Genito-urinary reconstruction in southern Nigeria
| Autor: | L E, Akporiaye, T C, Oguike, I, Evbuomwan |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Aged 80 and over Male Urologic Diseases Hypospadias Time Factors Urologic Surgical Procedures Male Adolescent Urinary Fistula Age Factors Infant Nigeria Middle Aged Plastic Surgery Procedures Young Adult Treatment Outcome Child Preschool Humans Female Genital Diseases Male Child Urinary Tract Genital Diseases Female Aged Retrospective Studies |
| Zdroj: | West African journal of medicine. 28(2) |
| ISSN: | 0189-160X 1991-1998 |
| Popis: | Urologic cases constitute about 25% of a busy surgical practice in Nigeria with up to 50% of these cases being genito-urinary abnormalities in adults and children. As most urologic surgery in Nigeria is done by general surgeons, a knowledge of the disease pattern and effective techniques in management would be helpful in surgical training.To describe the disease pattern and surgical outcomes in patients undergoing genito-urinary reconstruction in southern NigeriaWe retrospectively reviewed the medical records of patients who underwent genito-urinary reconstructive procedures by two urologists and one paediatric surgeon over a 7-year (1991-1998) period at two tertiary referral centres in southern Nigeria. We extracted data such as age, sex, nature of pathology, surgical therapy and outcomes. Patients with a follow up of 12 months were excluded. The pattern of genito-urinary disease, type and outcome of surgical therapy, and complications were determined.Two hundred and twenty seven patients (121 men, 39 women, and 67 children) underwent genito-urinary reconstruction during the seven years spanning 1991-1998. The study population consisted of 160 adults and 67 children (15 years old). Mean patient age was 43 years with a range of 18-87 years for adults and three years (range 18 months-13 years) for children. Mean follow up duration was 15 months, (range--13 months-seven years). Urethral abnormalities comprised 69% (98/ 227) of the lesions. The most common abnormality was urethral stricture in 98 (43%) patients. Urethral strictures were reconstructed as follows; primary anastomosis 83 (84.6%), pedicled penile skin island 6 (6.1%), Blandy 2 stage, 4 (4%), meatoplasty three (3%) and meatotomy, two (2%). The overall complication rate for repair of urethral strictures was 4.08%. There were 79 (35%) congenital lesions, including hypospadias 62 (27%), pelvi-ureteric junction obstruction 13 (6%), bladder exstrophy 2 (0.8%), chordee without hypospadias, 2 (0.9%), and concealed penis 1 (0.4%). These were managed using the following techniques; MAGPI, 30 (48.3%), urethroplasty, 22 (10%) single stage 10 (45%), two-stage 12 (55%), and urethral mobilization 10 (16%). Vesico-vaginal fistula complicating obstructed labour and pelvic surgery was the main cause of urinary fistulae. Ten patients underwent microsurgical epididymo-vasostomy for obstructive azoospermia resulting in three pregnancies.Lower urinary tract reconstruction represents a major proportion of urologic surgery in southern Nigeria. Management by urologic specialists results in good outcomes, therefore urologic training in this area should include a large component of lower urinary tract reconstruction. |
| Databáze: | OpenAIRE |
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