Background: Minimally invasive procedures in the surgical management of benign prostate enlargeme... more Background: Minimally invasive procedures in the surgical management of benign prostate enlargement (BPE) are of limited use in the resource-poor settings due to nonavailability of the requisite facilities and skills. It has been observed that teaching uroendoscopy inclusive of transurethral resection of the prostate (TURP) can be challenging in the resource-poor settings where the traditional master-apprentice (Halstedian) approach has remained the prevalent training technique. Patients and Methods: We aimed in this retrospective study to assess completeness of resection in TURP by comparing the proportion of prostate tissue resected to the proportion enucleated in open retropubic prostatectomy (ORP). We included all BPE patients on urethral catheter managed in the first 18 months after Halstedian training in TURP. The analysis was done using SPSS® 20 and VassarStats® online software. Results: Twenty patients' files for TURP and twenty-eight patients' files for ORP met the ...
South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie, 2012
BACKGROUND Fournier's gangrene is a necrotising fasciitis of the genitalia and perineum, with... more BACKGROUND Fournier's gangrene is a necrotising fasciitis of the genitalia and perineum, with associated polymicrobial infection and risk of organ failure or death. The purpose of this study was to determine the presentation, systemic and local predisposing factors, management challenges and outcome in south-eastern Nigeria. PATIENTS AND METHODS We studied 28 out of 34 consecutive male patients with complete case notes seen in two centres (the University of Nigeria Teaching Hospital and St Mary's Hospital) between January 1995 and December 2008. Operating theatre registers and urology ward admission registers were used to identify patients. RESULTS The mean patient age was 48.3 years (range 28 - 66 years), with a peak age incidence of 50 - 59 years. The majority of patients were farmers, manual labourers and artisans. The site of gangrene was scrotal in 22 patients (78.6%), penoscrotal in 3 (10.7%), abdominoscrotal in 2 (7.1%) and scroto-perianal in 1 (3.6%). The mean interv...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
To determine the relationship between prostate volume and international prostate symptom score (I... more To determine the relationship between prostate volume and international prostate symptom score (IPSS) in Africans with benign prostatic hyperplasia (BPH). This was a prospective study of 120 men aged between 45 to 85 years, who were referred to the urology outpatient facility for treatment of clinical BPH between July 2007 and October 2008 in Jos University Teaching Hospital. These patients were properly evaluated; a digital rectal examination was done to estimate the prostate size. The pre-treatment IPSS of the patient was also obtained. The prostate volume of each patient was then estimated by transabdominal ultrasound. The mean prostate volume was 72.79 +/- 44.38cm3. The mean values for the different diameters of the prostate were 5.63 +/- 1.17cm (longitudinal diameter), 4.48 +/- 0.95cm (anterior posterior diameter), 4.97 +/- 1.06cm (transverse diameter). The Pearson's correlation between pre-treatment International prostate symptom score and prostate volume was -0.0035 (P &g...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
To determine the relationship between prostate volume and international prostate symptom score (I... more To determine the relationship between prostate volume and international prostate symptom score (IPSS) in Africans with benign prostatic hyperplasia (BPH). This was a prospective study of 120 men aged between 45 to 85 years, who were referred to the urology outpatient facility for treatment of clinical BPH between July 2007 and October 2008 in Jos University Teaching Hospital. These patients were properly evaluated; a digital rectal examination was done to estimate the prostate size. The pre-treatment IPSS of the patient was also obtained. The prostate volume of each patient was then estimated by transabdominal ultrasound. The mean prostate volume was 72.79 +/- 44.38cm3. The mean values for the different diameters of the prostate were 5.63 +/- 1.17cm (longitudinal diameter), 4.48 +/- 0.95cm (anterior posterior diameter), 4.97 +/- 1.06cm (transverse diameter). The Pearson's correlation between pre-treatment International prostate symptom score and prostate volume was -0.0035 (P &g...
South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie, 2012
Fournier's gangrene is a necrotising fasciitis of the genitalia and perineum, with associated... more Fournier's gangrene is a necrotising fasciitis of the genitalia and perineum, with associated polymicrobial infection and risk of organ failure or death. The purpose of this study was to determine the presentation, systemic and local predisposing factors, management challenges and outcome in south-eastern Nigeria. We studied 28 out of 34 consecutive male patients with complete case notes seen in two centres (the University of Nigeria Teaching Hospital and St Mary's Hospital) between January 1995 and December 2008. Operating theatre registers and urology ward admission registers were used to identify patients. The mean patient age was 48.3 years (range 28 - 66 years), with a peak age incidence of 50 - 59 years. The majority of patients were farmers, manual labourers and artisans. The site of gangrene was scrotal in 22 patients (78.6%), penoscrotal in 3 (10.7%), abdominoscrotal in 2 (7.1%) and scroto-perianal in 1 (3.6%). The mean interval between onset of symptoms and present...
