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Inferior Epigastric Artery a Boon in Accessory Lower Polar Artery Revascularization in Renal Transplantation
Kabilan Saminathan,
Balaraman Velayutham,
Muthu Veeramani
Issue:
Volume 7, Issue 1, June 2023
Pages:
1-4
Received:
11 December 2022
Accepted:
3 January 2023
Published:
13 January 2023
Abstract: Multiple renal arteries occur unilaterally and bilaterally in 23% and 10% of the population, respectively. During renal transplantation failure to recognize and preserve an accessory renal artery may lead to ureteral necrosis, segmental renal infarction, postoperative hypertension, or calyceal fistula formation. The problem with accessory renal artery is prolonged ischemia and delayed graft function. Long ischemia can be avoided if lower polar accessory renal artery is anastomosed to inferior epigastric artery after de-clamping as soon as the main renal artery and venous anastomosis is done. Aim: In this study we report our experience with live donor renal transplantation with multiple arteries in which the lower polar artery was anastomosed to the inferior epigastric artery. This study describes the surgical technique and outcomes of live donor renal allografts with multiple arteries in which the lower polar artery was anastomosed to the inferior epigastric artery after de-clamping. Material & Methods: Between 2012 and 2020, 68 consecutive live donor renal transplants were performed involving single Urology-Nephrology team. This included 48 with single and 20 with multiple arteries. Anastomosis of the lower polar artery to the inferior epigastric artery was used for 8 grafts with multiple arteries. Results: Successful revascularization of all areas of the transplanted graft was confirmed by Doppler ultrasonography in most patients and radionuclide renal scanning + MRA in some patients. Conclusions: In live donor renal transplantation with multiple arteries; the anastomosis of the lower polar artery to the inferior epigastric artery after de-clamping, avoids prolongation of the ischemia time that occur with other surgical techniques.
Abstract: Multiple renal arteries occur unilaterally and bilaterally in 23% and 10% of the population, respectively. During renal transplantation failure to recognize and preserve an accessory renal artery may lead to ureteral necrosis, segmental renal infarction, postoperative hypertension, or calyceal fistula formation. The problem with accessory renal art...
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Monopolar Transuretral Resection of Prostate in the Urology Department of the University Hospital Pr Bocar S SALL of Kati
Amadou Kassogue,
Mamadou Lamine Diakite,
Idrissa Sissoko,
Albacaye Sember,
Moussa Salifou Diallo,
Daouda Sangare,
Philippe Togo,
Salia Coulibaly,
Honore Berthe
Issue:
Volume 7, Issue 1, June 2023
Pages:
5-8
Received:
1 December 2022
Accepted:
27 December 2022
Published:
31 January 2023
Abstract: Introduction: The objective of this study is to evaluate the results of monopolar TURP in the urology department of the University hospital Pr Bocar Sidy Sall de Kati. Materials and methods: this was a descriptive, cross-sectional and prospective collection study carried out in the urology department of the University hospital Pr Bocar Sidy Sall de Kati. It took place over a period from January 1, 2019 to June 31, 2020, i.e. 25 months. The parameters studied were: the age of the patients, the reason for consultation, the weight of the prostate, the type of gesture, the time of the resection, the duration of hospitalization and the postoperative follow-up. The data was entered and analyzed using Word 2016 and Excel 2016 and SPSS version 21.0 software. Result: we identified 45 cases of monopolar TURP. The age group of 61-80 years was the most represented, i.e. 84.4%. Acute urinary retention was the most common reason for consultation with 31.1%. On digital rectal examination, the prostate looked benign in 66.7% of cases. Escherichia Coli was the most encountered germ, 8 patients or 17.8%. The weight of the prostate was between 30 to 45g or 46.7%. The post-voiding residual between 101ml and 200ml was the most encountered with 31.1%. TURP was the most common type of surgery, 66.7% of cases. The operative time was 45 minutes in 66.7% of cases. The postoperative course was simple in 88.9% of cases. The duration of hospitalization was 3 days in 71.1% of cases. At 3 months after the TURP, the evolution was favorable in 44 patients, i.e. 97.8%. Conclusion: transurethral resection of the prostate is the gold standard in the management of benign prostatic hyperplasia. It has become common practice in our service and is integrated into urological training with satisfactory results.
