Lamine Niang

Cancer sur testicule non descendu intra-abdominal. A propos de 5 cas

Resume Le cancer du testicule est une pathologie rare chez le noir africain. Nous rapportons une serie de 5 observations de cancer de testicule sur testicule cryptorchide. Patients et methodes Nous avons realise une etude retrospective de 5 cas de cancer du testicule sur testicule cryptochide. Nous avons recueillis l’âge des patients au moment du diagnostic, les circonstances de diagnostic, les taux des marqueurs tumoraux et les resultats anatomo-pathologiques apres exerese de la tumeur. Les patients ont fait l’objet d’une description basee sur le resume de leur observation. Resultats L’âge moyen etait de 30,6 ans (27 ; 34). Un seul patient etait pere d’un enfant au moment du diagnostic. Tous les patients ont consulte pour mauvais etat general associe a une masse abdominale palpable. L’elevation des marqueurs tumoraux etait inconstante. Une effraction capsulaire a ete notee chez trois patients avec un cas de rupture dans la cavite peritoneale. Sur le plan ana-path, nous avons trouve 3 carcinomes embryonnaires et 2 seminomes. Il existait des metastases ganglionnaires chez trois patients. Conclusion La rarete des cancers des testicules intra-abdominaux ne doit pas les faire meconnaitre. Le diagnostic precoce de ces tumeurs passe par l’abaissement des testicules cryptorchides car meme si cet abaissement ne previent pas ces tumeurs, il permet une meilleure surveillance.

Screening for Prostate Cancer by Digital Rectal Examination and PSA Determination in Senegal

Objectives. The goal of our study was to investigate the prevalence of prostate cancer in an unselected population of Senegalese men. Patients and Methods. We conducted the study over two years (2008 and 2009) on an unselected population of 572 Senegalese men, aged 35 and older. The following parameters have been investigated: the subjects age, the presence or absence of urination disorders, the familys history of prostate cancer or prostate surgery, the aspects of the prostate on digital rectal examination (DRE), the total PSA level, and the outcomes of the prostate biopsies. Data entry was performed with Epi Info 6 software and was analyzed and recorded using Excel software. We performed mean and frequency calculations. Results. The mean age of our patients was 65.5 years, with extremes of 38 and 93 years. Age groups from 50 to 59 and from 60 to 69 were the most represented. DRE was normal in the age group from 35 to 39, and only one patient in the age group from 40 to 49 had a prostate nodule. PSA level was greater than or equal to 4 ng/mL in 66 cases. A total of 5.4% patients had a PSA level greater than or equal to 10 ng/mL. Only two patients in the age group from 40 to 49 had a PSA level greater than 4 ng/mL. Of the 72 biopsies we performed, prostatic adenocarcinoma was found in 30.6% of the cases. It is the only type of prostate cancer we found in our series. The cases of prostate cancer were mostly observed in the age groups from 60 to 69 and from 70 to 79. No cases were detected for ages younger than 50. DRE gave indications of possible adenocarcinoma in 27.30% cases. Its sensitivity was 27%, while its positive predictive value was estimated at 35%. Of all positive biopsies, 4.5% had a PSA level between 0 and 3.9 ng/mL. In this case, the sensitivity of PSA was 95.5%, and the positive predictive value was 31.8%. High-grade intraepithelial neoplasiae were observed in 21 cases. Conclusion. Prostate cancer is frequent in Senegal, and screening remains the best way for early diagnosis.

