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The aim was to carry out an epidemioclinical and therapeutic study of fractures of the penis at the Csréf in Markala. Patients and methods: This is a retrospective prospective descriptive study of 13 cases of fracture of the penis during four years at the Csréf of Markala from 01 January 2019 to 01 January 2023. All patients who had a treated penis fracture were included in our study. All patients who had other forms of trauma to the penis other than a penis fracture were excluded. Results: The frequency of fracture of the penis was 14.8% compared to other urological injuries. The average age of our patients was 36.30 years with extremes ranging from 25 to 54 years. 53.8% of our patients were single. The average consultation time was 14.8 hours, with extremes ranging from 3 hours to 47 hours. The approach was longitudinal in some cases and in other cases a circumferential incision or at the level of the balano preputial fold. The most frequent complications were penis bending, with 15.5% (2 patients), urethral fistula was observed in one patient (7.7%), and we also noted cases of fibrosis of the erectile bodies (23.1%). Conclusion: The fracture of the penis is a real uro-andrological emergency, and the treatment must be rapid and effective in order to avoid irreversible after-effects, which may even lead to erectile dysfunction or urethral stricture in these patients. The approach must be appropriate in order to prevent short, medium and late complications.

Introduction: Darier and Ferrant dermatofibrosarcoma is a rare malignant cutaneous mesenchymal tumour, representing less than 0.1% of malignant tumours and less than 5% of soft tissue sarcomas in adults. The aim of this study was to describe the evolutionary profile of cases of dermato fibrosarcoma of Darier et Ferrant reported in the dermato-venereology department of the National Centre for Disease Control (CNAM). Patients and methods: This was a descriptive cross-sectional study conducted in the dermatology department of the National Centre for Disease Control Support between 1991 and 2016, a period of 25 years. Was included, all patient with a histologically confirmed dermatofibrosarcoma notified in the registers of the CNAM histology laboratory or in the patient's medical file during the study period. Results: In total we collected 23 cases out of 5520 biopsied patients, i.e. a proportion of 0.41%. Males represented 60.8% with an average age of 40 years. The lesions were simple nodular in 12 of the 23 patients (52.2%), multi-nodular in 7 of the 23 patients (30.4%), nodulo-ulcerous and in patches in 4 of the 23 patients (17.4%). The lesions were located on the trunk in 60.8% of cases (image 1), on the head in 21.7% of cases and on the limbs in 17.5% of cases. The mean size of the lesions was 10×8cm with extremes of 3cm×3cm to 25cm×20cm. Management was exclusively surgical. Conclusion: DFSP is a rare tumour with a slow evolution, characterised by its rare metastasis but above all by its strong tendency to recurrence. The diagnosis is often evoked clinically and confirmed by histological study. The treatment of DFSP is surgical based on a large and deep lesion removal. Clinical monitoring allows early detection of recurrence, which is frequent in this disease.

Squamous cell carcinomas are favored by repeated sun exposure, especially in fair-skinned people who easily get sunburned. There are also genetic diseases including albinism which can promote their appearance early in life and multiple forms. We report the first observation of frontal squamous cell carcinoma with resection and reconstruction using the H-shaped flap in an albino (in Mali). Oculo -cutaneous albinism consulted for a frontal ulceration evolving for 3 years. The initial lesion was an erythematous macula which progressively evolved into a dragging ulceration. She had been treated with three sessions of cryotherapy (liquid nitrogen) without success. Physical examination found a slightly crusty ulceration, circumscribed (2 x 1.6 cm), painful and non-itchy. Otherwise the rest of the clinical examination was normal. A biopsy for pathological examination was performed. The diagnosis of invasive squamous cell carcinoma was confirmed. Surgical treatment was performed (resection and reconstruction with the H-shaped flap) with simple postoperative course and satisfactory results from an aesthetic point of view.

