[Radiochemotherapy for the treatment ofmuscle invasive bladder tumors in a west african radiotherapy service]

OBJECTIF

The aim of this study was to describe the results of radiochemotherapy in patients after transurethral resection of muscle invasive bladder tumors.

MATERIAL AND METHODS

A retrospective study from May 2014 to May 2016 in the radiotherapy department of the Mali Hospital. Have been included, all patients with bladder cancer infiltrating the muscle. Secondary cancers of the bladder and metastatic forms have been excluded from our study. Transurethral resection of bladder was performed. Neoadjuvant chemotherapy with paclitaxel- carboplatin was administered every three weeks in all patients, then external phototherapy 6 MV at a dose of 66 Gy due to 2 Gy of 5 sessions per week 6MV photon of external beam radiotherapy at a dose of 66 Gy due to 2 Gy of 5 sessions per week associated with concomitant cisplatin at dose of 40mg / m2 / week.

RESULTS

Eight patients were included in ourstudy. The average age of 53.75 ± 14.84 years. The male sex was predominant 87.5% (n = 7). The history of chronic smoking wasfound in four patients. The main carcinogenic risk factor identified in our patients was urogenital bilharzia (6 cases / 8).The histological type found was urothelial carcinomain 12.5% (n = 1) and invasive squamous cell carcinomain 87.5% (n = 7). Transurethral resection of the tumor was performed in 62.5% (n = 5). Endoscopic biopsy was performed in 37.5% (n = 3). The tumor was classified pT2N0M0 in 50% (n = 4), pT3aN0M0 in 37.5% (n = 3) and pT3bN0M0 in 12.5% (n = 1). Neoadjuvant chemotherapy with paclitaxel - carboplatin every three weeks was administered to all patients. The results of radiochemotherapy (see Table: evolution).

CONCLUSION

Concomitant radiochemotherapy is a conservative curative treatment that can be proposed as a replacement for cystectomy, for non-metastatic infiltrating tumors after the most complete endoscopic resection.

[Urological Complications of Pelvic Surgery at Point-G Hospital, About 23 Cases]

INTRODUCTION

Bladder and ureteral lesions are the most common urologic complications occurring during pelvic surgery with 1% and 0.5% to 3%, respectively. These lesions are rarely recognized intraoperatively and pose a major problem to urologists, gynecologists, and general surgeons.

OBJECTIVE

To study the factors favoring urologic complications following pelvic surgery at the University Hospital Point-G.

PATIENTS AND METHOD

We conducted a retrospective study at the University Hospital Point-G between 2006 and 2015. It involved 23 patients with a whole urological lesion following pelvic surgery. These patients underwent a clinical and para-clinical examination (intravenous urography, methylene blue test) to confirm the urological lesion and to determine its management.

RESULTS

The average age of our patients was 32.00 years with extremes of 18 and 40 years old. The leakage of urine was found in 82.6% (19/23). Interventions that caused urologic injury were: caesarean section 52.2% (12/23), hysterectomy 30.4% (7/23), as well as a caesarean section and hysterectomy 17.4% (4/23). Methylene blue was performed in 19 patients, it was positive in 52.2% (12/23) and intravenous urography (IVU) in 7 patients. The lesions encountered were: retrotrigonal fistula vesico-vaginal 10 cases, vesico-vaginal fistula under trigonal 2 cases, uretero-vaginal fistula 7 cases, and bilateral ureteral ligation 4 cases. Fistulorraphy was performed in 52.2% followed by direct ureterovesical reimplantation. The postoperative outcome was satisfactory in 100% of cases with obtaining a good bladder tightness. The average duration of hospitalization was 12 days (+/- 4 days).

CONCLUSION

Pelvic surgery results in urological injuries. Caesarean section and hysterectomy are contributing factors. Vesico-vaginal fistula or ureteral lesions are common.

[Social integration of women operated for obstetric urogenital fistula]

OBJECTIVE

To study the social integration of women supported in the urology department of the University Hospital of Point G for obstetric urogenital fistula.

PATIENTS AND METHOD

Prospective study conducted over a period of 13 months from June 2008 to June 2009 in the Department of Urology at the University Hospital of Point G. The study included all patients who have been operated on at least twice for obstetric fistula genitourinary. Records of surgical, medical records and tracking sheets for each patient were the media database.

RESULTS

Situation before treatment: before surgical treatment, 76.92% of patients were rejected by their spouses. The family attended the patient in 84.62% of cases. Situation after treatment: after treatment, 90.31% of women with fistula lived in the matrimonial home or family. The resumption of business activity was announced by 11.2% of patients. Among the women, 93.7% participated in housework. The number of patient intervention ranged from two to five. Healing (fistula closed and no sphincter dysfunction) was complete in 50% of cases. Among the women, 11.54% had sphincter dysfunction after closure of the fistula, which makes a total of fistula closed more than 61% after at least two attempts.

CONCLUSION

The urogenital fistulas are not a fatal disease but is a real handicap for women who suffer to conduct a socio-cultural and economic mainstream. Generally excluded from the ongoing operations of the company, these women are more integrated after successful surgical treatment of the fistula.

[Cystic lymphangioma of the scrotum]

The cystic lymphangioma is a relatively frequent affection. The scrotum is the least common sites. It is a benign tumor discovered during an examination or in a fortuitous way. The diagnosis is done with ultrasonography and the treatment of the limited and circumscribed cases, is a surgical excision. We reported the case of a child of 2 years old which was presented to the surgery emergency for the scrotum traumatism. The clinical and paraclinical exams founded a cystic mass. After mass excision, histopathology founded a cystic lymphangioma.

