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

Prostate Cancer Presenting with Parietal Bone Metastasis

Bone metastases from prostate cancer are very common. They are usually located on the axial skeleton. However, cranial bone metastases especially to the parietal bone are rare. We report a case of metastatic prostate cancer presenting with left parietal bone metastasis in a patient with no urological symptoms or signs. We should consider prostate cancer in any man above 60 years presenting unusual bone lesions

Adult Granulosa Cell Tumor of the Testis: A case report and review of the literature

Adult Granulosa Cell Tumor of the Testis (AGCTT) is a rare sex-cord stromal tumor. About 73 cases have been previously reported in the literature. We report a case of AGCTT in a 64 years old male, located in the left testis. We performed left radical inguinal orchiectomy. A sagittal section of orchiectomy specimen showed a solid yellowish-white mass measuring 1cm of long axis. On microscopic examination, we noted a well-limited tumor proliferation of solid architecture. The proliferation was made up of cells with scant cytoplasm and incised oval nuclei in a fibrous stroma. Rare Call-Exner bodies were noted

Penile fracture in burkina faso: our experience on the management of 21 cases

Abstract Background Penile fracture is relatively a rare urological emergency and has been the topic of a few publications in the literature through clinical cases or case series. Despite this relative scarcity, it is increasingly reported as one of the andrological emergencies in Burkina Faso. The purpose of this study was to report our experience of the management of such andrological emergency in the two main university teaching hospitals of Burkina Faso. Methods This was a cross-sectional study, including retrospectively patients managed for a penile fracture between January 2016 and September 2021, and having a minimum postoperative follow-up of 6 months. The literature review was performed by analyzing the content of the following documents: consultation logs, patient records, operative report protocol. The parameters studied were age, mechanism of occurrence, clinical data, delay of management, operative technique and functional and morphological results after surgery. Erectile function was assessed by the IIEF5 score and rigidity by the EHS scale. Results Among the 24 cases of penile fracture, 21 patients were included with a median age of 32.7 ± 5.74 years (23–43 years). The most common mechanism was a coital misstep or coitus interruptus (14 patients or 66.7%). Forced self-manipulation/masturbation was noted in 4 cases (19%), and direct trauma to the penis was noted in 3 cases (14.3%). Urethrorrhagia was reported by 5 patients. The mean delay of management was 65 h (6–432 h). The main sign found was the painful swelling of the penis with an “eggplant” appearance. The surgical approach was a circumferential balanopreputial incision in all our patients. Involvement of the spongy body and urethra associated with involvement of the cavernous body was noted in 4 patients, with a single case of spongy body and urethral involvement. The mean length of hospital stay was 3 days. Postoperatively, erectile dysfunction was noted in 6 patients. A palpable nodule at the penis was observed in 12 patients. No patient reported curvature of the penis. Conclusion Penile fracture is a clinical diagnosis requiring early exploration and surgical repair to ensure better functional and morphological outcomes

Characteristics of Obstetric and Iatrogenic Urogenital Fistulas in Burkina Faso: A Cross-Sectional Study

Objective. To compare the sociodemographic, clinical, and therapeutic characteristics of obstetric urogenital fistulas (OF) and iatrogenic urogenital fistulas (IF) treated in seven centers in Burkina Faso. Material and Methods. We carried out a cross-sectional study over a seven years’ period (January 1, 2010 to December 31, 2016). We considered as iatrogenic all urogenital fistulas (UGF) occurred after elective caesarean section, gynecologic surgery (hysterectomy, myomectomy, and prolapse repair), or induced abortion. UGF following vaginal delivery after prolonged labor without obstetric maneuvers or caesarean section were considered as obstetric. UGF caused by other mechanisms (emergency caesarian section, congenital, and traumatic) were excluded from this study. The statistical analysis was carried out using version 14 of the STATA software. A logistic regression model was used to compare the two groups. Results. 310 cases of UGF were included. IF accounted for 25.8% (n = 80) versus 74.2% (n = 230) for OF. The median age was 35 years for IF and 35.38 years for OF. The vesicovaginal fistulas were predominant (74.5%) in the two groups. All circumferential fistulas were found in the OF group. OF were frequently associated with residence in rural areas (OR = 1.8; CI = [1.05–3.1]), low level of education (OR = 5.4; CI = [2.3–12.9]), and a height under 158 cm (OR = 3.4 CI = [1.7–6.6]). Vaginal sclerosis was less common among IF (OR = 2.2; CI = [1–4.6]). The failure of surgical treatment after 3 months was more associated with OF (OR = 4.7; CI = [1.1–20.5]). Conclusion. OF were the most common, frequently affecting short women living in rural area and with low level of schooling. Fistulas were also more severe in the OF group. IF gave better results after surgical repair

