Introduction: To study the clinical, paraclinical, diagnostic aspects and manage patients with urolithiasis according to the available technical facilities in urology department of N'Djamena in Chad. Urolithiasis is defined as the presence of one or more stony concretions located at any level of a segment of the urinary tract: calyx, renal pelvis, ureters, bladder and urethra. Materials and Methods: This was a descriptive type of a prospective study over a period of 4 years, from January 2008 to December 2011, involving 233 patients with urolithiasis treated in the urology department. Clinical and paraclinical examinations were the basis for the selection of patients. Informed consent of patient or their parents (for minors) was obtained for the anonymous use of records and photographs for scientific aims. Results: Urolithiasis represented 5.72% (233/4072) of all urological pathologies. Male dominance was significant with a sex ratio of 4.5/1. The age group of 0 -10 years was the most affected with a staff of 67 (28.75%). The clinic was dominated by dysuria (44.63%), renal colic (33.91%) and hematuria (9.01%). The main anatomical location was bladder (62.23%). The management was essentially medical and surgical. We recorded 7 cases of death or post-interventional hospital mortality rate of 3%. Conclusion: Urolithiasis is a real public health problem in Chad. Due to the inadequacy of the technical platform, the management was based on the open surgery. Etiological research was impossible by lack of technical laboratory platform.

Introduction: Retrocaval ureter is a rare congenital anomaly concerning the inferior vena cava and the ureter, where the infra-renal segment of the vena cava is in front of the ureter embryologically normal. This anomaly is more frequent in the male sex. Its symptoms are dominated by right lumbar pain, which is managed surgically as dictated by its intensity. Observations: The cases involved three male patients aged 42 years, 38 years and 39 years respectively. These patients had consulted for intermittent right lumbar pain similar to that of renal colic. The patients' general condition was satisfactory. Renal function was normal. Urinary tract ultrasound, IVU and scanning were the main imagery examinations used in diagnosing retrocaval ureter, confirmed by exploratory lumbotomy. Ureteral anastomosis in front of the vena cava was carried out in the 3 patients during simple surgical procedure that resulted in disappearance of the lumbar pain. Conclusion: Retrocaval ureter is a rare congenital malformation, often encountered in the male sex. Clinical symptoms are dominated by right lumbar pain similar to renal colic. Surgical treatment is dictated by the intensity of the pain.

Introduction: We aim to report, from three observations, the diagnostic difficulties and complications, and ensure the management of pelvic kidney in women at childbearing age in the Urology Department of the National General Referral Hospital of N'Djamena. Pelvic kidney is due to an abnormality of the migration that can be associated or not with a malrotation. Its symptomatology is not specific, causing diagnostic difficulties and therapeutic errors. Observation: There were three observations of female patients aged respectively 26, 29 and 32 years who were taken care of for years in the gynecology department for pelvic inflammatory disease before being routed in urology. The diagnosis of pelvic kidney was retained on the basis of morphological examination (ultrasound, intravenous urography, CT urography). The patients have undergone nephrectomy; the postoperative aftermath was simple. Conclusion: Pelvic kidney is a rare disease. It is often discovered during autopsy. Symptoms are non-specific; nephrectomy is the treatment of choice in symptomatic cases.

Aim: To describe the clinical, anatomical, therapeutic aspects and propose a diagram of a new type of a complete urethral duplicity in classification of Effman. Material and Methods: This was a case report of a 14-year-old patient who suffered from birth of incontinence occurring while sitting with concept of preservation of normal urination. The patient was carrying two urethral meatus, one continent and the other incontinent. The two urethral meatus were easy to catheterize. The imagery was non-contributory. Resection of accessory urethra helped to make the patient continent. Informed consent was obtained from the patient's parents for the surgical management, the anonymous use of record and photographs for scientific aims. Results: The diagnosis of urethral duplicity was retained. An explanatory approach is reported, a new scheme is proposed to improve the classification of Effman. Conclusion: The urethral duplicity is a rare urogenital abnormality whose etiology and pathophysiology are not fully understood and has not finished delivering the secret of his classification.

Aim: Report the epidemiological, clinicopathological characteristics and ensuring management of recent traumas of the external genitalia in Urology. Methods: This was a descriptive retrospective study of 47 cases of patients suffering from recent traumas of the external genitalia over a period of 5 years. The variables studied were sociodemographic, clinical, paraclinical, therapeutic and evolutionary. Results: A total of 47 patients, including 46 men, were managed. The mean age was 26.8 years, ranging from 6 to 56 years. The circumstances of occurrence were: the missteps of coitus (n = 16), traffic accidents (n = 9) and criminal injuries (n = 8). The fracture of the penis (n = 16) was the most common lesion followed by the scrotal wound (n = 11). The management was medical and surgical and varied by the type of lesion. The outcome was favorable in 91.5% of cases. Conclusion: The incidence of traumas of the external genitalia was 9.4 in urology department in N'Djamena. Penis fracture was the frequent lesion. The management is multidisciplinary, medical and surgical.