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Adama Ouattara,1 Abdoul-Karim Paré,1 Delphine Yé,1 Mamadou Z Traoré,1 Mohamed Simporé,1 Mickael Rouamba,1 F Aristide Kaboré,2 Timothée Kambou1 1Division of Urology, Souro Sanou University Teaching Hospital, Bobo-Dioulasso, Burkina Faso; 2Division of Urology, Yalgado Ouedraogo University Teaching Hospital, Ouagadougou, Burkina FasoCorrespondence: Adama Ouattara, Division of Urology, P.O Box 1465, Bobo-Dioulasso, Burkina-Faso, Email adamsouat1@hotmail.comIntroduction: Spermatic cord torsion (SCT) is a rare urological emergency that can jeopardize the fertility of the patient. Our study aimed to investigate the epidemiological, diagnostic and therapeutic aspects of SCT in Souro Sanou University Teaching Hospital.Materials and Methods: This was a descriptive cross-sectional study with retrospective data collection from January 1, 2017, to December 31, 2021, in the emergency surgical and urology division of Souro Sanou University Hospital.Results: The annual frequency of SCT was 4.4 patients/year. The mean age of the patients was 17.82 ± 6.74 years. Painful swelling of the hemi-scrotum was the main presenting symptom. The torsion involved the left spermatic cord in 50% of cases and both spermatic cords in 5% of cases. The mean time of symptoms before presentation was 78.8 hours ± 153 hours. Only 27.3% of patients presented before the 6th hour after the onset of pain. The average time from presentation to surgical intervention was 5.6 hours ± 5 hours. Orchiectomy was performed in 11 patients (47.8%). The average hospital stay was 3.1 ± 1.4 days.Conclusion: SCT is a rare urological emergency. The prognosis depends on the duration and degree of torsion. A high orchidectomy rate can be observed with a delay in presentation.Keywords: spermatic cord torsion, emergency, orchiectomy

Adama Ouattara,1 Abdoul-Karim Pare,1 Fasnewinde Aristide Kabore,2 Clotaire Yameogo,2 Desire Ky,2 Dramane Bayané,1 Delphine Ye,1 Timothee Kambou1 1Division of Urology, Souro Sanou Teaching Hospital, Bobo-Dioulasso, Burkina Faso; 2Division of Urology, Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina FasoCorrespondence: Adama OuattaraDivision of Urology, P.O. Box:1465, Bobo-Dioulasso, Burkina-FasoEmail adamsouat1@hotmail.comAim: To describe the epidemiological aspects, etiology and outcome of iatrogenic ureteral injury repair at the urology division of Souro Teaching Hospital of Bobo Dioulasso (Burkina-Faso).Patients and Methods: This was a retrospective descriptive study of consecutive patients with iatrogenic ureteric injuries who were referred and managed in the urology division of Souro Sanou Teaching Hospital (Bobo-Dioulasso) from January 2012 to December 2017. Variables studied were age, the time at the diagnosis, the causative event, the method of repair, and the outcome of the management.Results: The mean age was 37.72± 3.5 years coming from the rural population in most cases. The mean time at the diagnosis was 15 days. The injuries were due to gynecologic surgeries with hysterectomy (66%) and caesarian section (33%). Ureteric reimplantation with anti-reflux system was performed in seventeen patients. The rate of treatment success was 94% and the postoperative course was uneventful for all the patients.Conclusion: Iatrogenic ureteric lesions at the department of urology of Sanou Sourou teaching hospital of Bobo Dioulasso were mainly caused by gynecologic and obstetric surgeries like hysterectomy and caesarian section.Keywords: iatrogenic, ureter, injury, pelvic surgery

Abstract Introduction African-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). Methods We 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. Results 166 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. Conclusion Prostate 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.

Abstract Background Malnutrition constitutes a public health problem throughout the world and particularly in developing countries. Aims The objective of the study is to assess the impact of an elementary integrator composed of Spiruline (Spirulina platensis) and Misola (millet, soja, peanut) produced at the Centre Medical St Camille (CMSC) of Ouagadougou, Burkina Faso, on the nutritional status of undernourished children. Materials and methods 550 undernourished children of less than 5 years old were enrolled in this study, 455 showed severe marasma, 57 marasma of medium severity and 38 kwashiorkor plus marasma. We divided the children randomly into four groups: 170 were given Misola (731 ± 7 kcal/day), 170 were given Spiruline plus traditional meals (748 ± 6 kcal/day), 170 were given Spiruline plus Misola (767 ± 5 kcal/day). Forty children received only traditional meals (722 ± 8 kcal/day) and functioned as the control group. The duration of this study was eight weeks. Results and Discussion Anthropometrics and haematological parameters allowed us to appreciate both the nutritional and biological evolution of these children. The rehabilitation with Spiruline plus Misola (this association gave an energy intake of 767 ± 5 kcal/day with a protein assumption of 33.3 ± 1.2 g a day), both greater than Misola or Spiruline alone, seems to correct weight loss more quickly. Conclusion Our results indicate that Misola, Spiruline plus traditional meals or Spiruline plus Misola are all a good food supplement for undernourished children, but the rehabilitation by Spiruline plus Misola seems synergically favour the nutrition rehabilitation better than the simple addition of protein and energy intake.