La dysfonction éréctile au Sénégal: Profil épidemiologique

RésuméEn Afrique, le vécu du patient présentant une dysfonction érectile (DE) est rendu particulier par la polygamie, et il existe peu de données sur cette pathologie. L’objectif de notre étude était de rapporter le profil épidémiologique des DE dans la population générale sénégalaise en adoptant un protocole standardisé basé sur l’Indice International de la Fonction Erectile (I.I.E.F.5) version française.MéthodologieII s’agit d’une enquête prospective transversale randomisée, qui s’est intéressée aux sujets âgés de 18 ans et plus. Un questionnaire auto administré totalement anonyme comportant deux parties, était utilisé : une première partie donnant des renseignements sur l’état civil, le terrain, l’existence d’une dysfonction ’rectile, les troubles sexuels associés, les pathologies associées, et une deuxième partie basée sur l’I.I.E.F.5. Deux groupes ont été identifiés : Groupe DE (sujets présentant une dysfonction ’rectile) et Groupe non DE (sujets ne présentant pas de dysfonction ’rectile). Au plan statistique, la différence entre les deux groupes concernant l’étude d’un caractère était considérée comme significative pour p ≤ 0,05 au test duKhi 2. Résultats La prévalence globale de DE était de 26%. La prévalence par tranche d’âge a révélé une augmentation progressive du taux de dysfonction érectile avec l’âge, passant de 11% entre 20 et 30 ans, à 76% entre 70 et 80 ans. Le nombre de polygames était significativement plus important chez les patients présentant une DE (29,2%) par rapport au groupe non DE (6,6%) (p < 0,0001), et la sévérité des DE augmentait avec le nombre d’épouses. Le nombre d’éthyliques chroniques était significativement plus important dans le groupe DE (p=0,023).Le taux de DE augmentait avec la durée de l’intoxication tabagique, passant de 11,9% pour une durée inférieure à 5 ans, à 16,9% de 5 à 10 ans, pour atteindre 71,2% lorsque la durée de l’intoxication est supérieure à 10 ans. Certaines affections (diabète, hypertension artérielle et dépression nerveuse) étaient significativement plus fréquentes dans le groupe DE. L’analyse du type de la DE avait permis de révéler que le taux des DE secondaires (95,6%) était plus important que celui des DE primaires (4,4%). Les troubles sexuels associés étaient plus importants dans le groupe DE avec une différence significative.AbstractThe life of patients in Africa with Erectile Dysfunction (ED) is made particularly difficult in men married to many wives and few data are available on this disorder. The purpose of this study was to report the epidemiological profile of ED in the Senegalese general population using a standard protocol based on the simplified version of the International Index of Erectile Function (IIEF5) translated into French and validated.MethodologyThis was a transverse randomized survey of subjects over the age of 18 years. Subjects completed a self-administered questionnaire composed of two parts. The first part contained information on demographic characteristics, associated diseases, erectile dysfunction and associated sexual disorders and the second part was based on IIEF5. Two groups were identified: a group with erectile dysfunction (ED group) and another group without erectile dysfunction (No ED group). Differences between the two groups were considered to be statistically significant for p ≤ 0.05 on the Chi-square test.ResultsThe global prevalence of erectile dysfunction was 26%. The prevalence by age-group revealed a progressive increase of ED with age from 11% between 20 and 30 years to 76% between 70 and 80 years. The rate of polygamous men was significantly higher in the group with ED (29.2%) compared to the group without ED (6.6%) (p < 0.0001) and the severity of ED increased in relation to the number of wives. Chronic alcoholism was significantly more frequent in the group with ED (p = 0.023). The frequency of ED increased with the duration of cigarette smoking from 11.9% for less than 5 years, 16.9% between 5 years and 10 years and 71.2% for more than 10 years. Some diseases (diabetes, hypertension and depression) were significantly more frequent in the group with ED. Analysis of the type of ED revealed that secondary erectile dysfunction was more frequent (95.6%) than primary erectile dysfunction (4.4%). Associated sexual disorders were significantly more frequent in the group with ED.

Prostate Cancer in Sub Saharan Africa

Prostate cancer is the leading male cancer worldwide. While there are abundant data on the epidemiology, natural history, treatment and outcomes of the disease in the US and many developed countries, prostate cancer is a good example of cancer disparity in that a little is known about the disease in Sub Saharan Africa. Because of the dominant black race in this region and the fact that black men suffer the higher burden of the disease, it is important to understand that cancer in this population. The purpose of this review is to describe the literature of prostate cancer in Sub Saharan Africa. The authors reviewed the published studies on prostate cancer in Sub Saharan Africa available on PubMed. In addition any other accessible study on the topic was included.

Congenital Penile Curvature in a Young Man: A Case Report and Review of Literature

A varied level of penile deformation characterizes congenital penile curvature. It may to some extent affect the quality of the patient’s sex life. We report a case of congenital penile curvature diagnosed at adult age. A corrective surgery was performed by plication of the tunica albuginea of the cavernous body. A review of the literature underscores the rarity of publication on this condition and the treatment modalities.

Incontinence urinaire de la femme : profil épidémiologique au sud du Sahara

UNLABELLED The objective of this study was to describe the epidemiologic profile of urinary incontinence of the African woman of three Sub Saharan African countries. MATERIAL AND METHODS A multicentric study summarized the epidemiological data collected in female from Nouakchott, Dakar and Ndjamena using a questionnaire. All participants filled an anonymous questionnaire including demographic data and marital status, medical, surgical, gynecological and obstetrical history and the characteristics of the urinary incontinence. RESULTS Overall, 3021 questionnaires were distributed, only 2070 answers (69%) could be processed. Mean age of the overall population was 28 years. Adult women aged less than 30 years accounted for 56% of the study population. The age group 30-49 years accounted for 42% of the population and only 2% of the study group had more than 50 years. The prevalence of incontinence was 367 cases over 2070 (17,7%). The types of incontinence found were: urgency in 28.6% of cases, stress incontinence in 38.4% of cases and mixed in 33% of cases. Approximately 23,9% of nulliparous and 23,5% of the multiparous had urinary incontinence. The leakage was occasional in 75% of the cases and regular in 25% of the cases. According to gravity, in 31% of cases the volume of urines lost necessitated a change of underwear. Of the women presenting urinary incontinence, 85 (23%) consulted a doctor. A psychosocial repercussion was found in 31% of the cases. CONCLUSION Urinary incontinence is much more frequent in our areas than it was thought to be because it was rarely acknowledged.

