A propos d'un cas d'hematurie &#235 par bilharziose urinaire observe au Chu de Lome (Togo)

Intentions and observation: The gravity of the urine schistosomiasis is classically bound to the lesions of sclerosis. Although the main symptom of the illness is the urinary bleeding, this one has never worried the clinician at the point to make him fear a hemorrhagic shock from the patient, by acute hematuria. Our patient was a case of haemorrhagical complication of the illness, which required a cystostomy at the gynecoobstetrical department for pelvic pains, dysuria and total hematuria. In conclusion, the acute haemorrhagic complication of a hematuria by urine schistosomiasis although scanty may be dramatic in the development of this illness if any precautionary measures haven’t been taken. Propos et observation : la gravité de la bilharziose urinaire est classiquement liée aux lésions de sclérose. Bien que le maître symptôme de la maladie soit le saignement urinaire celui-ci n’a jamais inquiété le médecin au point de lui faire redouter chez le malade un choc hémorragique par hématurie aiguë. Le tableau clinique de notre cas était celui d’une complication hémorragique de la maladie qui a nécessité une cystostomie au service de gynéco-obstétrique pour douleurs pelviennes, dysurie et hématurie totale. En conclusion, la complication hémorragique aiguë d’une hématurie par bilharziose urinaire bien que rare, peut être dramatique dans l’évolution de la maladie si l’on y prend garde

Pronostic obstetrical des gestantes Togolaises porteuses de cicatrice de cesarienne. A propos de 282 cas colliges au Chu de Lome(Togo)

Objective: To assess the security granted to women delivering with a scarred uterus in a maternity where labour is monitored only by clinical examination.Methods: Retrospective study held from January 1st 1999 to December 31st 1999. We analysed delivering route, maternal complications, and perinatal prognosis in 282 pregnant women who previously had caesarean operations.Results: Scarred uteri represented 5.9% of all deliveries; caesareans were performed in 116 cases (41.1%); trial of labour was monitored in 166 cases (58.9 %), from which 104 (62.7 %) were deliveredvaginally. Favourable factors raising normal delivery rate were previous vaginal deliveries (p = 0.00001). We registered 1 maternal death (0.35%), 6 ruptures of scarred uterus (2.1%) including 2 frank rupturesand 4 dehiscences of scar. Perinatal mortality rate was 4 % and perinatal morbidity rate 8 % caused by perinatal anoxia (81.8%) especially in cases of failure of trial of labour.Conclusion: An adequate selecting to trial of scar and an adequate monitoring of labours should significantly reduce the likely risky outcomes observable in deliveries on scarred uterus

Survie globale des patientes traitees pour cancer du sein au Chu de Lome (Togo)

Objectives: To evaluate the global survival of patients treated for breast cancer, to identify the prognostic factors influencing survival, and to measure the relation between survival and these factors,and to suggest steps to improve the survival.Patients and method: We carried out a retrospective and transversal study on 82 patients with histopathologically confirmed breast cancer, who were treated and followed up at Lome Teaching Hospital between March 1993 and March 2001. Age of patients before treatment, tumours size and nodal status, type of treatment, five-years overall survival and disease free survival, loco-regional status recurrences, and metastasis were studied. We tested the relation between survival and prognostic factors influencing survival with the test of ÷², with a significant degree of 5 %.Results: The median age of our patients was 49.5 years ranging from 27 to 78 years. The group of 36-45 years (35.4%) was the most important and the group of 66-75 years the less important (4.8 %) Most of them took at least one year before coming to the hospital for the first time (51.0%). The size of the tumours was superior to 50 mm (58.5%). Suspect clinical nodes were found in 57.3%. Mastectomyaccording to PATEY method was performed in 76.8% and associated to the chemotherapy in 85.3% and radiotherapy (2.4%). 20 patients died during the period of the study (24.4%). Five-years overall survivaland disease free survival were 20.7 % and 17.0 % respectively. Loco-regional recurrence was noted in 35.3% and of metastases in 39.0%. Survival was strongly related with tumour size (p<10-4), malignant nodes (p<0.05), histopronostic grading of Scarff, Bloom, and Richardson (p<3.10-3), histological type of the cancer (p<10-8), loco-regional recurrence (p<10-8), and metastases (p<10-8) No influence was found between age of the patient and type of treatment received.Conclusion: Early diagnostic and treatment as well as improvement in our technical possibilities must be our first and urgent priorities. Objectifs : Evaluer la survie globale des patientes traitees pour cancer du sein, identifier les facteurs pronostiques influencant la survie, mesurer la force de liaison entre la survie et ces facteurs, et proposerdes mesures propres a ameliorer la survie.Methodes : Etude retrospective transversale dfune serie continue de 82 patientes traitees et suivies a la clinique gynecologique et obstetricale du CHU de Lome de Mars 1993 a Mars 2001 pour cancer du sein confirme par l'examen anatomopathologique. Il a ete etudie lfage de la patiente au debut du traitement, la taille de la tumeur, le statut ganglionnaire, le type de traitement administre, les taux de survie globale et de survie sans rechutes a 5 ans, les recidives locoregionales, et les metastases. Le test du ƒÔ2, a 5 %, a eteutilise pour mesurer la force de liaison entre la survie et les facteurs pronostiques qui lfinfluencent.Resultats : Lfage median des patientes etait de 49,5 ans, avec des extremes de 27 et 78 ans. La tranche d'age la plus touchee etait celle de 36-45 ans (35,3 %) et la moins touchee celle de 66 75 ans (4,8 %) Le delai entre la decouverte et la consultation etait superieur a 1 an dans 51,0%. La taille de la tumeur etait superieure a 50 mm dans 58,5 % des cas avec des adenopathies dures fixees dans 57,3% des cas. Letraitement chirurgical a consiste surtout en une mastectomie selon la methode de PATEY dans 76,8 % des cas. La chimiotherapie a ete administree dans 85,3% des cas. Seules deux patientes ont beneficied'une radiotherapie. Pendant la periode dfetude, il a ete enregistre 20 deces soit 24,4 %. Le taux de survie globale a 5 ans etait de 20,7 % et le taux de survie sans rechute a 5 ans de 17,0 %. Le taux derecidives locoregionales etait de 35,3 %, tandis que le taux de metastases etait de 39,0 %. La survie etait fortement liee a la taille de la tumeur (p<10-4), a lfenvahissement ganglionnaire (p<0.05), au grade histopronostique de of Scarff, Bloom, and Richardson (p<3.10-3), au type histologique du cancer (p<108), aux recidives locoregionales (p<10-8), et aux metastases (p<10-8) Lfage de la patiente et le typede traitement recu nfavait aucune influence sur la survie.Conclusion : Un depistage precoce associe a une prise en charge rapide et a une amelioration consequente du plateau technique doivent constituer nos objectifs urgents et prioritaires

Apport de l'imagerie dans le diagnostic des complications de la bilharziose urinaire

(J. de la Recherche Scientifique de l'Université de Lomé, 2000, 4(1): 255-258

Les métaplasies ostéoïdes de l'endomètre. A propos d'un cas

(J. de la Recherche Scientifique de l'Université de Lomé, 1999, 3(2): 229-232