Abstract: Introduction: The objective of this study is to evaluate the results of monopolar TURP in the urology department of the University hospital Pr Bocar Sidy Sall de Kati. Materials and methods: this was a descriptive, cross-sectional and prospective collection study carried out in the urology department of the University hospital Pr Bocar Sidy Sall de...
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A Case of Recurrent Bilateral Hydronpehrosis and Pyelonephritis Due to Pelvic Organ Prolapse
Shozaburo Mayumi,
Satoshi Washino,
Tomoaki Miyagawa
Issue:
Volume 7, Issue 1, June 2023
Pages:
9-12
Received:
9 January 2023
Accepted:
13 February 2023
Published:
27 February 2023
Abstract: Although bilateral hydronephrosis caused by pelvic organ prolapse (POP) is not rare, it does not usually cause severe pyelonephritis or acute renal failure. Recurrence of POP accompanied with hydronephrosis and pyelonephritis following curative surgery for POP has been rarely reported. We describe a case of recurrent pyelonephritis due to POP. A 79-year-old woman visited our hospital with anorexia. She was diagnosed with right pyelonephritis, acute renal failure with bilateral hydroureteronephrosis, uterine prolapse, and cystocele. She underwent right nephrostomy and received antibiotics, and her condition then improved. Two months later, she revisited us with left pyelonephritis. She underwent left nephrostomy and received antibiotics. As POP seemed to cause bilateral ureteral obstructions, laparoscopic hysterectomy and uterosacral ligament suspension was performed. Although her POP and ureteral obstructions improved temporarily cystocele and ureteral obstructions with left pyelonephritis recurred two months later. Subsequent pessary treatment managed POP and ureteral obstructions during 1-year follow-up. Pyelonephritis in patients with POP is rare. In the review of literature, all of patients undergoing nephrostomy or ureteral stent survived whereas some of patients not undergoing such interventions died. Additionally, most of patients undergoing POP management survived whereas more than half of patients not undergoing POP management died. We encountered a case of recurrent bilateral hydronephrosis and pyelonephritis caused by POP. There was a clear association of POP occurrence with ureteral obstruction and pyelonephritis, suggesting the importance of managing POP and ureteral obstruction appropriately in such case.
Abstract: Although bilateral hydronephrosis caused by pelvic organ prolapse (POP) is not rare, it does not usually cause severe pyelonephritis or acute renal failure. Recurrence of POP accompanied with hydronephrosis and pyelonephritis following curative surgery for POP has been rarely reported. We describe a case of recurrent pyelonephritis due to POP. A 79...
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Testicular Torsion: A Rare and Unknown Urological Emergency in Rural Senegalese
Thierno Oumar Diallo,
Alimou Diallo,
Youssouf Keïta,
Amadou Ba,
Emmanuel Kazubengue,
Mamadou II Barry,
Abdoulaye Bobo Diallo,
Oumar Raphiou Bah
Issue:
Volume 7, Issue 1, June 2023
Pages:
13-16
Received:
24 January 2023
Accepted:
13 February 2023
Published:
27 February 2023
Abstract: Testicular torsion is an urological emergency most commonly observed in teenagers, and that requires urgent treatment to avoid the loss of testis. This study aimed to report the diagnostic and therapeutic aspects of testicular torsion in a peripheral hospital in Senegal. Methods: A total of 17 patients who underwent scrotal exploration for testicular torsion were included. We performed a retrospective and descriptive study between (January 2021 and October 2022) of patients who were diagnosed with testicular torsion and managed at Kolda Regional Hospital, Senegal. Results: The mean age was 18± 2.1 years (range, 14 - 22 years) and the mean duration of symptoms was 72.2±76.8 hours range (4h to 10 days). The Doppler ultrasound performed was in favor of torsion of the spermatic cord in all cases in the patients who performed the Doppler ultrasound. The color Doppler had shown 6 cases of testicular necrosis. The testis was retained in 11 (64.7%) patients and resected in 6 (35.3%). We noted a case of delayed healing (one month), and the postoperative course was simple. Conclusion: Testicular torsion affects younger under the age of 20. Testicular torsion is a rare emergency in urology which requires an accurate and timely diagnosis in order to avoid testis loss. The rate of orchidectomy is higher our hospital center.
Abstract: Testicular torsion is an urological emergency most commonly observed in teenagers, and that requires urgent treatment to avoid the loss of testis. This study aimed to report the diagnostic and therapeutic aspects of testicular torsion in a peripheral hospital in Senegal. Methods: A total of 17 patients who underwent scrotal exploration for testicul...