The aim of this study was to determine the epidemiological-clinical and therapeutic aspects of MU in children. This was a descriptive cross-sectional study, over a period of 5 years from January 1, 2016 to December 31, 2020 carried out in the urology department at the University Hospital Center "Point-G". We collected a total of 69 cases of malformative uropathy (MU) in children. The frequency was 1.41% of all hospitalizations and 5% of patients operated on during the study period. The sex ratio was 7.6 in favor of the male sex. They were admitted by referral from health personnel in the majority of cases, i.e. 93%. The mean age at diagnosis was 7 years. The circumstances of discovery were ectopic abutment of the urethral meatus (43.5%), pain in the lumbar fossa (23.2%) or bladder globe (10%). Ultrasound was performed in all of our patients, and revealed uropathy in 25.9% of cases. The most common uropathies were hypospadias (42%), pyelo-ureteral junction syndrome (23.2%) and posterior urethral valves (13%). All cases benefited from surgical correction adapted to the type of malformative uropathy. The evolution was without complication in the majority of cases in the 1st postoperative week, i.e. 84% of cases.

Introduction: Our study aimed to evaluate the anesthetic management of women suffering from obstetric vesico-vaginal fistulas at the Point G University Hospital. Patients and Methods: A descriptive retrospective study from 02 January 2018 to 31 December 2018 in the anesthesia-intensive care unit of the University Hospital Center (CHU) of Point G. Results: During the study period, we collected 48 cases of obstetric fistula out of a total of 237 operated during the period, a frequency of 20.25% of all surgical activities. Housewives were the most represented with 72.91% of cases. The most affected age group was 21-30 years with 37.5% of cases. Anesthesia was performed in 87.5% of cases by a medical assistant. The technique used was spinal anesthesia, so all patients received bipuvacaine for their anesthesia. One case of low blood pressure and one case of bradycardia were intraoperative incidents or a total of 2.08% of cases. Conclusion: Resuscitation anesthesia plays an important role in the successful management of obstetric fistula. Regional anesthesia is the most widely used method.

Summary: Introduction: Sexual violence is an all-encompassing term that refers to "any sexual act, attempt to obtain a sexual act, comment or advance of a sexual nature directed against a person's sexuality using coercion" according to the WHO. Objective: Study sexual violence based on gender at the level of the care unit << One Stop Center >> the Reference Health Center of Commune V of the District of Bamako. Materials and Methods: This was a descriptive and analytical cross-sectional retrospective study from January 1, 2019 to December 31, 2020. We included in this study, all survivors of sexual violence at least 10 years old admitted to the "One Stop Center" care unit of the Reference Health Center of Commune V of the District of Bamako. Results: The prevalence of sexual violence was 54.62% in relation to all cases of gender-based violence and 3.36% in relation to all gynaecological emergencies. The age group less than or equal to 19 years accounted for 54.18% of survivors, 69.68% of survivors were single. In 39.95% of the cases the incident took place in the home of the alleged perpetrator of the sexual assault. The survivors had presented a state of fear and panic in 23.92% of cases. Penetration was << penis-vagina >> in 37.1% of survivors. Survivors received psychiatric assistance in 12.87% of cases. Conclusion: Sexual violence is relatively common in our care unit << One Stop Center >>. They had constituted the majority of cases of gender-based violence. The care was holistic.

Introduction: Medical evacuation in general is characterized by the need for the rapid transfer of a patient from one medical centre to another more equipped or better specialized. Obstetric emergencies are multiple causes of maternal and neonatal death. Purpose: Was to study the reasons for reference / medical evacuation obstetrical at the Reference Health Center of Commune V of the District of Bamako. Materials and Methods: This was a descriptive study with a retrospective collection from January 1, 2017 to December 31, 2020. Results: We collected 4280 referrals/evacuations out of 28974 admissions; or 14.8% of admissions. The median age was 26.17 years. Housewives accounted for 45.4%. Dystocia was the main reason for references/evacuations with 41.1%. The reasons for referral/evacuation were consistent in 60.3% of cases. These evacuations were relevantin 21.8%. Maternal mortality was 0.8%. Conclusion: Evacuations accounted for 14.8% (4280) of deliveries. The most commonly cited reasons were dystocia, antepartum haemorrhage and high blood pressure and its complications. Dystocia, fetal asphyxia and high blood pressure and its complications were the main diagnoses.

Introduction: It is estimated that 60 to 80% of women in developing countries continue to give birth at home without any assistance or with the help of unskilled people and usually in an unsanitary environment. Purpose: It was tostudy unassisted home birth in two districts of Commune V. Materials and Methods: This was a prospective, crosssectional and analytical study from 1 March 2019 to 28 February 2020. Results: We recorded 263 home deliveries or 13% of deliveries in Sabalibougou and 62 home deliveries or 3% of deliveries in Badalabougou. The proportion of women not attending school was 74.64% in Sabalibougou against 25.36% in Badalabougou. In Sabalibougou, 89.40% of women had given birth at home due to lack of financial means compared to 10.60% in Badalabougou. Haemorrhage by uterine atony was the most represented complication in the two districts, 72.92% in Sabalibougou and 27.08% in Badalabougou.