Enugu State typifies a Third World environment where most deliveries occur outside the hospital s... more Enugu State typifies a Third World environment where most deliveries occur outside the hospital setting. In such circumstances, hospital-based data about congenital defects are unreliable and call for special methods of approach. To determine the prevalence and pattern of male external genital defects in Igbo male secondary school students in Nigeria. Samples of male students aged 10 years and above seen in randomly selected secondary schools in Enugu State, of South-East Nigeria were guided through a protocol involving, self administered questionnaires, personal interviews and physical examinations for evidence and types of anomalies present in their external genitalia. The participating schools were selected by stratified random sampling; first by local government Areas (LGA) and then by schools. Consents for the study were obtained from Local Government Authorities, Heads of the schools and Parents' Teachers Associations, (PTA) Executives. Altogether, four urban and thirteen ...
Men of Black African descent are known to have the highest incidence of prostate cancer. The dise... more Men of Black African descent are known to have the highest incidence of prostate cancer. The disease is also more aggressive in this group possibly due to biologically more aggressive tumor or late presentation. Currently, serum prostate-specific antigen (PSA) assay plays a significant role in making the diagnosis of prostate cancer. However, the obtained value of serum PSA may not directly relate with the Gleason score (GS), a measure of tumor aggression in prostate cancer. This study explores the relationship between serum total PSA at presentation (iPSA) and GS. The iPSA of patients with histologically confirmed prostate cancer was compared with the obtained GS of the prostate biopsy specimens. The age of the patients at presentation and the prostate volumes were also analyzed with respect to the iPSA and GS. The data were analyzed retrospectively using IBM SPSS Version 20. Pearson correlation was used for numeric variables, whereas Fisher's exact test was used for categorical variables. Significance was set at P≤0.05. There were 205 patients from January 2010 to November 2013 who satisfied the inclusion criteria. iPSA as well as age at presentation and prostate volume were not found to significantly correlate with the primary Gleason grade, the secondary Gleason grade, or the GS. However, the presence of distant metastasis was identified to significantly correlate positively with GS. GS may not be confidently predicted by the iPSA. Higher iPSA does not correlate with higher GS and vice versa.
Background: Minimally invasive procedures in the surgical management of benign prostate enlargeme... more Background: Minimally invasive procedures in the surgical management of benign prostate enlargement (BPE) are of limited use in the resource-poor settings due to nonavailability of the requisite facilities and skills. It has been observed that teaching uroendoscopy inclusive of transurethral resection of the prostate (TURP) can be challenging in the resource-poor settings where the traditional master-apprentice (Halstedian) approach has remained the prevalent training technique. Patients and Methods: We aimed in this retrospective study to assess completeness of resection in TURP by comparing the proportion of prostate tissue resected to the proportion enucleated in open retropubic prostatectomy (ORP). We included all BPE patients on urethral catheter managed in the first 18 months after Halstedian training in TURP. The analysis was done using SPSS® 20 and VassarStats® online software. Results: Twenty patients' files for TURP and twenty-eight patients' files for ORP met the ...
South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie, 2012
BACKGROUND Fournier's gangrene is a necrotising fasciitis of the genitalia and perineum, with... more BACKGROUND Fournier's gangrene is a necrotising fasciitis of the genitalia and perineum, with associated polymicrobial infection and risk of organ failure or death. The purpose of this study was to determine the presentation, systemic and local predisposing factors, management challenges and outcome in south-eastern Nigeria. PATIENTS AND METHODS We studied 28 out of 34 consecutive male patients with complete case notes seen in two centres (the University of Nigeria Teaching Hospital and St Mary's Hospital) between January 1995 and December 2008. Operating theatre registers and urology ward admission registers were used to identify patients. RESULTS The mean patient age was 48.3 years (range 28 - 66 years), with a peak age incidence of 50 - 59 years. The majority of patients were farmers, manual labourers and artisans. The site of gangrene was scrotal in 22 patients (78.6%), penoscrotal in 3 (10.7%), abdominoscrotal in 2 (7.1%) and scroto-perianal in 1 (3.6%). The mean interv...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
To determine the relationship between prostate volume and international prostate symptom score (I... more To determine the relationship between prostate volume and international prostate symptom score (IPSS) in Africans with benign prostatic hyperplasia (BPH). This was a prospective study of 120 men aged between 45 to 85 years, who were referred to the urology outpatient facility for treatment of clinical BPH between July 2007 and October 2008 in Jos University Teaching Hospital. These patients were properly evaluated; a digital rectal examination was done to estimate the prostate size. The pre-treatment IPSS of the patient was also obtained. The prostate volume of each patient was then estimated by transabdominal ultrasound. The mean prostate volume was 72.79 +/- 44.38cm3. The mean values for the different diameters of the prostate were 5.63 +/- 1.17cm (longitudinal diameter), 4.48 +/- 0.95cm (anterior posterior diameter), 4.97 +/- 1.06cm (transverse diameter). The Pearson's correlation between pre-treatment International prostate symptom score and prostate volume was -0.0035 (P &g...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