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Anatomical-Clinical Aspects of the Retrocaval Ureter: Report of 4 Cases and Review of the Literature
Samba Thiapato Faye,
Alioune Sarr,
Amath Thiam,
El Hadji Malick Diaw,
Hassan Gazal,
Mamadou Dembele,
Cyrille Ze Ondo,
Babacar Sine,
Racine Kane,
Abdoulaye Ndiaye,
Alain Kassim Ndoye
Issue:
Volume 7, Issue 1, June 2023
Pages:
17-22
Received:
22 February 2023
Accepted:
13 March 2023
Published:
31 March 2023
Abstract: Introduction: Retrocaval ureter (RCU) is a birth defect, characterized by a spiral path of the ureter around the inferior vena cava. It is an abnormal in the development of the inferior vena cava, which can lead to ureteral obstruction. The aim of this study was to report 4 cases of RCU with a literature review. Patients and method: This was a retrospective, descriptive study in two department of urology including patients followed up and undergone a surgery for a RCU, from January 2016 to December 2021 in two tertiary hospitals of Dakar. We used radiological classification to describe the anatomical and clinical features. Results: Four adult patients suffering from RCU were diagnosed and treated over a 6-year period of time. Their mean age was 39 years (36 and 44 years). There were as many men as women. Low back pain was the most common sign. The Uro-CT scan showed a type I of RCU in 3 patients. For all of them, we performed an open surgical procedure to unhook the ureter followed by an uretero-ureteral anastomosis on a JJ stend. The portion of the ureter in retro cave atresic position was resected. The postoperative follow-up was simple. Conclusion: Retrocaval ureter is a very rare birth defect for which the right incidence is not known because of the clinical latency. Although classical surgery leads to positive outcomes, the minimally invasive approach is very promising.
Abstract: Introduction: Retrocaval ureter (RCU) is a birth defect, characterized by a spiral path of the ureter around the inferior vena cava. It is an abnormal in the development of the inferior vena cava, which can lead to ureteral obstruction. The aim of this study was to report 4 cases of RCU with a literature review. Patients and method: This was a retr...
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Management of Urinary Trauma in the Urology Department of the Ignace Deen National Hospital in Conakry
Diallo Thierno Mamadou Oury,
Bah Mamadou Bissiriou,
Diallo Alimou,
Bah Mamadou Diawo,
Amougou Boris,
Kanté Daouda,
Cissé Demba,
Diallo Thierno Oumar,
Keita Youssouf,
Gnammi Lahoumbo Ricardo,
Diallo Abdoulaye Bobo,
Bah Oumar Raphiou
Issue:
Volume 7, Issue 1, June 2023
Pages:
23-28
Received:
9 March 2023
Accepted:
28 March 2023
Published:
17 May 2023
Abstract: Objective: to highlight the epidemiological, lesional and therapeutic aspects of urinary trauma in the urology department of the Ignace Deen National Hospital in Conakry. Material and methods: this was a retrospective study that took place over a period of 5 years, during which we collected all cases of urinary trauma in the urology department of the Ignace Deen National Hospital in Conakry. The variables studied were socio-demographic, anatomical-clinical and therapeutic. Results: we collected 75 cases of urinary trauma, representing 15.5% of abdomino-pelvic trauma admitted to hospital during the study period. The average age of patients was 29 years old with extremes of 8 and 66 years. Men were the most affected with a gender ratio of 25. Road traffic accidents were the most frequent etiologies. The consultation time was less than 24 hours in 92% of cases. Trauma involved the urethra in 80% of cases, the bladder (10.7%) and the kidney (9.3%). The mechanism of trauma to the urethra was dominated by astride falls on the perineum in 52% of cases. Posterior urethra ruptures were associated with pelvic trauma in 20/25 cases and bladder trauma in 5/8 cases. The treatment was carried out according to the type of lesion. Conclusion: urinary trauma is not uncommon in our practice. They are the prerogative of young men in full activity. They are dominated by urethral ruptures, followed by trauma to the kidney and bladder. Treatment should be as conservative as possible in closed kidney trauma and peritoneal ruptures of the bladder.
Abstract: Objective: to highlight the epidemiological, lesional and therapeutic aspects of urinary trauma in the urology department of the Ignace Deen National Hospital in Conakry. Material and methods: this was a retrospective study that took place over a period of 5 years, during which we collected all cases of urinary trauma in the urology department of t...
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