Introduction: In Mali, adolescent girls aged 15 to 19 contribute nearly 14% total fertility carried health risks for the mother and the fetus during pregnancy and childbirth. Purpose: To study knowledge attitudes and practices among adolescents relating to contraception in school in Commune V of the District of Bamako. Material and Methods: This was a cross-sectional study with an evaluative and descriptive aim on knowledge attitudes and practices among adolescents relating to contraception in school in Commune V of the District of Bamako. Results: In our study, 87% of adolescents knew about contraception and 29% usued to contraceptive method. The 16-17 age group represented 74%. 36.33% of adolescents girls had already had sexual intercourse. The most usued contraceptive method was the condom with 24. 34%. The use of contraception in school was influenced by sci o-cultural, religious weigtht and ignorance (lack of sex education). Conclusion: Knowledge of contraception does not equate to its pratical use among adolescents. The majority of teenage girls said they knew about contraception, of which only a Fès of them used a contraceptive.

Introduction: A descriptive analysis of contraception discontinuation, based on Demographic and Health Survey data from six countries with high level of contraceptive use, fonds that approximately one-third of couples discontinuous their contraceptive use, method within 12 months and about half cease within 24 months. Aim: Was to study the reasons for abandoning contraception at the Reference Health Center of Commune V of District of Bamako. Material and Methods: We carried out a prospective, descriptive and cross-sectional study on the reasons for abandoning contraceptive methods from January 1, 2020 to December 31, 2020. Results: The frequency of abandonment of contraceptive methods in Commune V was 18.19%. The main reasons mentioned among the 200 former users of contraceptive methods interviewed were side effects with 35% of cases, husband's opposition (10 %), complications (20%), the desire to pregnancy (10%), reception of clients and occasional unavailability of inputs (5%). Conclusion: Inadequate management of side effects and complications related to contraception, the husband's reluctance and rumors had been the determining factors in the abandonment of contraception.

Objective: The aim of this study was to evaluate the epidemiological, para-clinical and histological profile of prostate tumours at the Gabriel Touré University Hospital in Bamako. Patients and Methods: This was a cross-sectional and descriptive retrospective study conducted over 12 years, from 1 November 2005 to 1 November 2017. It covered all patients received and operated on in the Urology Department of the Gabriel Touré University Hospital for prostate tumours and having a complete medical file. Results: Out of a total of 4,250 patients operated on in the urology department, 1,350 cases of prostate tumours were listed, i.e. a frequency of 31.7%. Prostatic adenomyoma was found in 90.9% of patients and prostatic adenocarcinoma in 6.7%. The average age of the patients was 70.5 years with extremes of 51 and 100 years. Pollakiuria was the most frequent reason for consultation (33.8%). TR, renal-vesicoprostatic ultrasound and PSA were essential for the diagnosis. The most frequent germ was Escherichia coli (25.5%), hyper creatinemia was found in 22.3% of patients. PSA was elevated in 33.4% of benign prostate tumours and 2% of prostatic adenocarcinomas were histologically discovered (normal PSA). Transvesical adenomectomy of the prostate (TVAP) was performed in 82.3% of patients and cervicoprostatic evacuation in 17.7%. The postoperative course was simple in 90.2% of patients, an infection of the surgical site (6.8%), bleeding complications (0.6%), we recorded 2% of deaths in the department and 0.4% of transfers to the intensive care unit. Conclusion: Prostate tumours are frequent in Bamako. Prostate tumours are frequent in Bamako, transvesical adenomectomy of the prostate and cervicoprostatic evacuation are the therapeutic means used. Prostatic adenomyoma is the most frequent histological type (90.9%) followed by prostatic adenocarcinoma (6.7%).

Bladder exstrophy is a rare urogenital birth defect. In the sub-Saharan context, most cases are diagnosed at birth or older due to lack of prenatal surveillance. The treatment is exclusively surgical. Several techniques have been described and modified over time. The surgical reconstruction technique can be done in a single or several procedures. This clinical observation was reported a case of complex epispadias bladder exstrophy, managed in a single procedure in a 10-year-old boy. The postoperative follow-up was simple.

