Background Benign prostate hyperplasia (BPH) is characterized by an increase in the number of epithelial and stromal cells in the periurethral area of the prostate. Lower urinary tract symptoms (LUTS) often develop as a manifestation of bladder outlet obstruction (BOO) due to benign prostate enlargement. When the prostate enlarges, protrusion into the bladder often occurs as a result of morphological changes of the gland. Prostatic protrusion into the bladder can be measured with ultrasound as intravesical prostatic protrusion (IPP). There are studies that have shown IPP as a reliable predictor of bladder obstruction index (BOOI) as measured by pressure flow studies. IPP is thereby reliable in assessing the severity of BOO in patients with BPH. The severity of symptoms in patients with BPH can be assessed through several scoring systems. The most widely used symptoms scoring system is the International Prostate Symptoms Score (IPSS). The aim of this study is to determine the correlation of IPP with IPSS in men with BPH at our facility. Methods The study was a cross-sectional observational study that was conducted at the Division of Urology, Department of Surgery, in our facility. The study was conducted on patients greater than 50 years LUTS and an enlarged prostate on digital rectal examination and/or ultrasound. All consenting patients were assessed with the International Prostate Symptoms Score (IPSS) questionnaire, following which an abdominal ultrasound was done to measure the intravesical prostatic protrusion (IPP), prostate volume (PV) and post-void residual (PVR) urine. All the patients had uroflowmetry, and the peak flow rate was determined. The data obtained were entered into a proforma. The results were analyzed using Statistical Package for Social Sciences (SPSS) software package version 20. Results A total of 167 patients were seen during the study period. The mean age was 63.7 ± 8.9 years, with a range of 45–90 years. The mean IPSS was 18.24 ± 6.93, with a range of 5–35. There were severe symptoms in 49.1%, while 43.1% had moderate symptoms and 7.8% had mild symptoms. The overall mean IPP was 10.3 ± 8 mm. Sixty-two patients (37.1%) had grade I IPP, 21 patients (12.6%) had grade II IPP and 84 patients (50.3%) had grade III IPP. The mean prostate volume and peak flow rate were 64 g ± 34.7 and 11.6 ml/s ± 5.4, respectively. The median PVR was 45 ml with a range of 0–400 ml. There was a significant positive correlation between the IPP and IPSS (P = 0.001). IPP also had a significant positive correlation with prostate volume and post-void residual and a significant negative correlation with the peak flow rate (P < 0.01). Conclusion Intravesical prostatic protrusion is a reliable predictor of severity of LUTS as measured by IPSS, and it also shows good correlation with other surrogates of bladder outlet obstruction.
Background Circumcision has been practiced since antiquity and is one of the most commonly performed surgical procedures. The aim of the study was to compare the efficacy and safety of the two most common techniques: Freehand and Plastibell techniques of circumcision. Methods The study was a prospective randomized study that was conducted on uncircumcised males at or below the age of 5 years that presented for circumcision. All boys who satisfied the inclusion criteria and whose parents consented, were randomized into two groups. Group A had freehand circumcision, while Group B had Plastibell circumcision. Patients were followed up at day 7 and day 28 postoperatively. The variables compared were operating time, cost, complications and parents’ satisfaction. All the data obtained were entered into a proforma. The data obtained were analyzed using SPSS version 20. Results A total of 110 boys were circumcised, 55 boys in each group. The median ages in the Plastibell and freehand groups were one and three months respectively. The mean operating time was significantly shorter in the Plastibell group compared to freehand (3.53 min versus 16.7 min). Total cost implication per procedure was also cheaper in Plastibell compared to freehand (₦3700 versus ₦6600). However, complications were more in the Plastibell group compared to freehand (29.1% versus 9.1%; P = 0.008). These complications in Plastibell group were age related. Parents in both groups were equally satisfied with the outlook on day 28. Conclusion Plastibell circumcision has the advantage of being faster and cheaper than freehand circumcision. Complications were more in the Plastibell group, and they were found to be age related.
Objectives Emergency urologic conditions are relatively common, albeit rarely life threatening, there is often a need for prompt and expedient management in order to avert severe or permanent morbidities. This study aimed to evaluate the spectrum of Urologic emergencies and interventions offered in a tertiary hospital in Nigeria. Patients and methods We retrospectively reviewed the records of patients who were managed in our institution for emergency urologic conditions over a period of 6 years (2011–2017). The data extracted included; the demographic information, diagnosis and the treatment offered. The data obtained were analyzed using SPSS version 20. Data were displayed using mean +/− standard deviation and percentages. Results The records of a total of 681 patients were retrieved and they span across almost all ages with age range or 2–90 years. Urinary retention was the commonest emergency seen, accounting for 51.7% of the patients. Testicular torsion was the next most common (10%), others are bilateral ureteric obstruction and priapism with 5.4% and 5.3% respectively. Suprapubic cystostomy (SPC) was the commonest operative procedure performed (37.6%). The age range for patients with urinary retention was 3–90 years, though the peak incidence was in the 7th decade (37.3%). Patients with testicular torsion were young adults between the ages of 11 and 44 years. Conclusion Urinary retention was the commonest urologic emergency followed by testicular torsion. Though urethral catheterization was successful in most patients urinary retention, making it the commonest procedure. SPC was the commonest emergency operative procedure performed. Other emergencies occurred sporadically.
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