Background: Long surgical wait times and limited hospital capacity are common obstacles to surgical care in many countries in Sub-Saharan Africa (SSA). Introducing ambulatory surgery might contribute to a solution to these problems. The purpose of this study was to evaluate the safety and feasibility of introducing ambulatory surgery into a pediatric hospital in SSA., Methods: This is a cross-sectional descriptive study that took place over 6 months. It includes all patients assigned to undergo ambulatory surgery in the Pediatric University Hospital in Ouagadougou, Burkina Faso. Eligibility criteria for the ambulatory surgery program included >1 year of age, American Society of Anesthesiologists (ASA) 1 status, surgery with a low risk of bleeding, lasting <90 minutes, and with an expectation of mild to moderate postoperative pain. The family had to live within 1 hour of the hospital and be available by telephone., Results: During the study period, a total of 1250 patients underwent surgery, of whom 515 were elective cases; 115 of these met the criteria for ambulatory surgery; 103 patients, with an average age of 59.74 ± 41.57 months, actually underwent surgery. The principal indications for surgery were inguinal (62) and umbilical (47) hernias. All patients had general anesthesia with halothane. Sixty-five percent also received regional or local anesthesia consisting of caudal block in 79.23% or nerve block in 20.77%. The average duration of surgery was 33 ± 17.47 minutes. No intraoperative complications were noted. All the patients received acetaminophen and a nonsteroidal anti-inflammatory drug in the recovery room. Twelve (11.7%) patients had complications in recovery, principally nausea and vomiting. Eight (7.8%) patients were admitted to the hospital., Conclusions: No serious complications were associated with ambulatory surgery. Its introduction could possibly be a solution to improving pediatric surgical access in low-income countries.

Objective: To report efficacy and morbidity of periurethral adjustable balloons (PUAB) in the treatment of stress urinary incontinence (SUI) with intrinsic sphincter deficiency (ISD)., Patients and Methods: Retrospective descriptive and analytic patients cohort study was performed from July 2010 to June 2012. We reviewed data from 43 patients (19 women and 24 men). The patients were categorized into 3 groups: i) women, ii) men after prostatectomy, iii) men with neurogenic SUI (prostate in position). Sandvick score and the average of 3 days 24 h Pad test evaluated the efficacy of the device. The patients impression of improvement was assessed in three degrees: completely improved, partially improved, not improved., Results: After a median follow-up of 67 weeks (min. 40, max. 91) a significant improvement of the score of Sandvik was observed (8 to 4, P<0.005). The proportion of dry patients or with one security protection in the three groups was 57.9%, 64.3% and 50% respectively for women, men after prostatectomy, and men with neurological SUI. About 27.9% (12/43) of the patients had post-operative complications. These complications required an explantation of the PUAB in 11/12 patients among whom 7/11 (63.6%) had a delayed re-implantation of the device., Conclusion: In this series, the overall efficacy observed was 67.4% with a post-operative complication rate of 27.9%. The device adjustment was done in consultation as well as the complications management and the explantation when necessary., Level of Evidence: 4., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Objective: To report the epidemiological and diagnosis characteristics of urolithiasis in the city of Ouagadougou (Burkina Faso)., Patients and Methods: We performed a retrospective and descriptive study of a cohort of urolithiasis patients from January 2009 to December 2011 at the department of urology of the Yalgado Ouédraogo University hospital of Ouagadougou. The minimum required data were: age, gender, occupation, residence, complete medical observation and medical imaging results., Results: Four hundred and fifty patients with a median age of 35 years were included in this study. Urinary stones prevalence was 12.5%. There was a male predominance with a sex ratio of 1.91. Renal colic found in 32% of patients was the main pattern of consultation. Urinary schistosomiasis was the main etiological factor correlated with the occurrence of urolithiasis (P < 0.05). The majority of urinary stones in this study were located in the upper urinary tract (86.5%). Complications were dominated by urinary tract infections (45.2%) and obstructive renal failure (8.9%)., Conclusion: The characteristics of urolithiasis in our center were similar to those reported in the developing world but seem to evolve toward those of industrialized countries.