Introduction: necrotizing fasciitis (FN) is a medico-surgical emergency that often involves the vital prognosis. Despite its rarity in children, necrotizing fasciitis is complicated by septic shock in 74 cases out of 100 and it is a serious infection, fatal in about 30% of cases. The aim of this work was to study the risk factors for necrotizing fasciitis in children. Methodology: This was a case-control study interesting children aged 0-15 years seen in dermatological consultation and included in accordance with the objectives of the study for a given period from January 1, 2020 to December 30, 2021. Diagnosis of necrotizing fasciitis was based on clinical and histological. Results: During the study period, 2501 children were seen in dermatological consultation, of which 20 had necrotizing fasciitis, ie a hospital frequency of 0.80%. These twenty cases of necrotizing fasciitis were matched with 20 controls by age, sex, hospital, date of admission. The age of children with necrotizing fasciitis ranged between 3 and 15 years, and the average age was 11.7 years. Preschool children (3-5 years old) accounted for 5%, school-age children (6-10 years old) accounted for 25% and adolescents accounted for 70%. The cases were divided into 11 boys (55%) and 9 girls (45%), the sex ratio was 1.22. The average duration of evolution of necrotizing fasciitis in children was 7.6 days with extremes ranging from 3 to 12 days. Conclusion: Many factors in our study were associated with the occurrence of necrotizing fasciitis in children, led by NSAIDs, traditional medications and traumatic wounds. In view of these results obtained in our study carried out under unfavorable conditions, it is necessary that cohort studies be carried out in order to confirm our results.

Context and Objective: Urological emergencies correspond to pathological situations of the urinary tract of both sexes and/or the male genital tract, with a functional and/or vital prognosis at stake in the absence of appropriate and effective treatment as soon as possible. The objective of this study was to evaluate the management of urological emergencies at the Markala health centre. Method: Our work is a prospective descriptive study of 12 months from May 2021 to April 2022 during which we recorded 107 cases of urological emergencies. The average age of occurrence of these pathologies was 47.6 years. The extremes were 04 months and 92 years. The most represented age group was 61 to 80 years with 30.8%. The male sex was the most affected with a sex ratio of 4.94. The most frequent reason for consultation was total inability to urinate with 42.1%. Acute urinary retention (AUR) was the most common urological emergency with 42.1% of cases. The main etiologies of AUR included BPH (57.7%) and urinary lithiasis (17.7%). Non- surgical procedures accounted for 78.5% of the therapeutic procedures performed. Bladder catheterisation accounted for 63.6% of non-surgical emergency procedures. Debridement accounted for 21.7% of emergency surgical procedures. Prostatic adenomectomy was the most performed etiological treatment with 23.4%. We recorded one case of death (0.93%) due to sepsis from Fournier's gangrene. Conclusion: Urological emergencies occupy an important place in our daily activity. The most frequent urological emergency was acute retention of urine, the predominance of which was linked to the frequencies of benign prostatic hyperplasia, urinary lithiasis and urethral stricture. The target population, dominated by adult males in their 50s, implied an etiological role for prostate adenoma. The emergence of these emergencies was mainly related to the delay in consultation and the lack of health education in the general population. Urethral catheterisation, .........

Introduction: Late pregnancies are a hot topic for both women and perinatal health workers because of their increasing increase. In the elderly primiparous pregnancy, pregnancy has always preoccupied birth attendants for a long time because high-risk pregnancy is the one that is associated with certain risk factors that can hinder its normal evolution. Objective: Study childbirth in the elderly primiparous at the Reference Health Center of Commune V of the District of Bamako. Materials and Methods: This was a retrospective and analytical case/control study (1 case for 2 controls), from 1January 2019 to 31 December 2021.It had covered all deliveries recorded in the ward. Results: The frequency of delivery in the elderly primiparous was 0.36%. The most educated elderly primiparous accounted for 73.3% (p=0,000; OR= 2.014; 95% CI = [0.006-0.31]). Dystocia was the most common obstetric complication (p=0.13; OR= 0.69; 95% CI = [0.42-1.12]). Caesarean delivery accounted for 77.1% in cases versus 49% in controls (p=0.000; OR= 0.28; 95% CI = [0.170.48]). Apgar's score was greater than or equal to 8 in 90.5% of cases versus 82.4% of controls. We have not recorded any maternal deaths. Conclusion: Pregnancy and childbirth in the elderly primiparous are risk situations in some cases. Childbirth in the elderly primipare requires a skill that can detect and prevent morbid situations and allow adequate care.