Azoospermias au Sénégal: quelle prise en charge à l’heure de l’ICSI?

ResumeObjectifIl s’agit de déterminer la place de l’azoospermie parmi les étiologies de l’infertilité au Sénégal.Matériel et méthodesNous avons répertoriés, parmi 492 dossiers de patients hypofertiles 141 cas d’azoospermie. Nous avons étudié le profil clinique, paraclinique et évolutif après prise en charge.RésultatsL’âge moyen était de 40,6 ans. Une atrophie testiculaire était retrouvée dans 35% des cas. A la biopsie testiculaire 72% de cas d’azoospermie sécrétrice étaient confirmés. Une varicoc#x00E8;le était associée dans 56% des cas. La cure de varicoc#x00E8;le effectuée dans 32,6% des cas a permis d’obtenir une amélioration des paramètres du spermogramme dans 28% des cas.AbstractAzoospermia is one of the most serious causes of couple infertility, has a very high prevalence among all causes of infertility and is due to multiple aetiologies.Objectiveto determine the place of azoospermia among the various causes of infertility in Senegal.Material and methods141 cases of azoospermia were identified from a series of 492 infertile patients. The clinical profile, laboratory results and outcome after management were studied.ResultsThe mean age was 40.6 years. Testicular atrophy was detected in 34.75% of cases. Azoospermia was secretory in 71.69% of cases. A varicocele was associated in 56% of cases. Varicocele repair was performed in 32.62% and allowed an improvement of sperm parameters in 28.3% of cases. Testicular biopsy, performed in 53 cases, demonstrated 2 cases of Sertoli cell syndrome, 3 cases of arrested maturation, 8 cases of hypo spermatogenesis, and 25 cases of seminiferous tubules. Forty nine cases of azoospermia were associated with normal FSH levels. Only one patient was treated by assisted reproductive technologies (ART).

Lésions des organes génitaux externes par arme a feu: a propos de six observations

RésuméL’usage fréquent des armes à feu fait que tout médecin doit avoir des notions de balistique lésionnelle.Butsinsister sur les aspects épidémiologiques, balistiques lésionnels et thérapeutiques.Patients et Méthodesil s’agit d’une étude rétrospective qui s’est intéressée aux dossiers de patients admis pour lésions des organes génitaux externes par armes à feu dans services d’urologie de l’Hôpital Aristide Le Dantec, de l’Hôpital Général de Grand Yoff et de L’Hôpital Principal de Dakar durant la période allant du mois de Janvier 1998 au mois de Janvier 2003.RésultatsLes patients étaient tous de sexe masculin avec un âge moyen de 37,7 ans (22 ans à 52 ans). Dans cinq cas les lésions étaient survenues dans un cadre accidentel. Les lésions étaient: deux cas d’amputation du testicule, deux cas de plaies des corps caverneux, deux cas de lésion urétrale, un cas de plaies périnéoscrotales. Après parage des lésions, les gestes complémentaires ont été une orchidectomie (deux cas), une suture albuginéale (deux cas) et une urétrorraphie termino-terminale (deux cas). Tous les patients ont bénéficié d’une antibiothérapie et d’une sérothérapie antitétanique. Aucun cas de décès n’a été observé dans les suites immédiates. Avec un recul moyen de plus de 18 mois aucun cas de sténose urétrale ou de dysfonctionnement érectile n’était noté. Le spermogramme était normal dans les cas d’amputation du testicule.AbstractGunshot injuries to the external genital organs are rare. In this study, the authors report six cases and describe the epidemiological, terminal ballistic and therapeutic aspects.Patients and MethodsThis is a retrospective study of patients admitted with gunshot injuries to the external genital organs to the urology departments of Aristide Le Dantec Hospital, Grand Yoff General Hospital and Dakar Principal Hospital, between January 1998 and January 2003. The following parameters were studied: patients’ age and gender, interval between accident and admission, clinical features, complementary investigations and treatment, and early and late outcomes.ResultsOnly males were observed and the mean age of these patients was 37.7 years (range: 22–52 years). Lesions were accidental in five cases. Two cases of testicular wounds, two cases of corpus cavernosum injuries, two cases of urethral injury, and one case of perineal wound were observed. After excision of the lesions, complementary procedures consisted of: orchidectomy in two cases, corpus cavernosum — albuginea suture in two cases and end-to-end urethral suture in one case. Perineoscrotal wounds were sutured three days after debridement. All patients received antibiotics and antitetanus serum. No death was observed during the immediate follow-up. No case of urethral stricture or erectile dysfunction was observed with a follow-up of 18 months. Semen analysis was normal in the two cases of orchidectomy.