To determine the relationship between prostate volume and international prostate symptom score (I... more To determine the relationship between prostate volume and international prostate symptom score (IPSS) in Africans with benign prostatic hyperplasia (BPH). This was a prospective study of 120 men aged between 45 to 85 years, who were referred to the urology outpatient facility for treatment of clinical BPH between July 2007 and October 2008 in Jos University Teaching Hospital. These patients were properly evaluated; a digital rectal examination was done to estimate the prostate size. The pre-treatment IPSS of the patient was also obtained. The prostate volume of each patient was then estimated by transabdominal ultrasound. The mean prostate volume was 72.79 +/- 44.38cm3. The mean values for the different diameters of the prostate were 5.63 +/- 1.17cm (longitudinal diameter), 4.48 +/- 0.95cm (anterior posterior diameter), 4.97 +/- 1.06cm (transverse diameter). The Pearson's correlation between pre-treatment International prostate symptom score and prostate volume was -0.0035 (P &g...
South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie, 2012
Fournier's gangrene is a necrotising fasciitis of the genitalia and perineum, with associated... more Fournier's gangrene is a necrotising fasciitis of the genitalia and perineum, with associated polymicrobial infection and risk of organ failure or death. The purpose of this study was to determine the presentation, systemic and local predisposing factors, management challenges and outcome in south-eastern Nigeria. We studied 28 out of 34 consecutive male patients with complete case notes seen in two centres (the University of Nigeria Teaching Hospital and St Mary's Hospital) between January 1995 and December 2008. Operating theatre registers and urology ward admission registers were used to identify patients. The mean patient age was 48.3 years (range 28 - 66 years), with a peak age incidence of 50 - 59 years. The majority of patients were farmers, manual labourers and artisans. The site of gangrene was scrotal in 22 patients (78.6%), penoscrotal in 3 (10.7%), abdominoscrotal in 2 (7.1%) and scroto-perianal in 1 (3.6%). The mean interval between onset of symptoms and present...
Enugu State typifies a Third World environment where most deliveries occur outside the hospital s... more Enugu State typifies a Third World environment where most deliveries occur outside the hospital setting. In such circumstances, hospital-based data about congenital defects are unreliable and call for special methods of approach. To determine the prevalence and pattern of male external genital defects in Igbo male secondary school students in Nigeria. Samples of male students aged 10 years and above seen in randomly selected secondary schools in Enugu State, of South-East Nigeria were guided through a protocol involving, self administered questionnaires, personal interviews and physical examinations for evidence and types of anomalies present in their external genitalia. The participating schools were selected by stratified random sampling; first by local government Areas (LGA) and then by schools. Consents for the study were obtained from Local Government Authorities, Heads of the schools and Parents' Teachers Associations, (PTA) Executives. Altogether, four urban and thirteen ...
Men of Black African descent are known to have the highest incidence of prostate cancer. The dise... more Men of Black African descent are known to have the highest incidence of prostate cancer. The disease is also more aggressive in this group possibly due to biologically more aggressive tumor or late presentation. Currently, serum prostate-specific antigen (PSA) assay plays a significant role in making the diagnosis of prostate cancer. However, the obtained value of serum PSA may not directly relate with the Gleason score (GS), a measure of tumor aggression in prostate cancer. This study explores the relationship between serum total PSA at presentation (iPSA) and GS. The iPSA of patients with histologically confirmed prostate cancer was compared with the obtained GS of the prostate biopsy specimens. The age of the patients at presentation and the prostate volumes were also analyzed with respect to the iPSA and GS. The data were analyzed retrospectively using IBM SPSS Version 20. Pearson correlation was used for numeric variables, whereas Fisher's exact test was used for categorical variables. Significance was set at P≤0.05. There were 205 patients from January 2010 to November 2013 who satisfied the inclusion criteria. iPSA as well as age at presentation and prostate volume were not found to significantly correlate with the primary Gleason grade, the secondary Gleason grade, or the GS. However, the presence of distant metastasis was identified to significantly correlate positively with GS. GS may not be confidently predicted by the iPSA. Higher iPSA does not correlate with higher GS and vice versa.
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