Introduction: The purpose of this study was to conduct an analysis of the diagnostic and therapeutic aspects of prostate abscess and a review of the literature. Clinical Observation: We report the case of a 24-year-old patient; admitted to our ward for acute detention associated with a febrile state at (38°C). On physical examination, the digital rectal examination could not assess the condition of the prostate due to severe pain and the rest of the examination was unremarkable. We formulated the following diagnostic hypotheses: prostate abscess, prostate cyst, acute prostatitis. Ultrasound allowed the diagnosis of a prostatic intraparenchymal cyst. The CBC reveals hyperleukocytosis and the ECBU came back positive for Escherichia coli. The diagnosis of a prostate abscess was retained after a guided echo puncture. Treatment consisted of transperineal drainage combined with antibiotic therapy suitable for ECB of pus aspirated during ultrasound-guided puncture. The evolution was favourable. Conclusion: Prostatic abscess is a rare pathology. Faced with a prostate collection in a febrile context, a puncture under ultrasound guidance could confirm the diagnosis. His treatment of choice remains endoscopic drainage and adapted antibiotic therapy.

The aim was to study the epidemiological, clinical and therapeutic aspects of paraphimosis at the CSRéf of Markala. Patients and Methods: We conducted a prospective and descriptive study of five patients who had consulted for paraphimosis in the operating theatre of the Markala referral health centre from 1er January 2019 to 31 December 2021, i.e. a two-year period. Our study included all patients who consulted for paraphimosis at the CSRéf of Markala with a usable medical file. The criteria for non-inclusion were: Phimosis without other pathologies of the penis. The records were not usable, as this was a prospective study. Results: The frequency of paraphimosis was 2.1% out of 235 patients hospitalized and operated on at the CSRéf of Markala during the study period. Four of our patients had no particular medical or surgical history, but the oldest of our patients had already undergone a hernia repair and an appendectomy at the time ; the average age of our patients was 15.3 years, with extremes ranging from 3 years to 53 years . However, we note that there is no specific age of onset of paraphimosis The treatment received by all our patients was posthectomy. No major complication was noted in our patients, however we deplore a loss of sight in two of our patients for a long term follow-up in order to identify other unknown aspects in the management of paraphimosis. Conclusion: Paraphimosis is a true urological emergency that occurs in uncircumcised men when the foreskin is trapped behind the glans crown, which can lead to long-term strangulation of the glans and compromise its vascularity hence their immediate management paraphimosis.

Crossed renal ectopia is a rare congenital anomaly, it was described by WILMER in 1938 [1], implies that one of the two kidneys sits on the contralateral side, the ureter of the ectopic kidney crosses the midline to meet in the bladder on the opposite side, the existence of a parenchymal fusion is frequent (85 to 90%). This anomaly is most often asymptomatic and discovered incidentally. We report the observation of a 21-year-old woman with a G1P1V1A0 obstetrical history (ATCD), presenting cross renal ectopia discovered fortuitously following pain in the right flank associated with palpation of an abdominal mass and to review the literature.

The aim was to study the epidemiological, clinical, paraclinical and therapeutic aspects of obstructive urinary calculi of the urinary tract. This was a prospective and descriptive study of 111 patients admitted to the urology department over a period of 6 years (January 2016 to December 2021). All patients with obstructive (symptomatic) urinary stones over 1.5 cm in diameter were included. Treatment results were analyzed 6 months later. Surgery for urolithiasis represented 4.10% of the interventions performed over the study period. The average age of the patients was 41 years old, with extremes of 1 and 81 years old. The age group 21 to 30 years was predominant, i.e. 24.3% of cases. The M/F sex ratio was 2.26. Renal colic was the main reason for consultation, i.e. 72.1%. Staphylococci, E. coli and Enterococci were respectively 22.5%; 21.6% and 12.6%. The operative technique used was open surgery. The postoperative course was simple in 92.8% and complicated in 7.2%.

