Gynecological malignancies in Aminu Kano Teaching Hospital Kano: A 3 year review

Objective: To study the pattern of gynecological malignancies in Aminu Kano Teaching Hospital.Materials and Methods: This was a retrospective observational study carried out in the Gynecology Department of Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria between October 2008 and September 2011. Casenotes of all patients seen with gynecological cancers were studied to determine the pattern, age and parity distribution.Results: A total of 2339 women were seen during the study period, while 249 were found to have gynecological malignancy. Therefore the proportion of gynecological malignancies was 10.7%. Out of the 249 patients with gynecological malignancies, most (48.6%) had cervical cancer, followed by ovarian cancer (30.5%), endometrial cancer (11.25%) and the least was choriocarcinoma (9.24%). The mean age for cervical carcinoma patients (46.25 ± 4.99 years) was higher than that of choriocarcinoma (29 ± 14.5 years) but lower than ovarian (57 ± 4.5years)and endometrial (62.4 ± 8.3 years) cancers. However, the mean parity for cervical cancer (7.0 ± 3) was higher than those of ovarian cancer (3 ± 3), choriocarcinoma (3.5 ± 4) and endometrial cancer (4 ± 3). The mean age at menarche for women with cervical cancer (14.5 ± 0.71 years) was lower than for those with choriocarcinoma (15 ± 0 years), ovarian (15.5 ± 2.1 years) and endometrial (16 ± 0 years) cancers. There was one case of vulva cancer and none with vaginal cancer.Conclusion: Cervical cancer was the most frequent malignant tumor and the least was choriocarcinoma. Estimates of this important public health problem need to be addressed in various regions of Nigeria.Key words: Cancers, gynecological, nigeria, north-west, pattern, tertiary hospita

Epidemiology of pelvic organ prolapse in rural Gambia, West Africa.

OBJECTIVES: To investigate the prevalence of pelvic organ prolapse in rural Gambia. DESIGN: Community-based reproductive health survey. POPULATION: 1348 women residing in 20 villages in rural Gambia. METHODS: Health questionnaire and standard gynaecological examination to detect symptoms and signs of pelvic organ prolapse and other reproductive diseases. Association between prolapse, socio-demographic data and other morbidities was examined. MAIN OUTCOME MEASURES: Presence and degree of pelvic organ prolapse. RESULTS: Out of 1067 women consenting to speculum examination 488 (46%) were found to have some degree of prolapse. In 152 women (14%) the prolapse was severe enough to warrant surgical intervention. After adjustment for confounders the likelihood of pelvic organ prolapse increased with parity and age and was higher in women of the Wolof tribe, pregnant women, those with insufficient perineum, and moderately and severely anaemic women. Only 13% of women with moderate or severe prolapse reported symptoms on direct questioning. CONCLUSIONS: Pelvic organ prolapse has a high prevalence in this first community-based study of prolapse in West Africa. Many of those affected did not complain about their problem, thus increasing the large, silent burden of reproductive morbidity in this population. Parity was confirmed to be the strongest risk factor followed by age and anaemia. Ethnic origin was a previously unknown risk factor suggesting possible genetic factors in the pathogenesis of prolapse