Bilateral Orchiectomy With or Without Flutamide for Metastatic Prostate Cancer

Prostate cancer is the second most common malignancy in males and the sixth leading cause of cancer mortality in men with a relatively higher death rate in men of African descent. In the United States and other parts of Europe, more than 80% of diagnosed prostate cancer is localized, and 80-90% of these men receive some form of treatment. The projected data may not be a direct reflection of the disease in the sub-Saharan region as less than 40% presents with localized disease. Results from prostate cancer screening have shown that most African men in the sub-region have little knowledge of the disease. There are recommended international guidelines for the management of localized prostate cancer, however, a guideline in a local context could be ideal. World J Oncol. 2019;10(4-5):162-168 doi: https://doi.org/10.14740/wjon1221

/pdf/a-review-of-localized-prostate-cancer-an-african-perspective-4vm586wah4.pdf

A Review of Localized Prostate Cancer: An African Perspective.

The estimated incidence rate of prostate cancer in Africa was 22.0/100,000 in 2016. The International Agency for Research on Cancer (IARC) has cited prostate cancer as a growing health threat in Africa with approximated 28,006 deaths in 2010 and estimated 57,048 deaths in 2030. The exact incidence of advanced and metastatic prostate cancer is not known in sub-Saharan Africa. Hospital-based reports from the region have shown a rising trend with most patients presenting with advanced or metastatic disease. The management of advanced and metastatic prostate cancer is challenging. The available international guidelines may not be cost-effective for an African population. The most efficient approach in the region has been surgical castration by bilateral orchidectomy or pulpectomy. Medical androgen deprivation therapy is expensive and may not be available. Patients with metastatic castrate-resistant prostate cancer tend to be palliated due to the absence or cost of chemotherapy or second-line androgen deprivation therapy in most of Africa. A cost-effective guideline for developing nations to address the rising burden of advanced prostate cancer is warranted at this moment.

/pdf/management-of-advanced-and-metastatic-prostate-cancer-a-need-33uvrpf4km.pdf

Management of Advanced and Metastatic Prostate Cancer: A Need for a Sub-Saharan Guideline

Resume Objectif Decrire les caracteristiques epidemiologiques, anatomiques et cliniques des fistules urogenitales et recto-vaginales ainsi que l’issue de leur prise en charge chirurgicale au Togo. Materiel et methodes Une etude retrospective a collige tous les cas operes sur une periode de cinq ans dans le centre national de prise en charge des fistules obstetricales. Les parametres etudies etaient les donnees sociodemographiques des patientes, les caracteristiques cliniques et l’issue de la reparation chirurgicale. Resultats Le nombre de patientes traitees etait de 197, pour un nombre total de 217 interventions chirurgicales. L’âge moyen des patientes etait de 40,7 ans avec des extremes de 18 et 70 ans. Les causes obstetricales predominaient (95 %) et 3,5 % etaient causees par une chirurgie. Sur le plan anatomo-clinique, la fistule vesico-vaginale (FVV) etait la forme la plus frequente representant 87,3 % tandis que la fistule vesico-uterine n’occupait que 4,1 %. La multiparite etait un facteur de risque de survenue de fistule obstetricale et une cesarienne a ete necessaire dans 70 % marquee par une forte mortalite du fœtus (88,2 %). La prise en charge chirurgicale a ete tardive dans la majorite des cas, avec un delai d’environ 10 ans entre la survenue de la fistule et sa reparation. Le taux de guerison etait de 78,1 %. Conclusion Les fistules urogenitales sont principalement d’origine obstetricale au Togo avec comme facteur de risque la multiparite. La prise en charge est tardive mais permet un bon taux de guerison. Leur prevention passe par la lutte contre la dystocie. Niveau de preuve IV.

Profil épidémiologique, anatomoclinique et thérapeutique des fistules urogénitales et rectovaginales au Togo

Introduction. Prostate cancer is currently a public health problem with a frequency that varies from country to country. This study aims to describe the epidemiological, clinical, and histopathological and outcome features of prostate cancer in Lubumbashi in the Democratic Republic of Congo. Materials and Methods. This was a descriptive longitudinal study of patients diagnosed with prostate cancer at the University Clinics of Lubumbashi. The study period was 3 years (2017 to 2019). Parameters studied were age and clinical, biological (PSA level, prostatic specific antigen), histopathological, and outcome features. Results. The mean age of patients was 68.7 years (range: 47 and 90 years). The 60 to 69 age group was the most affected (43.18%). Elderly subjects (≥60 years old) represented 89.77% of the cases (n = 79). Voiding disorders were the main reason for consultation in 55.68% of the cases. The mean PSA level was 133.7 ng/ml (range: 4 and 1564.5 ng/ml) at diagnosis and 125.4 ng/ml after 3 months of follow-up (range: 0.16 and 1782.1 ng/ml). Adenocarcinoma was the predominant histological type (100%). In prognosis, 31.82% of patients had a Gleason score greater than 7 and 59.10% had a high risk at the D’Amico risk classification for Prostate Cancer. Hormone therapy was administered alone in 75% of the cases and in combination with pulpectomy in 13.64% of the cases. The 3-year overall survival was 56.82%. Conclusion. Prostate cancer is frequent and has a poor outcome in our country. The establishment of an individual screening policy would be an undeniable advantage in improving the prognosis.

/pdf/clinical-histopathological-and-prognostic-characteristics-of-2pnhflqqgb.pdf

Clinical, Histopathological, and Prognostic Characteristics of Patients with Prostate Cancer in Lubumbashi, Democratic Republic of Congo.

https://www.ajol.info/index.php/aju/article/download/136856/126351

Profil épidémiologique, diagnostique, thérapeutique et évolutif du cancer de la prostate au Togo

https://www.ajol.info/index.php/aju/article/download/113420/103141

Complications urologiques de la chirurgie pelvienne au CHU Aristide Le Dantec de Dakar

Notre experience de la prise en charge de la fracture de verge au CHU de Lomé

https://www.ajol.info/index.php/aju/article/download/182269/171647

Morbidité et mortalité après adénomectomies prostatiques par voie transvésicale au CHU Kara (Togo)

The purpose of this study is to describe a simple, non-expensive, accessible and effective technique of ureterovaginal fistula diagnosis, and to assess the results of surgical management in a resource-constrained hospital. During a campaign of obstetric fistulas repair, we diagnosed ureterovaginal fistulas by vaginal exam with the blue methylene test associated to abdominal ultrasonography, two simple and non-expensive explorations which permitted to identify ureterovaginal fistula and to do differential diagnosis with vesicovaginal fistula. The management was surgery, by ureterovesical reimplantation. Four ureterovaginal fistulas have been diagnosed in 32 women presented with obstetrical fistula. The mean age of those fistulas was 4.85 years; it was located on the left ureter in three cases, on the right in one case. The ureteral lesion was consecutive to a caesarean section in all patients and sited on the pelvic segment of ureter. In three patients, diagnosis was performed by the negativity of the blue test and unilateral dilation of ureter and kidney while the discovery was done during the treatment of vesicovaginal and rectovaginal fistulas associated in the last patient. After effects of surgery were simple, characterized by disappearance of urine leakage and dilation of ureter kidney. In resources-constrained context, techniques such as blue test and ultrasonography are enough to perform diagnosis of ureterovaginal fistula. Ureterovesical reimplantation is an effective therapeutic method for diagnosing ureterovaginal fistula.

[Ureterovaginal fistula after caesarean: Diagnosis and management in a resource-constrained hospital in Togo].

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