Huge Pelvic Lipomatosis as an Unusual Cause of Acute Urinary Retention

Pelvic lipomatosis is a benign tumor of adipose tissues rarely seen in young males. Its clinical presentation is variable. Acute urinary retention is unusual pattern of presentation. This reports a case and management of huge pelvic lipomatosis in a 33‑year‑old African male presenting with lower urinary tract symptoms and acute urinary retention. The relevant literatures were also reviewed

Primary Infertility Secondary to Posterior Urethral Valve

A 34-year-old civil servant presented to our facility, following a referral from a gynecologist who was also seeing the wife. The man presented with a history of anejaculation and the inability to impregnate his wife after 23 months of marriage. History, physical examination, and ancillary investigation led to a diagnosis of primary infertility secondary to posterior urethral valve which was subsequently ablated. Three weeks after ablation, he started ejaculating, and 2 months later, the wife became pregnant

Unsuspected skin metastasis of adenocarcinoma of the prostate in a patient on goserelin (Zoladex)

Prostate cancer remains the most common noncutaneous cancer in men, especially in this era of prostate-specific antigen assay. Prostate cancer metastases have been known to commonly affect the lymphatics, bones, and lungs. Prostate cancer metastasis to the skin is very rare (<1%) and often signifies a terminal disease. Involvement of the skin has been thought to be through lymphatic spread by embolization or permeation, hematogenous spread, and implantation during surgery (port site in radical prostatectomy). We report a 74-year-old man on management for advanced prostate cancer with subcutaneous goserelin (Zoladex) but developed skin metastasis in the course of treatment. The skin metastasis in our patient, however, was initially localized to the site of the regions of subcutaneous goserelin injection that we imagined if there is a link between the two. We reviewed the literature and currently found no connection. Is there truly a link

Post-circumcision urethrocutaneous fistulae: presentations, repairs and outcomes in a tertiary centre

Background: Circumcision is regarded as the most common surgical procedure world over. It is also perceived to be a simple and safe procedure; however, it could be fraught with major urological complications such as urethrocutaneous fistula (UCF). Repair of these fistulae poses a great reconstructive challenge to the paediatric surgeon/urologist with varied outcomes. Aim: We seek to review the presentations, repair and outcome of post-circumcision UCFs managed in a tertiary centre. Patients and Methods: This is a retrospective review of all the consecutive cases of repaired post-circumcision UCFs in Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East Nigeria, over a period of 9 years (January 2012–December 2020). Data on demography, size of fistula, type of repair and outcome were retrieved from the Records Department and patients' case notes and were analysed using SPSS (version 22, Chicago, Illinois). Results: A total of 22 boys had post-circumcision UCF repair within the period, and they were aged between 2 weeks and 108 months with a median age of 4 months at presentation and aged between 8 months and 144 months with a median age of 24 months at the time of surgery. Circumcisions were by freehand technique in 21 (95.5%). Nurses performed most of the circumcisions in 19 (86.4%), and most of the circumcisions were performed in private hospitals 7 (31.8%), maternity homes 3 (13.6%) and general hospitals in 10 (45.5%) each, respectively. Most 17 (77.3%) fistulae were coronal, and the size of defect ranged from 1 mm to 10 mm. The most commonly employed technique of repair was simple closure in 16 (72.2%). Meatal stenosis and re-fistulation occurred in 2 (9.1%) and 4 (18.2%), respectively. Only two (12.5%) required reoperation. There was no relationship between the size of defect and re-fistulation, P = 0.377. Conclusion: Majority of the Post-circumcision urethrocutaneous fistulae were from free hand technique of circumcisions . These were performed mostly by nurses in general, private hospitals and maternity homes. Hence, there is a need to ramp up training of providers of neonatal circumcision in our environment. Most UCF in children could be repaired with simple closure technique reinforced with dartos flap

Assessment of Complications of Transurethral Resection of the Prostate Using Clavien‑Dindo Classification in South Eastern Nigeria