Introduction: Hematuria is the presence of erythrocytes in abnormal amounts in the urine during urination, it is macroscopic if the number of erythrocytes is greater than 500 000 red blood cells / min. considered as a banal sign, particularly the endemic countries of Bilharzia, it remains a frequent reason for consultation and a concern in urology. A total of 71 patients met our inclusion criteria; the mean age was 54.28 ± 18 with extremes ranging from 11 years to 85 years. The sex ratio is 2.22 in favors of men, 70% of our patients had consulted for total hematuria and 49.3% in outpatient. The duration of evolution of hematuria was greater than three months in 42% of cases, cystoscopy was performed in 38% of patients and the selected diagnoses were dominated by bladder tumors (67.9%). prostate adenoma (14%), adenocarcinoma of the prostate (7.2%). Saline bladder irrigation was performed in 63.4% of patients for 1 to 3 days in 53%. The discharge of our patients was done after diagnosis and specific treatment in 38.4% of cases and in 25% of cases after the management of hematuria. Conclusion: Macroscopic hematuria affects twice as many men as women, bladder tumors and prostatic disease alone are responsible for almost all etiologies. Bladder irrigation and specific treatment play an important role in its management.

Male infertility remains a public health problem today. Varicocele looms large and is significantly associated with impaired sperm quality. Varicocele being defined as an abnormal and/or tortuous dilation of the scrotal veins of the pampiniform plexus. Method: This was a descriptive cross-sectional study with retrospective during 24 months. Our inclusion criteria were all patients operated on for varicocele on grounds of infertility or spermogram abnormality in the department, varicocele patients not operated on, or operated on for varicocele for other causes and incomplete records were not included in our study. Result: The 25-40 age group was the most represented with 60%, The desire for procreation was the reason for consultation most encountered with 73.33% and this desire had been evolving for 5 to 10 years in 53.33% of cases. High blood pressure was the most common medical history at 26.7%. Inguinal hernia was the most common surgical history, 36.66%. The normal spermogram rate increased from 13.33% before the intervention to 56.66% at 12 months postoperatively and the pregnancy rate increased to 33.33% at 12 months. Conclusion: Varicocele is a frequent pathology, Surgical cure for varicocele also significantly improves the fertility parameters of sperm in infertile patients within 3 to 6 months after the operation.

In Sub-Saharan Africa, the amount of household waste is expected to increase due to population growth and rapid urbanization. In addition to their impact on human and animal health, it has been proven that these wastes strongly contribute to global warming. Their management is nowadays a major concern in cities and countryside. The study was carried out to evaluate the prospects for the valorization of green kitchen waste in animal feed. A system for separating green kitchen waste from other household waste was set up in about thirty households in the commune V of Bamako. After the installation of the trash cans, weekly visits were made to the households to characterize the contents of the trash cans before weighing them. The results show a strong variability in the production of green kitchen waste according to the socio-professional category of the household head. The weekly production of this waste is between 0.46 and 1.90 kg for households of 2 to 16 people. The bromatological analysis carried out on a mixed sample shows that they constitute a potential feed resource for urban and peri-urban livestock with feed values that are between those of forage and oilcake. The valorization of these sub-products in livestock feed could contribute to the sanitation of our neighborhoods but also to the reduction of methane emissions in municipal dump sites.

The purpose of this work was to evaluate the results of three campaigns to support women victims of obstetric or non-obstetric fistulas. This is a retrospective and descriptive study of a series of 58 patients operated on during three campaigns for the management of urogenital and rectovaginal fistulas (February 2016, January 2017 and June 2021). All women with urogenital or rectovaginal fistula after questioning and physical examination were included. Fistula concerned 94.8% of housewives. At the time of diagnosis, 41.4% of our fistula patients were between 11 and 25 years old, with an age at first marriage of 11 to 20 years in 94.8%. Married women accounted for 79.3%. The births took place in 41.4% at home and were spontaneous in 55.2%. The repair techniques used were fistulorrhaphy by low or high way in 91.4%. The healing rate of closed and dried fistula was 62.1%.