High Prevalence of Opaline Silica in Urinary Stones From Burkina Faso

International audienceOBJECTIVE To underline peculiar composition of kidney stones and to propose an epidemiologic study of urinary stones in West African countries, where epidemiologic studies are scarce. Only few data are available regarding stone composition in sub-Saharan countries. Recently, a set of 100 stones consecutively removed by surgery in the Department of Urology of the University Hospital of Ouagadougou in Burkina Faso were collected for physical analysis, which provided the opportunity to obtain an epidemiologic profile of stone composition in this country. MATERIALS AND METHODS A total of 100 stones from 64 men, 22 women, 10 boys, and four girls were analyzed by morphologic examination, infrared spectroscopy, and electron microscopy in our laboratory. The results were considered by sex and separately for adults and children. RESULTS Sixty-five percent of the 100 stones contained calcium oxalate as the main component. Interestingly, the second main component was opaline silica (18%). Furthermore, opaline silica was identified in any proportion in 48% of the stones. The prevalence was sex and age dependent. Opaline silica was detected as the main component in 42% of the nuclei, which underlines its role as one of the main components involved in the initiation of calculi in this country. CONCLUSION For the first time, a dramatically high occurrence of a ``scarce'' urinary stone component, namely opaline silica, was reported in a series of consecutive calculi from a single country. We propose that a regular consumption of clay could be the origin of this phenomenon in these populations

Élucidation structurale de la silice présente dans des calculs rénaux prélevés au Burkina Faso

International audienceHundred kidney stones obtained from the University Hospital of Ouagadougou (Burkina Faso) were finally characterized by a panel of complementary spectroscopic and diffraction tools. The most surprising result is the high occurrence of opaline silica as a component in these kidney stones. Opaline silica is a scarce mineral phase in renal calcification; however, we found that at least 48% of the stones had a detectable proportion of silica. SEM images demonstrate the presence of micrometric objects (of spheroidal shape) in close association with monohydrated calcium oxalate crystals. X-ray fluorescence, XRD and 29Si solid state MAS NMR demonstrate unambiguously the presence of amorphous silica, whose composition is comparable to that of natural opals. As NMR is a local spectroscopic probe, other nuclei can be probed. We demonstrate that traces of aluminium are present in the kidney stones by using 27Al solid state MAS NMR. These experiments may offer the first clues of pathological processes that are responsible for these stones.Cent calculs rénaux obtenus du CHU de Ouagadougou (Burkina Faso) ont été caractérisés par une série d'outils spectroscopiques et de diffraction complémentaires. Le résultat le plus marquant a été la très haute prévalence de la silice opaline comme composant de ces calculs. La silice opaline est un composant rare des calculs rénaux. Cependant, nous l'avons trouvée dans près de 48% des calculs, dans des proportions suffisantes pour être détectables par analyse infrarouge. Les images au MEB démontrent la présence d'objets micrométriques (de forme sphérique) en association intime avec des cristaux d'oxalate de calcium monohydraté. La fluorescence des rayons X, la diffraction des rayons X et la RMN du solide du 29Si démontrent sans ambiguïté la présence de silice amorphe, de manière comparable au cas des opales naturelles. Comme la RMN est une sonde spectroscopique locale, d'autres noyaux peuvent être détectés. Nous avons ainsi démontré que des traces d'aluminium sont présentes dans les calculs rénaux étudiés en utilisant la RMN du solide du noyau 27 Al. Ces expériences peuvent offrir les premiers éléments de réponse concernant le processus pathologique conduisant à la formation de ces calculs