Hématométrie unilatérale sur utérus didelphe de découverte fortuite chez une multipare Camerounaise de 31 ans : à propos d’un cas et revue de la littérature

L’utérus didelphe est une malformation utérine par défaut de fusion des canaux de Müller entre la 10e et la 13e semaine de gestation, aboutissant à la persistance plus ou moins complète de la dualité de ces canaux. Certains types de malformations utérines ont des conséquences sur la vie reproductrice et exigent la chirurgie pour rétablir la continuité ou vider une collection des voies génitales si elles sont découvertes à temps. Nous vous présentons un cas d’hématométrie unilatérale sur utérus didelphe de découverte fortuite en per opératoire chez une multipare et traitée par hémi hystérectomie en urgence. La rareté de cette pathologie peut amener à omettre le diagnostic. Le diagnostic précoce et par conséquent une meilleure prise en charge permettent de diminuer les complications. L’hématométrie sur utérus didelphe est une urgence gynécologique dont la prise en charge exige la chirurgie. Les gestes doivent être moins mutilants chez les patientes souvent jeunes.Mots Clés hématométrie ; utérus didelphe ; hémihystérectomi

Non-Puerperal Uterine Inversion Following a Prolapsed Leiomyoma in a Cameroonian Woman

Non-puerperal uterine inversion is a rare condition that occurs as a complication of intrauterine tumors, especially giant submucosal leiomyomas. This condition can cause severe pain and hemorrhage. Management can consist of manual repositioning through the cervical ring, or surgical corrective measures. We report here a case of uterine inversion following the prolapse of a submucosal leiomyoma, managed by laparotomy. We also discuss alternative therapeutic approaches.Keywords uterine inversion; non-puerperal; leiomyom

Cancer Du Sein Inflammatoire Chez La Femme Camerounaise

Introduction : Le cancer du sein inflammatoire (CSI), est relativement fréquent chez la jeune femme camerounaise. L’objectif était de présenter les caractéristiques du CSI en milieu camerounais. Patients et méthodes : Il s’est agi d’une étude transversale descriptive, multicentrique à collecte rétrospective allant du 1er Janvier 2010 au 31 Décembre 2014. Ont été inclues toutes les femmes de nationalité camerounaise diagnostiquées pour un CSI histologiquement confirmé. Résultats : Vingt-et-un cas de CSI ont été colligés et représentaient 3% de l’ensemble des mastopathies dans quatre hôpitaux. L’âge moyen des patientes était de 37,7 ans. Quatorze (66,7%) femmes avaient consulté après un intervalle supérieur à six mois. La localisation de la tumeur était unilatérale dans tous les cas. Dix-huit (85,7%) des patientes avaient un statut ganglionnaire cliniquement positif. La taille tumorale médiane était de 5cm. Les patientes étaient classées respectivement PEV3 dans 52,4%, PEV2 dans 28, 6% et PEV1 dans 19%. Huit patientes (38%) étaient métastatiques. Seize (76,2%) femmes avaient une négativité aux récepteurs œstrogènes et progestérones. Le carcinome canalaire infiltrant était le plus fréquent (66,6%). Treize (62%) patientes ont recouru au traitement traditionnel rituel. Une chimiothérapie néoadjuvante et adjuvante était systématiquement instituée. Dix-huit (85,7%) patientes étaient opérables et avaient bénéficié d’une mastectomie. Six cas de récidive ont été notés au cours du suivi. La survie à cinq ans était de 42, 9%. Conclusion : L’utilisation systématique de la chimiothérapie neoadjuvante et adjuvante a amélioré le pronostic du CSI. Introduction: Inflammatory breast cancer (IBC) is relatively common in young Cameroonian women. This paper aims to present the characteristics of the IBC in the Cameroonian environment. Patients and Methods: The paper uses a descriptive, multicentre cross-sectional study with retrospective collection from 1st of January 2010 to 31st of December 2014. All Cameroonian women affected by an IBC diagnosed and histologically confirmed were included in the study. Results: Twenty-one cases of IBC, which represented 3% of all treated mastopathies, was collected in four Church Hospitals. The mean age of the patients was 37.7 years. Fourteen (66.7%) consulted after an interval more than six months. The location of the tumour was unilateral in all of the cases. Eighteen (85.7%) of the patients had clinically positive lymph node status. The median tumour size was 5cm. The patients were classified into PEV3 52.4%, PEV2 28.6% and PEV1 19%, respectively. Eight patients (38%) were metastatic. Sixteen (76.2%) women had negative oestrogen and progesterone receptors. The most common histologic type was invasive ductal carcinoma with 66.6% of cases. Thirteen (62%) patients used traditional ritual treatment. Neo-adjuvant and adjuvant chemotherapy were systematically instituted. Eighteen (85.7%) patients were operable and had undergone mastectomy. Six (33.3%) cases of recurrence were observed during the follow-up. The 5-years survival was 42.9%. Conclusion: Systematic use of neo-adjuvant and adjuvant chemotherapy improved the prognosis of IBC