Objectives: To evaluate the efficacy of chronic transcutaneous tibial nerve stimulation (TNS) on overactive bladder syndrome in female patients with Parkinson's disease (PD) and multiple system atrophy (MSA)., Patients and Methods: A prospective monocentric study enrolled six female patients with PD or MSA suffering from overactive bladder syndrome for a six-week study period. Daily sessions of 20 minutes of TNS were provided. The primary outcome measurement was the Patient Global Impression of Improvement (PGI-I scale). The secondary outcomes measurements were symptom and quality of life scores, bladder diary and urodynamics. The outcomes after 6 weeks of TNS were compared to baseline., Results: TNS was considered as an effective treatment by five patients out of six (83%) who ask to pursue the treatment and were still doing it 6 months after the end of the study. A trend improvement was observed in only two of the secondary evaluation criteria the V8 median score 21/40 to 14/40 (P=0.2) and the maximum cystometric capacity increased from 211 mL ± 106 to 260 mL ± 226 (P=0.6) after SNT., Conclusion: Although urodynamics and symptoms scores did not show significant difference, an efficacy of TNS on overactive bladder in PD and MSA is possible. Additional placebo controlled works enrolling more patients are required to ensure these preliminary results., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: To identify and describe functional urinary symptoms, uro-nephrological complications and their impact on quality of life in a cohort of patients diagnosed with the Wolfram syndrome (SW)., Patients and Methods: A transversal descriptive patient's cohort study was performed. The Urinary Symptom Profile (USP) and the International Consultation Incontinence Questionnaire - Female Lower Urinary Tracts Symptoms (ICIQ-FLUTS) were used to evaluate urinary symptoms and their impact on quality of life through direct interviews conducted by telephone. A less than 6-month old renal ultrasound and serum creatinine results were asked to the patient or physician., Results: Thirty-three patients have been contacted and 22 (73%) agreed to participate in this study. Eighteen patients over 22 had spontaneous micturition when four of them had an urinary diversion (two definitive, two temporaries) before being included in this study. Seventy-three percent of patients with spontaneous micturition had urinary symptoms. A severe or moderate symptoms score was noted in 67% (12/18 patients) and 11% (2/18 patients) respectively., Conclusion: Functional urinary dysfunctions were frequent and impacted quality of life in more than one half of patients diagnosed with SW in this study. Early diagnostic and regular urological follow-up can improve the quality of life and prevent severe urinary complications., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: To evaluate the results of Anderson-Hynes open pyeloplasty in our institution. And then to compare them to those of laparoscopic procedure and identify what can be considered now as the indications of the open procedure., Patients and Methods: It was a retrospective study on 30 cases of ureteropelvic junction syndrome managed by Anderson-Hynes open procedure. The clinical, biological and radiologic characteristics of the patients as well as the surgical technique and its results were taken into account. The patients were classified, according to Valdeyer and Cendron classification as type II in eight cases (26.7%), type III in ten cases (33.3%) and type IV in four cases (13.3%). There were also eight cases of giant hydronephrosis (26.7%). The operating time, the length of hospital stay and the outcomes were studied and compared with those of the laparoscopic pyeloplasty found in the medical literature., Results: The mean operating time was 115 ± 33.4 minutes (90-230 min). The mean length of hospital stay was 10.4 ± 5.1 days. Six patients (20%) had postoperative complications. After a mean follow-up of 28 ± 13.7 months (13-48 months), our first-hand success rate was 90% (n=27)., Conclusion: Anderson-Hynes open pyeloplasty reached good results but nowadays its indications can be limited to laparoscopic contraindications, severe hydronephrosis (grade IV or giant hydronephrosis) and second-hand cases. The two latter indications depend on the surgeon experience in laparoscopic surgery., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Objectives: The aim of this study was to report the transrectal prostate biopsy complications, to identify the factors involved in their occurring and to insist on their prevention., Patients and Methodology: It is a prospective study interested on patients managed in the urological and andrological service in Aristide le Dantec Hospital in Dakar for prostate tumour from February 2002 to March 2004 and in whom the indication of prostate biopsy was performed. All the patients fulfilling the including criteria were taken in care according to a same protocol that was a transrectal sextant biopsy This act was performed under preventive antibiotherapy based on fluoroquinolones started one day before and going on three days after biopsy associated to a rectal preparation performed the same day of biopsy At the end of the biopsy the patient was managed externally during three days after biopsy Following parameters were studied: age of patients, the histopathological results and the post operative complications., Results: Two hundred and four (204) biopsies were performed. The median age of the patients was 69.1 years with the extremes of 42 years and 93 years. The global rate of complications was 13.5% with a majority of bleeding. There no major complication registered. Rectal and urethral bleeding was over in 24 hours. The complete urine retention was under the form of a unique happening complication. The distribution of complications according to the results of the biopsy did not reveal any particularity., Conclusion: The rectal preparation associated to preventive antibiotherapy seems to reduce infectious complications.