Priapism is a painful and pathological erection caused by various abnormalities in erectile hemodynamics [1]. There are several aetiologies of which the common long-term risk is to cause sequelae erectile dysfunction in 50 to 60% [1, 2, 3]. In Mali, the main cause of priapism is sickle cell anemia. Our objective is to study the socio-demographic, clinical and therapeutic aspects of priapism at the Fousseyni Daou hospital in Kayes. This was a cross-sectional and descriptive study involving a series of 21 patients. It lasted 56 months (April 2016 to February 2020); performed in the urology department of the Fousseyni DAOU hospital in Kayes. The inclusion criteria for the study were: records of patients who presented with priapism during the study period. Records of patients with intermittent priapism were excluded. Treatment consisted of a transglandular caverno-cancellous shunt type Ebbehoj to local anesthesia associated with drug treatment. The main reasons for seeing patients are pain and being in a state of priapism. The age group of 8 to 20 years was 52% and 71.4% of our patients presented sickle cell traits including SS phenotype: 19%, SC: 19% and AS phenotype: 33.3%. 42.9% of our patients presented a lack of erection after an episode of priapism. Delays of more than a week were observed in 3 patients. Prevention of these priapisms involves regular monitoring of sickle cell patients.

The aim of the study was to study the clinical and therapeutic aspects of injuries secondary to trauma to the external genitalia. This was a prospective and descriptive study of 18 patients with trauma to the external genitalia admitted and operated on at the urology department of the Fousseyni DAOU hospital in Kayes from June 2015 to November 2020. The average age of the patients was 17 years with extremes of 10 and 62 years. 3 clinical forms have been studied (coital missteps, accidental trauma to the penis and trauma to the purses). Coital missteps affected 38.8% of patients (7 cases). The average age of the patients was 48 years with extremes of 29 years and 62 years. These were consensual, heterosexual relationships. The main reason for consultation was Cracking accompanied by pain and swelling of the penis. We had collected 9 cases of open bursa trauma, i.e. 50% of patients. The average age of the patients was 18 years with extremes of 10 and 28 years. The reasons for consultation were pain, open wound in the scrotum, bleeding. Associated lesions were urethral rupture in 3 cases, rupture of the vas deferens in 1 case, leg fracture in 1 case and loss of skin substance. Penile trauma after road accident was 2 cases (11.11%). They most often occur in the context of war or psychiatric illness. Repair of trauma to the external genitalia accounted for 0.63% of our surgical activities.

Objective: To evaluate the criteria for therapeutic choice between systematic laparotomy and non-operative treatment "selective abstentionism" in penetrating wounds of the abdomen. Patients and methods: This is a retrospective study performed at the second referral hospital of Kayes from January 1, 2016 to December 31, 2020. We included all patients admitted to the department for penetrating wounds of the abdomen. The parameters studied were visceral injuries, systematic laparotomy, non-operative treatment "selective abstentionism" Results: We collected 66 patients of which 57 were men and 9 were women, i.e. a sex ratio of 6.3. The mean age was 25.6 years with a standard deviation of 28.72 years and extremes (7 years - 60 years). Criminal assault was the main circumstance of occurrence in 34 cases (51%), the vulnating agent was a knife in 38 cases (58%), the site of the lesions was para umbilical in 12 cases (18%), the most eviscerated organ was the omentum in 25 cases (54%). Systematic laparotomy was performed in 41 cases (62%), during this operation the white laparotomy was performed in 6 cases (15%), intraoperatively the wounds of the small intestine were the most frequent in 15 cases (37%), the operative gesture was the simple suture in 24 cases (58%) The morbidity of the systematic operative treatment was 15% (4 parietal suppurations, 2 fistulas of the anastomosis). Mortality was 5% (2 cases). The non-operative treatment "selective abstentionism" was practiced in 25 cases (38%), we had 2 cases of therapeutic failure that required a secondary surgical intervention the lesions in per operative were 1 case of stomach wound and 1 case of wound of the right colonic angle. The morbidity was nil. Conclusion: In the management of penetrating wounds of the abdomen, systematic laparotomy has the advantage of making the lesion assessment while taking into account to avoid the patient a white laparotomy, the non operative treatment must be based on strict selection .......

Ritual circumcision has been practiced for cultural and religious reasons since antiquity in Egypt, then in Judaism and the Muslim world. The rite is also in use among certain Christian communities (especially in the East). In Mali the practice of circumcision is cultural and religious. In our current practices, complications related to this act are not frequent. We report here two cases of complications related to the act of circumcision received at the regional hospital center "Fousseyni DAOU hospital in Kayes". These were aesthetic and infectious complications. The treatment was urethroplasty according to DUPAY and necrosectomy with controlled healing followed by scrotal plasty and removal of the penis. In Mali, circumcision is ritual. It exposes when it is practiced outside health structures or by unqualified personnel to sometimes formidable complications.