Sitz Bath Vs Iodine Antiseptic (Betadine) Imbibed Gauze for the Management of Perineal and Vaginal Tears

Aims: Sitz bath is a warm or cold bath used for healing or cleansing purposes. With over 85% of women having a vaginal birth who sustain some form of perineal trauma and placed on Sitz bath without really effectively applying it, we thought of proposing an alternative simpler and relatively effective method: iodine based antiseptic(betadine) imbibed gauze cleansing. Study design: A randomized prospective trial. Setting and period: January 2009 to June 2009 in the central maternity of the Yaoundé Central Hospital because of the diversity and inflow of patients. Methodology: All women who suffered a perineal or a vaginal injury during delivery and who gave consent were recruited, into different treatment groups depending on randomization, by filling a pre-established and tested questionnaire. Randomization was done with respect to the day of the week they suffered the injury. They were then followed up with specific appointments for 9days and the parameters of efficacy evaluated and compared among the randomly selected participants. Results were analyzed using the V9 SAS software analytical system and significance value was tested with p <0.05 and CHI square. Results: We registered a 8% (94/1045) injury prevalence, episiotomies and tears together. After 9 days follow up of the randomized groups, the efficacy (degree of healing, infections, pain) was similar in the different treatment groups although compliance was better in the antiseptic imbibed gauze group than the sitz bath group. Conclusion: Our results permitted us to conclude that the efficacies are comparable although the compliance was better with betadine gauze cleaning than Sitz bath. We recommend that a large scale with bigger sample size be carried out. While awaiting a broader scale that imbibed gauze cleaning of perineal injuries be used instead of Sitz bath as this will facilitate applicability and reduce perineal infections postpartum. Limitations: Chronic pathologies like diabetes that could influence healing wasn't screened Same category of patients can be found on similar days particular to a treatment choice Some patients didn't respond correctly due to literacy level

Body Mass Index as a Risk Factor for Prostate Cancer and Benign Prostate Hypertrophy: a Comparative Study at Three Reference Hospitals in Cameroon

Introduction: Prostate cancer (PCa) is the second most commonly diagnosed cancer and the sixth most common cause of cancer-related mortality among men worldwide. Obesity increases the prevalence and mortality of multiple cancers. Consequently, the relationship between obesity and cancer is receiving more and more attention.Objective: To evaluate the impact of body mass index (BMI) on prostate cancer detection and aggressiveness in Cameroonian population.Methodology: This was a comparative cross-sectional study carried out at the hospitals in Cameroon. The study included Cameroonians who underwent prostate biopsies during a 9-year period, from 2008 to 2016. We analysed the BMI, age, prostate volume, and PSA of patients with prostate cancer in comparison with patients with benign prostate tissue who underwent prostate biopsies. Data entry was performed using CSpro 6.3.2, analysis was done using SPSS version 23.0.Results: A total of 316 patients were included in our study, 158 PCa and 158 BPH. The patients had a mean age ± standard deviation of 67.8 ± 10.32 with a modal class of 61 and 70 years. In our study, the mean age ± SD of the PCa group (71.48 ± 8.96) was significantly greater than that of the BPH group (64.17 ± 10.31) (p0.05). The median total PSA and the median PSA f/t ratio was significantly different in both groups (p<0.001 and p = 0.006). A Gleason score of 7 was the most frequent. Amongst those with a high BMI 77.5% (55) had a high Gleason score, which was significantly higher than the fraction in the low BMI group (60.9%) (53) (P = 0.026).Conclusion: We therefore conclude that BMI is not an independent risk factor for the development of prostate cancer; rather, it is associated with High Gleason PCa