Background:&nbsp;Benign prostatic hyperplasia is one of the most common diseases in aging males. For men that need surgical treatment, transurethral resection of the prostate (TURP) is the gold standard. The aim of this article is to retrospectively review the complications of TURP over a 3-year period in Nnamdi Azikiwe University Teaching Hospital Nnewi and a Specialist Urology Center in Awka all in Anambra South-East Nigeria using Clavien-Dindo classification.&nbsp;Patients and Methods:&nbsp;The study was a retrospective review of consecutive TURPs done over a 3-year period. Patients' information and complications arising from the procedure were collected and graded using the Clavien-Dindo classification with a pro forma designed for the study and analyzed with the Statistical Package for the Social Sciences software version 20.0.&nbsp;Results: Ninety-seven patients had TURP during the period of this study. Twenty-nine complications were noted in 24 patients. The postoperative morbidity rate was 24.74%, and no mortality was recorded. Most of the complications were grade 2 (55%), followed by grade 1 and 3 (20.69%) each. Grade 4a complication accounted for only 3.45%. No grade 5 complication was recorded. Conclusion:&nbsp;TURP is safe, with minimal life-threatening morbidity even in a resource-poor economy where TURP is gradually gaining grounds

Correlation between Body Mass Index and Gleason Score in Men with Prostate Cancer in Southeastern Nigeria

Introduction: Prostate cancer has an increasing global burden. The clinical course varies from an indolent disease to a rapidly aggressive cancer. It is associated with higher mortality in less developed nations due to late presentation. The Gleason scoring system for prostatic adenocarcinoma has prognostic implications in diagnosed cases. Obesity has been associated with the evolution of many cancers including prostate cancer. There are conflicting reports on the relationship between obesity, as measured by body mass index (BMI), and prostate cancer aggressiveness, as measured by Gleason score. This study is aimed to determine if a correlation exists between BMI and Gleason score in men with prostate cancer. Methodology: This was a prospective, hospital-based, cross-sectional study involving consecutive patients with prostate cancer. Clinical evaluation including anthropometry, digital rectal examination, and relevant investigations were done for each patient and data collected with pro forma. This was followed by prostate needle biopsy and those diagnosed with adenocarcinoma of the prostate had their Gleason grades and scores obtained. Data were analyzed statistically using Spearman Correlation.&nbsp; Results:&nbsp;The mean age of the patients was 69.54 ± 8.61 years (range 47–83 years). The BMI ranged from 16.98 to 36.45 kg/m2, with a mean of 27.03 ± 5.03 kg/m2. Twenty-six of the patients (36.1%) were overweight and 34.7% were obese. The mean total prostate-specific antigen was 118.65 ± 84.43 ng/ml, with a range of 31–406 ng/ml. The modal Gleason score was 9 with a range of 4–10. There was a strong positive correlation between BMI and Gleason score (r&nbsp;= 0.817,&nbsp;P&nbsp;= 0.0003).&nbsp;Conclusion:&nbsp;The BMI of patients with prostate cancer correlated positively with their Gleason score

Assessment of health-care research and its challenges among medical doctors in Nigeria

Introduction: Health‑care research in Nigeria has been growing over the years but is constrained by many difficulties. This study aimed to identify the challenges encountered in health‑care research and suggest policies to address these problems. Materials and Methods: It was a cross‑sectional study of medical doctors who have been involved in health‑related researches. All participants filled a self‑administered online questionnaire comprising 31 questions in five sections. The responses were analyzed using the Google forms and the Statistical Package for the Social Sciences software version 23. Results: The mean age of the study participants was 41.0 ± 8.4 years. Three‑quarters of the respondents (75.5%) worked in teaching hospitals. Nearly all (96.6%) carried out their studies using personal funds and only one in 10 had been involved in high‑budget projects (≥₦1,000,000). The generation of quality researches was impeded by the restriction of literature review to free online journals (93.2%), incomplete health records (88.0%), limited access to research kits (65.7%), limited use of advanced statistical analysis (29.8%), and challenges with obtaining ethical approval (21.2%). Despite the average online visibility of these researches (52.2%), only 28.5% stated that it has been locally adopted to influence medical practice in their center. Conclusion: There is a wide disparity in research capacity among hospital tiers. It is important to leverage on and expand existing partnerships to provide institutional access to premium literature, offer robust, and assessable financial support for the conduct of high‑quality researches and provide a framework to bridge the gap in the use of these works to influence practice change in Nigeria