Background: Ultrasound is the main method of exploring the prostate. In benign prostatic hyperplasia (BPH), it provides important morphological information and assesses its impact, helping to guide the treatment. Objective: To compare intravesical prostatic protrusion (IPP) and middle lobe volume by ultrasound in BPH. Method: This was a single center prospective, descriptive and analytical study, over a period of 6 months, including 95 patients, undergoing prostatic trans-abdominal ultrasound. Patients were selected by a single urologist for clinical suspicion of benign prostatic hypertrophy. The ultrasound examination was done by a single senior radiologist. Results: The mean age of the patients was 66.63 ± 11.55 years with ranges from 38 to 98 years. The prevalence of BPH was 76.84%. The rate of patient with middle lobe protrusion was 48.42%. The mean middle lobe volume was 11.29 ± 12.90 ml. More than half of the patients (50.91%) had an IPP stage 3 of. The mean bladder wall thickness was 6.08 ± 2.58 mm, with 50.53% being pathological. The post-voiding residue (PVR) was significant in 38.75% of patients. Renal repercussions were present in 17.89%. The correlation analysis did not note a statistical link between prostate volume and quality of life score (p > 0.05). There was a statistically significant correlation between IPP values and quality of life score (p = 00461), IPSS score (p = 0.0424) and PVR (p = 0.0395). For middle lobe volume, there was a correlation with PVR (p = 0.0018). There was no correlation with clinical impact (quality of life score and IPSS score). Conclusion: The IPP appears to be an easy element to measure and better than the volume of the prostate and the middle lobe in assessing the impact of BPH.

/pdf/intravesical-prostate-protrusion-ipp-versus-middle-lobe-1m4b0oz984.pdf

Intravesical Prostate Protrusion (IPP) versus Middle Lobe Volume on Ultrasonography in Assessing the Impact of Benign Prostatic Hyperplasia

Background: The urology department of the Teaching Hospital of Kara is the 2nd urology department in Togo, Kara being a semi-urban town located 400 km from Lomé the capital. While for a long time only open surgery was used, the acquisition of urological endoscopic equipment in February 2021, has revolutionized the urological management of patients. Objective: Report the results of the first 15 months of urological endoscopy practice at the Kara Teaching Hospital, identify the particularities, announce the prospects. Patients and Methods. This was a retrospective and descriptive study, which took place in the urology department of the Kara Teaching Hospital, from February 2021 to April 2022, i.e. a period of 15 months. The register of operative reports and patient records were used for data collection. The following parameters were studied: age, sex, diagnosis, indication, diagnostic or therapeutic nature of the procedure, and results. EPI INFO 7.2.4.0 software was used for data analysis. Results: A total of 102 urological procedures (endoscopic and non-endoscopic) were performed during the study period; of the 102 interventions, 62 were endoscopic urological interventions, i.e., 60.7% of the interventions. The average age of patients treated was 55.5 years (±16.4) with extremes ranging from 28 to 87 years. Men accounted for 84% of patients treated. Prostatic hypertrophy was the most common urological pathology in our study, requiring endoscopic intervention in 40% of cases. Transurethral resection of the prostate was the most performed endoscopic procedure in our study with 43.5% of cases. The various endoscopic interventions resulted in success in 96.7% of cases. Conclusion: Urology nowadays cannot be done without endoscopy. At the Kara Teaching Hospital, the results are already promising after less than 24 months of endoscopic practice in urology. Advocacy must be made to political decision-makers, so that the situation is even better, for the good of both urologists and patients. 

Urological Endoscopy: Results of the First 15 Months, in Kara (Togo)

Objectif. Le but etait d’evaluer les resultats et les complications de l’adenomectomie prostatique par voie transvesicale au service d’Urologie de l’hopital national Ignace Deen CHU (Conakry). Patients et Methodes. Il s’agissait d’une etude prospective  allant du 1er janvier 2017 au 31 Mai 2019 portant sur les patients operes d’adenome de la prostate par voie transvesicale selon la technique de Hrynstchack. Les variables etudiees etaient socio- demographiques, cliniques, paracliniques, therapeutiques et anatomo-pathologiques. Resultats. Au cours de notre periode d’etude, l’adenomectomie transvesicale etait l’intervention la plus pratiquee dans notre service soit 73,53% des cas (n=150). L’âge moyen de nos patients etait de 67,17 ans avec des extremes de 50 a 79 ans. Le PSA moyen etait de 2,1 ng /ml avec des extremes de 0,23 et 6 ng/ml. L’Escherichia coli etait le germe le plus incrimine au cours de l’infection urinaire (68,12% des cas). La retention chronique d’urines vesicales compliquee d’ureterohydronephrose bilaterale dominait les indications operatoires soit 83,33% (n=125). La complication post-operatoire la plus frequente etait l’infection du site operatoire avec 31,82% (n=7). La duree moyenne de sejour hospitalier des patients etait de 12 jours (extremes de 10 a 33 jours). Elle etait fonction de la nature des complications post-operatoires. La periode de suivi etait de six mois. Conclusion. L’adenomectomie transvesicale de la prostate est la technique la plus utilisee pour l’ablation de l’adenome prostatique dans notre service. . Comparativement aux donnees de la litterature, le taux de complications reste encore eleve. RESUME Objective. To report the results and complications of transvesical prostate adenomectomy at the Urology Department of the Ignace Deen National Hospital CHU (Conakry). Patients and Methods : This was a prospective, dynamic study from January 1, 2017 to May 31, 2019 on patients undergoing transverse prostate adenoma surgery. The variables studied were socio-demographic, clinical, paraclinical, therapeutic and anatomo-pathological. Results. During our study period, transvesical adenomectomy was frequently performed in our department,  73.53% of cases (n=150). The mean age of our patients was 67.17 years with extremes of 50 to 79 years. The mean PSA was 2.1 ng/ml with extremes of 0.23 and 6ng/ml. Escherichia coli was the most incriminated germ in 68.12%. Chronic retention of bladder urine complicated by bilateral ureterohydronephrosis  was the most common indication for suregery (n = 125; 83.33%) . The most frequent post-operative complication was surgical site infection with (n=7; 31.82%). The average length of hospital stay was 12 days (extremes of 10 to 33 days) depending on the nature of the post-operative complications. Conclusion. Transvesical prostate adenomectomy is the most commonly used technique for prostate adenoma removal in our context. Compared to the data in the literature, the complication rate is still high.