[Bladder rhabdomyosarcoma apropos of a case in the Urology Service, University Hospital Center du Point G]

The bladder rhabdomyosarcoma in children is a rare tumor. We report a case of bladder rhabdomyosarcoma in a child 3 years, who consulted for more dysuria hematuria. The aim of this work is to remind the symptomatology and clinical aspects of para-clinical examinations of this disease in children after a review of the literature of this disease and discuss treatment options. The rhabdomyosarcoma should be discussed before any symptoms of dysuria associated with hematuria in children. His diagnosis is suspected by medical imaging and confirmed by pathology. Our attitude has been resection of the tumor, then chemotherapy.

[Contribution to the classification of obstetrical vesicovaginal fistula]

Our study was made with the C.H.U of the hospital of the Point G in the Service of Urology in Bamako in Mali. It is about a retrospective study in a service which has a dosage unit in load of F.V.V.O on average two hundred patients per annum. We included in our study all the F.V.V.O examined in the service which had an organic assessment. This assessment noted the aspect of the vagina and the topographic situation of the dent. Sometimes the examination of certain patients required a loco-regional anaesthesia and tests with the methylene blue to individualize the dent.

CONCLUSION

The classification proposed is the result of an experiment on the ground. It is a tool for learning thus enabling him to distinguish from the types of dent with their forecast and from the technical epic to realize.

[The diverticulum of the female urethra. Clinical aspects, paracliniques and therapeutiques. In connection with ten cases]

OBJECTIVE

To specify the aspects clinical, para-private clinics and therapeutic of the diverticulum of the female urethra in the services of Urology of the CHU of the Point G.

PATIENTS AND METHODS

Il acts of a retrospective study relating to ten patients having been hospitalized with the diagnosis of urethral diverticulum in the service of urology of the hospital of the Point G. The clinical examination of our patients, the examinations Para biological private clinics and of medical imagery made it possible to pose the operational indication.

RESULTS

The majority of our patients were a secretary of office. The average age was 32 years with extremes of 28, 65 years. In antecedents gyneco- obstetrician 80% had normal childbirth and 20% were the nulliparous ones. All patients are without surgical antecedents. The urinary infection with repetition was found in all our patients in spite of the catch of antibiotics. The symptomatology of the low urinary tract was expressed by our patients (pollakiurie, of mictionnelles burns, dysurie). et the dyspareunie by some. The vaginal examination finds a tumefaction under urethral in all our patients. Echography endo-vaginale showed the mass under urethral contained liquid evocative of a diverticulum under urethral or a cyst under urethral in all the cases. The assumption of responsibility of all our patients was surgical E (gynaecological position, even procedure: the diverticulectomie transvaginale. The histology did not announce any case of process neoplastic. The immediate continuations post operational were simple. No patient announced a urinary symptomatology after six months.

CONCLUSION

The diverticulum of the urethra of the woman is an ignored affection her treatment is surgical.

[Skin gangrene]

OBJECT

The cutaneous gangrenes, in particular those of Fournier are described like evolving/moving often in a way striking down. We report, over a study period of 10 months, the clinical and therapeutic characteristics of the lesions observed thus that their evolution in a context of developing country.

PATIENTS AND METHOD

it is about an exploratory study running 2005 in the service of surgery "A" of the hospital of the Point G and of urology. We listed a patient presenting a cutaneous gangrene post Caesarean like 5 cases of gangrene of the external genitals or gangrene of Fournier. The six clinical observations constituted the sample of study. The socio demographic data, the duration of evolution before the reference to the hospital of the Point G, the mechanim, the type and the seat of the lesions, the germs in question, the type of treatment were studied.

RESULTS

the traumatic mechanism was raised here. The treatment of the lesions was medical and surgical in one or two times. The cicatrization of the lesions was obtained at 6 weeks on average. Localization at the scrotum and penises due to streptococcus were observed. Observations 3 and 4 had jointly a urethral traumatism by survey, a fumigation of the purses on immunodepressive ground ignored until there. The cutaneous plastic in a case and the preserving medical treatment for the other allowed the cicatrization of the lesions.

[Not Available]

Summary The urethral duplication in the child is has very rare congenital malformation which is more often seen At the servant boy many anatomical forms are described. The authors carryforward has box of urethral duplication one-eved with constitution of has mass will will intra scotale taking the form of one 2nd testicle At has 7 year old servant boy. The clinical observation, radiological investigation, and the treatment are described.

[Lung diseases complicating acute poisoning with psychotropic drugs]

474 patients admitted in ICU between 1976 and 1981 were retrospectively analysed. Pneumonia (P) was assessed by condensation on chest X ray. P developed in 14,3%. 24 hours after admission 77,6% of P had appeared. Initial location was unilateral in 79,4% with predilection to the inferior half of the right lung. Fever was almost constant (89,5%). Promoting factors were observed: delay between ingestion and admission, vomiting and tracheobronchial embarrassment, coma depth. Recovery was simple in 83,3%. Among the 14 deads, 6 died because only of p, in 4 other P was aggravating. Duration in ICU was much longer when P was present (9 +/- 8,1 days) than when P was absent (2,5 +/- 2,1) p less than 0,001.