Urethroplasty practices among reconstructive urologists in Nigeria

Objectives: To determine the national practice patterns in the management of male urethral stricture disease by the open urethroplasty technique. Materials and Methods: A questionnaire-based national survey of Nigerian urologists was performed during the 19th Annual General Meeting and Scientific Conference of the National Association of Urological Surgeons of Nigeria, held at Ibadan, Southwest Nigeria in 2013. Results: A total of 55 respondents (67.1%) completed the questionnaire. About 43.6% were between the ages of 40 and 49 years. Almost 41.8% had between 5 and 9 years of experience as a reconstructive urologist, and 50.9% performed 1–9 urethroplasties/year. A total of 80 responders reported trauma as the most common etiology for their strictures. About 63.7% preferred to treat strictures after 3–6 months of diagnosis and 67.3% of respondents preferred the combination of retrograde urethrography and voiding cystourethrography for the diagnosis of urethral stricture. Stenting of the urethra was done after urethroplasty using size 16 Fr of 18 Fr silastic catheter; however, the duration of stenting varied among urologists. About 41.8% followed up their patients for a year, and uroflowmetry was used by 36.6% of the responders to follow-up their patients. Stricture recurrence was the most common reported complication by 36.4% of the respondents. Conclusions: In Nigeria, most urethral stricture diseases are treated by open urethroplasties. Very few of these surgeries are performed annually by young urologists. There is no uniformity in the method of diagnosis, stenting, and follow-up after treatment

Complications of prostate biopsy in two centres in Anambra State

Background: Prostate cancer is the most common malignant neoplasia in men and second cause of cancer related death after lung cancer. Prostate biopsy is the commonest procedure done by urologists and it is not without complications. We looked at the pattern of complications in our environment.Objective: To assess the incidence of complications and associated risk factors amongst our prostate biopsy patients.Methodology: A prospective study of the complications of prostate biopsy in 2 centers in Anambra South-Eastern NigeriaResult: A total of 208 patients qualified for the study. The commonest complication was haematuria which occurred in 22(10.6%) of the patients. No patient had haematospermia and no death was recorded. Other complications recorded were rectal bleeding (2.4%), Acute Urinary Retention (5%), fever (3.8%) and pain (4.3%). Other recorded complications were syncopal attack and caudal parasthaesia in one patient each.Conclusion: Prostate biopsy though considered safe, has attendant complications. This calls for caution in doing the procedure.Keywords: Transrectal biopsy, Haematuria, Rectal bleeding, Saddle paraesthesi

Retained Surgical Instruments in The Pelvis Complicated by Colo-vesical Fistula

Retaining a surgical instrument in the patient unintentionally could lead to serious complications and in extreme cases, death. It also damages the reputation of the healthcare provider, as well as the health facility involved. We report a case of retained haemostat and dissecting forceps complicated by colo-vesical fistula 10 years after hysterectomy in a 50-year-old lady with a 7-month history of passage of urine per rectum. The foreign bodies were removed as well as an associated bladder calculus. The fistulae were repaired and recovery was uneventful