http://www.hsd-fmsb.org/index.php/hsd/article/download/2268/pdf_1052

Adénomectomie Prostatique Transvésicale : Résultats et Complications au Service d’Urologie Andrologie de l’Hôpital Ignace Deen, CHU de Conakry

Introduction: Open transvesical prostatectomy remains today one of the most effective approaches for the management of benign prostatic hyperplasia despite the fact that, this method is associated with multiple complications.The objective of this study was to evaluate the influence of prostate weight on the morbidity and mortality of transvesical prostatectomy for adenoma in the urology-andrology department of the Ignace Deen National Hospital.Materials and Methods: This was a prospective, longitudinal and analytical study lasting 6 months, from March 1, 2022 to August 31, 2022 including patients admitted and operated on by open transvesical prostatectomy by assessing the influence of prostate weight on the morbidity and mortality of transvesical adenomectomies.Results: 108 patients were included in our study, the average age of our patients was 70 ± 7.7 years, cultivators were the most represented profession with 38.89%, and hypertension was the most represented comorbidity with 75%.33.06% of cases became complicated and surgical wound infection was the main complication with a frequency of 17.40%.Statistical analysis did not conclude that, the prostate weight does not have a statistically significant influence on the morbidity and mortality of transvesical open prostatectomy for benign prostatic hyperplasia.Conclu- 

pdf/evaluating-the-influence-of-the-prostate-weight-on-the-4p7k3b5ya1.pdf

Evaluating the Influence of the Prostate Weight on the Morbidity and Mortality of Transvesical Open Prostatectomy: Prospective Analysis of 108 Cases in the Urology-Andrology Department of the Ignace Deen National Hospital in Conakry

Objective: To study postoperative complications of transvesical adenomectomy of the prostate in the urology department of the Gabriel TOURE University Hospital in Bamako. Patients and Methods: This was a prospective, cross-sectional, descriptive study conducted over 12 months, from December 1, 2022 to November 30, 2023. It covered all patients admitted, operated on and followed up in the Urology Department of CHU Gabriel Touré for benign prostatic hypertrophy and having a complete medical record. Results: Out of 102 patients operated on for prostate adenoma in the urology department of CHU Gabriel Touré, 26 cases of postoperative complications (POC) were recorded, representing a frequency of 25.49%. The average age of our patients was 71.38 years. Urinary bilharziasis was the main urological antecedent in 50% of patients, while inguinal hernia repair was the most common surgical antecedent, accounting for 27% of cases. Pollakiuria was the main reason for consultation (46.15%). Urinary tract infection was found in 57.69% of patients, with Escherichia coli the main germ involved (34.61%). The mean ultrasound prostate weight was 63.82g, with a mean total PSA level of 2.98ng/ml. Preoperative catheterization was strongly associated with postoperative complications (37.21%). The main indication for surgery was complicated BPH (infectious complication: 38.46%). The average duration of bladder irrigation was 2.3 days. Parietal suppuration was the main postoperative complication (30.77%). Postoperative indwelling catheterization lasted an average of 16 days. The average hospital stay was 7.3 days for patients with CPO versus 5 days for other patients. The mortality rate was estimated at 3.84%. Conclusion: In our context, transvesical adenomectomy of the prostate is still the most common surgical treatment for benign prostatic hyperplasia. Postoperative complications are dominated by parietal suppuration.

Postoperative Complications of Transvesical Adenomectomy of the Prostate in the Urology Department of the Centre Hospitalier Universitaire GABRIEL TOURE in Bamako

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

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

Analyze the management of gynecomastia and adipomastia; and identify the peculiarities in black people in a general surgery department of the CHU Sylvanus Olympio in Lomé (Togo).Descriptive retrospective study included 43 cases of gynecomastia and 5 cases of adipomastia (January 2014 to December 2020). The data taken into account were: epidemiological, clinical, paraclinical and the treatment (surgery and medical). The administration of hydrocortisone (solumedrol 120mg/day) for 3days immediately after surgery and the application of shea butter on the scar were performed.Patients consult for aesthetic discomfort, especially with bilateral lesions and fear of breast cancer for unilateral lesions. Morpho-types 3 and 4 are therefore the most frequent in 75% of cases. Age was over 30years in 87% of patients. We noted retro-areolar fibrosis. The etiology was dominated by idiopathic causes. The surgery was performed in 85% of the cases. The morbidities were 5 cases of hypertrophic scars without keloid.Surgical difficulties on black skin are not only technical, but also scarring: hypertrophy and keloids. A delay in surgical management after 30years, and the prevention of unsightly scars would be a track for improving the aesthetic result. 

Gynécomastie et adipomastie sur peau noire : particularités clinique et chirurgicale

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

Gynécomastie et adipomastie sur peau noire : particularités clinique et chirurgicale