Fasnéwindé A. Kaboré

Prostate cancer outcome in Burkina Faso.

IntroductionAfrican-American black men race is one of non-modifiable risk factors confirmed for prostate cancer. Many studies have been done in USA among African- American population to evaluate prostate cancer disparities. Compared to the USA very few data are available for prostate cancer in Sub-Saharan African countries. The objective of this study was to describe incident prostate cancer (PC) diagnosis characteristics in Burkina Faso (West Africa).MethodsWe performed a prospective non randomized patient’s cohort study of new prostate cancer cases diagnosed by histological analysis of transrectal prostate biopsies in Burkina Faso. Study participants included 166 patients recruited at the urology division of the university hospital of Ouagadougou. Age of the patients, clinical symptoms, digital rectal examination (DRE) result, serum prostate-specific antigen (PSA) level, histological characteristics and TNM classification were taking in account in this study.Results166 transrectal prostate biopsies (TRPB) were performed based on high PSA level or abnormal DRE. The prostate cancer rate on those TRPB was 63, 8 % (n=106). The mean age of the patients was 71, 5 years (52 to 86). Urinary retention was the first clinical patterns of reference in our institution (55, 7 %, n = 59). Most patients, 56, 6 % (n = 60) had a serum PSA level over than 100 ng/ml. All the patients had adenocarcinoma on histological study of prostate biopsy cores. The majority of cases (54, 7 % n = 58) had Gleason score equal or higher than 7.ConclusionProstate cancer is diagnosed at later stages in our Country. Very high serum PSA level and poorly differentiated tumors are the two major characteristics of PC at the time of diagnosis.

Urachus Fistula about Two Cases in Yalgado Ouedraogo Teaching Hospital, Ouagadougou (Burkina-Faso)

The purpose of these serial cases was to report the diagnostic and therapeutic features of urachal fistulas at Yalgado Ouedraogo teaching Hospital. We have reported retrospectively two cases of urachus fistula at the Surgery Department of Yalgado Ouedraogo Teaching Hospital in Ouagadougou. The parameters studied were sex, age, reason for consultation, clinical and paraclinical signs, treatment, length of hospital stay, delay of urinary catheterisation and evolution. Two serial cases of urachal fistula were reported, one 14 years old female patient and a 32 years old male patient. Clinical signs were marked by urine flow through the umbilicus. The diagnosis was made by fistulography in one case and during surgery for the second case. The treatment was surgical and consisted of laparotomy followed by removal of the urachal fistula from bladder. The urinary catheter was removed after 10 days. The postoperative course for the two patients was uneventful.

Iatrogenic Lesions of the Ureter Following Obstetric or Gynaecological Surgery Managed at Yalgado Ouedraogo University Hospital: A Series of 14 Cases

Objective: To describe the aetiology, clinical presentation, management and outcomes of a series of patients with iatrogenic lesions of the ureter following obstetric or gynaecological surgery treated at Yalgado Ouedraogo University Hospital, Ouagadougou, Burkina Faso. Methods: This is a case series looking at 14 consecutive patients from 1 January 2011 to 28 February 2017, operated on for urological complications following obstetric and gynaecological surgery. Results: Our study focused on fourteen cases. The average age was 32.9 years (range 20 - 60 years). Thirteen were housewives. Eleven lived in rural areas. The aetiological factor was Caesarian section in seven cases, laparotomy in four cases and hysterectomy in three cases. The type of ureteral injury was bilateral ligation in nine cases. The average time to diagnosis was 16 days (range 2 - 120 days). Anuria was the commonest presenting symptom. Ultrasound in ten patients showed evidence of uretero-hydronephrosis. Eight patients required renal dialysis. Surgical management was uretero-vesical re-implantation in eleven cases, disunion of sutures associated with catheterization in two cases and a termino-terminal ureteral anastomosis in one case. The average hospital stay was 26 days (range 9 - 44 days). The post-operative period was complicated by two cases of vesico-vaginal fistula, one case of parietal suppuration, one case of pyelonephritis and one case of hydronephrosis. No deaths were recorded and a complete cure was ultimately obtained in all patients. Conclusion: Urological complications of obstetric and gynaecological surgery are dominated by ligation of the ureters in our setting. Caesarian section is the commonest cause. Treatment is essentially surgical.