Vesico-uterine fistula associated with secondary infertility: A case of successful repair

Genitourinary fistulas usually have devastating consequences on a woman's reproductive health. vesicouterine fistulae though uncommon variant of genitourinary fistula, are usually due to iatrogenic etiologies. The case reported was diagnosed after second caesarean section when she was being evaluated for secondary infertility. Keywords: Youseff 'syndrome, Amenorrhea, Caesarean Section, Fistula

The prevalence of adult obesity in Ogbomoso, southwest Nigeria

Background: In many developing countries obesity and obesity-related morbidities are now becoming a major health challenges. Objectives: To determine the prevalence of obesity among adults using the measure of body mass index (BMI) and waist circumference (WC). Methods: A hospital based cross-sectional descriptive study of 400 adults was carried out. A standardized questionnaire was administered to the participants and had measurements of weight, height and waist circumference taken. Results: Four hundred subjects were randomly selected (221 females and 179 males) and the mean age was 48.7 ± 16. 6 years. The overall prevalence of obesity using BMI was 14.8%, and based on WC was 33.8%. The prevalence of obesity using the BMI and WC among the males was the same (8.9%) while among the females the prevalence based on BMI was 19.5% and that of WC was 53.8%. The female subjects were more sedentary than the males (50.8% for males, 62.4% for females,

Penetrating injury caused by the gear pedal of a motor-cycle

This is a case of a penetrating injury to the left lower extremity caused by the gear pedal of a motor-cycle that pierced through the foot of one of the 3 passengers on a motor-cycle involved in a road traffic accident. He had no neurovascular injury but was found radiologically to have an ipsilateral tibia fracture. The object was removed in the operation theatre under general anaesthesia by gentle manipulation. The fracture was reduced conservatively on the 8th post-operative day using an above knee cast

Outcome of Infertility Consultations in a tropical tertiary health institution in Nigeria

Aim: To examine the outcome of gynaecological consultations for infertility in a tropical Teaching Health facility.Material & Methods: This is a cross-sectional study of infertility cases seen at the Bowen University Teaching Hospital, Ogbomoso over a year (16 October, 2010 to 15 October, 2011). The patients were followed up for twelve months thereafter. Data collection was done using a designed profoma. All patients coming for gynaecological consultations because of infertility within the study period were included in the study after giving their informed consents. Patient information recorded in the profoma included age, parity, educational status, occupation, duration of infertility, investigations, modality of treatment and treatment outcome. Outcome was measured by the number of live births amongst treated patients.Results: A total of 195 patients presented for gynaecological consultations during the one year period; infertility was one of the commonest reasons for gynaecological consultation, accounting for 38.5% (75) of the cases. Tubal factor, 25(33.5%) was the commonest etiological cause. The treatment modality involved myomectomy (20, 26.6%), ovulation induction (20, 26.6%), laparoscopic adhesiolysis (8, 10.7%) and tubal surgery (5, 6.7%). Treatment of infertility resulted in 10 (13.3%) live births, with ovulation induction giving the highest percentage of live births (5, 50%).Conclusion: The outcome of treatment of infertility is poor. Therefore, establishing a standard assisted reproductive technology (ART) unit will be of immense value in improving the outcome.Keywords: Infertility, consultation, outcom

An audit of uterovaginal prolapse in Ogbomoso, south-west Nigeria

Objective: Uterovaginal prolapse (UVP) as a gynaecological problem is very common especially in multipara. This condition is important to gynaecologists practicing in Sub-Saharan Africa because of its strong link with multiparity, poor conduct of labour, and most importantly, its role as a cause of chronic morbidity in many post-menopausal women necessitating major gynaecological surgeries.Methods: A retrospective study of utero-vaginal prolapse to determine the prevalence, presentation , management patterns and complications of UVP at the Bowen University Teaching Hospital , Ogbomosho, Oyo State, Nigeria between January 1, 2010 and December 31, 2014. Relevant data were obtained from the case notes, which included age, parity, presenting symptoms, number of living children, types of delivery, types of surgical management and associated operative morbidity and mortality. The data were presented as simple percentages.Results: The prevalence of uterovaginal prolapse was 5.4%. The mean age at presentation was 51.4± 3.3 years. The mean parity was 4.2± 1.6. Fifty-six (90.3%) of them were at least 40 years old . Majority of the patients( 80.6%) were grand-multiparous. The commonest symptom was 'something coming down the vagina' in 96% of the study subjects. Difficult labour was found to be the most common associated factor in 47 (76.2%) of the patients Second degree prolapse was the commonest type of presentation (74.2%). The most common form of treatment offered was vaginal hysterectomy with pelvic floor repair, 46 (74.2%) of the patients. Twenty -four (38.7%) patients had vaginal pessaries inserted for various degrees of UVP.Conclusion: Uterovaginal prolapse is a common gynaecological condition of the parous and elderly postmenopausal women associated with a decreased body image and quality of life. Supervised hospital deliveries and limiting the family size by efficient contraception deserve priority attention to prevent this social malady.Keywords: Difficult labour, uterovaginal prolapse, hysterectomy, multiparit

A clinical audit of hysterectomy in Bowen university teaching hospital, Ogbomoso, south west Nigeria.

Context: Hysterectomy is a major gynaecological surgical procedure which involves the removal of the uterus, occasionally structures in the adnexae are removed alongside depending on the need to do so. Hysterectomy can be approached Abdominally, vaginally or even with laparoscopic assistance.Objective: This study was embarked on to ascertain the prevalence, indication, pattern and outcome of hysterectomy over a four (4) year period.Study design, Settings and Subjects: This study is a four (4) year retrospective review of all cases of hysterectomy either for gynaecological or obstetric reasons managed at BUTH from 1st January 2011 through 31st December 2014.Result: During the period under review a total of 127 hysterectomies were done for gynaecological and obstetrical indications, However, only 103 case records were available. Gynaecological indication was the reason for hysterectomy in 95 (92.2%) , while the remaining 8 (7.8%) had hysterectomy for Obstetrical indications. The mean age of patients in our study was 49.2±12.6 years; there was an age distribution of 18-90 years. The mean age of patients who had abdominal hysterectomy was 45.3±7.4 years, while the mean age for patients who had vaginal hysterectomy was 68.7±5.3 years. Abdominal hysterectomy accounted for 90( 87.4%) , while vaginal hysterectomy accounted for the remaining 13(12.6%) ; there was no case of laparoscopically assisted vaginal hysterectomy done. There were three(3) deaths following emergency hysterectomy performed on account of primary postpartum haemorrhage.Conclusion: Hysterectomy remains a major gynaecological procedure. Necessary steps are needed to ensure that gynaecologist acquire skills for hysterectomy especially vaginal hysterectomy and even laparoscopic assisted hysterectomy