (n = 60) had a serum PSA level over than 100 ng/ml. All the patients had adenocarcinoma on histological study of prostate biopsy cores. The majority of cases (54, 7 % n = 58) had Gleason score equal or higher than 7.</p> <p>Conclusion</p> <p>Prostate cancer is diagnosed at later stages in our country. Very high serum PSA level and poorly differentiated tumors are the two major characteristics of PC at the time of diagnosis.</p

Entero-cutaneous fistula: an unusual complication of suprapubic cystostomy

Supra-pubic cystostomy, often done to relieve urinary retention or protect a bladder outflow reconstructive surgery, is often considered a “simple” procedure by all standards. The complications following this procedure are few, being limited to haemorrhage and bladder collapse with difficulty in identifying intra-operatively, especially in closed cystostomy. Uncommon complication includes bowel injury. We report on a patient who presented with entero-cutaneous fistula following supra-pubic cystostomy (SPC). He had right hemicolectomy with ileo-transverse anastomosis and repair of cysto-cutaneous fistula. Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 199-20