Introduction: pelvic abdominal surgery may be associated with urological complications requiring reoperation. The aim of this study was to evaluate the urological surgical complications of gynecological and obstetric procedures conducted at the Ignace Deen University Hospital of Conakry in Guinea. Methodology: This was a retrospective, cross-sectional, descriptive study of ten years, from 1 January 2006 to 21 December 2015. Results: Of 14,500 patients hospitalized in the maternity ward during the study period, 31 patients had secondary urological complications during gynecological or obstetric intervention 0.2%). The mean age of the patients was 34.77 years (range: 17 to 58 years). The mean duration of hospital stay was 13.29 days (range: 3 to 28 days). Signs of complication were mainly postoperative abdominal pain (64%, n = 20), vaginal urine leakage (19.35%, n = 6) and vaginal bleeding (9.68% n = 3). The diagnosis was mainly confirmed by ultrasound (70.45%, n = 31). The lesions were primarily ureteric (77.42%, n = 17) or on the urethral wounds (8.12%, n = 12). Urological complications mostly occurred during hysterectomy (41.94%, n = 13) and caesarean section (32.26%, n = 10). Repair procedures included uretero-vesical reimplantation (58.06%, n = 18), vesico-vaginal fistuloraphy (22.58%, n = 7), vesico-uterine fistuloraphy (12.90%, n = 4) and temporary ureterostomy (6.45%, n = 2). Treatment were successful in 28 patients (90.32%) and a lethality of 9.68% (n = 3) was recorded. Conclusion: Urological surgical complications of obstetric gynecological surgeries were
Introduction: Death is a major accident which constitutes an element whose evaluation and analysis are necessary in a surgical service. Such a study is especially important in our country where the health structure operates with limited resources and more than half of the population lives below the poverty line. The objective of this study was to determine the frequency of post-operative mortality, to describe the main comorbidity factors responsible for this mortality and to identify the main cause of post-operative death in the urology department of the Ignace Deen National Hospital Material and Method: This was a retrospective descriptive study lasting 5 years from January 1, 2015 to December 31, 2019. It had focussed on all the files of patients operated on at the Urology Department of the Ignace Deen National Hospital, either in an emergency or planned and who died in per or post-operative immediately or 30 days later. Results: We recorded 63 cases of post-operative death, or a frequency of 1.84%. The average age was 61.92 ± 16.91 with the extremes of 12 and 91 years. Bladder (20.63%) and prostate tumours (60.3%) were the main admission diagnoses. High blood pressure was the main comorbidity factor found with 38.09% of cases followed by diabetes with 12.69%. Transurethral resection of the prostate, transurethral resection of the bladder and prostate adenocomectomy were the most performed surgical procedure with respective proportion of 19.04%, 20.63% and 38.09%. Probable cause of death were anemia in 25 cases (39.68%), septic in 20 cases (31.75%), heart failure in 6 cases (9.52%), pulmonary embolism in 5 cases (7.94%), obstructive renal failure 4 cases (6.35%) and stroke in 3 cases (4.76%). Conclusion: The majority of deaths occurred in patients over the age of fifty.
Aim: To report the indications, the approach and the complications of nephrectomy in the urology department of the University Hospital of Conakry. Material and methods: Retrospective descriptive study of 10 years duration, from October 1, 2006 to September 30, 216, on 34 patients who underwent nephrectomy. The parameters studied were: age, sex, operative indication, approach, type of nephrectomy, postoperative morbidity and mortality. The average follow-up was 12 months. Results: Between October 2006 and September 2016, 7064 surgical procedures were performed, including 34 nephrectomies, i.e. 0.48% of cases. Nephrectomy was indicated in 13 cases of renal tumor, 12 cases of pyeloureteral junction syndrome, 6 cases of pyonephrosis and 3 cases of American Association of Surgeons of Trauma stage IV kidney trauma.) Lumbotomy was the approach in 22 patients. Nephrectomy was extended in 16 patients and total in 18 others. We noted 4 cases of bleeding complications, 4 cases of parietal suppuration, 2 cases of death and 1 case of phlebitis. Conclusion: The indication for nephrectomy was rare in the department. The indications were varied, the most common being renal tumors and decompensated pyelo ureteral junction anomaly. Early management of renal pathologies would reduce the indication for nephrectomy.
Bladder Extrophy is a rare urogenital malformation of the penis and bladder. This is an impressive fact at birth, due to the absence of the anterior bladder wall and the dorsal side of the penis. We report the clinical observation of a 21-month-old child who consults for urine incontinence from birth, when physical examination showed complete bladder extrophy. The reconstructive surgery allowed forming a bladder reservoir associated with a repair of the penis at the same time. Bladder extrophy is a benign condition whose operative consequences can be simple but urinary incontinence is not uncommon after reconstitution.
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