Objective To study the factors associated with morbidity and mortality in benign prostatic hyperplasia (BPH) and carcinoma of the prostate in native Africans. Patients and methods A prospective study was conducted from 1993 to 1998 at the Ahmadu Bello University Teaching Hospitals, Zaria, Nigeria. During this 5-year period 686 patients were investigated and treated for symptoms and signs of prostatism. They were followed up for a mean (range) of 19.

The complications of traditional male circumcision were studied in 48 boys seen between January 1981 and December 1995. Their ages ranged from 3 days to 7 years (mean: 4 years). Haemorrhage, the commonest complication, was seen in 25 (52%) and infection in ten; one child had amputation of the penis. Other complications included meatal stenosis and urethro-cutaneous fistula. Sixty-four per cent of those with haemorrhage were neonates and their haemoglobin levels ranged between 6 and 15 g/dl. Three required blood transfusion, seven ligation of bleeding vessels and two required both. Overall, 21 patients required surgery and the average duration of hospital stay was 2-8 days. Most complications were seen between 1991 and 1995 when surgical fees had been introduced and the number of boys circumcized in our hospital decreased. We advocate the provision of adequate and safe facilities to cope with the increasing demand for circumcision in our society.

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Objective To study the aetiological factors and clinical presentation of haematuria as seen in a tertiary healthcare centre in a developing country in Africa. Patients and methods The study comprised a retrospective review of the diagnostic indices and notes of patients with macroscopic haematuria presenting at the Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, over a 7‐year period from 1985 to 1991. Results Of a total of 2726 urology patients and 11 232 surgical patients, 482 had haematuria (17.7% and 4.3%, respectively, 387 males and 95 females, ratio 4.1 : 1, mean age 44.8 years, range 6–80). Many presented late with advanced malignant disease (T3, T4). Investigations useful in the diagnosis were urinary cytology, intravenous urography and cysto‐urethroscopy. Common causes of haematuria were bladder carcinoma in 142 (31%), benign prostatic hypertrophy in 64 (14%) and urinary stones in 54 (12%). Conclusion Recurrent haematuria in patients over 30 years of age in this environment should be considered or deemed to be caused by malignancy until confirmed otherwise. An educational programme is required to alert the population to the significance of haematuria as a symptom demanding a thorough investigation before treatment. This would need support by a haematuria service for accelerated diagnosis and treatment.

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