BackgroundIntrauterine contraceptive device is the most common method of reversible contraception in women. The intrauterine contraceptive device can perforate the uterus and can also migrate into pelvic or abdominal organs. Perforation of the urinary bladder by an intrauterine contraceptive device is not common. In West Africa, intravesical migration of an intrauterine contraceptive device has been rarely reported. In this report, we present a case of an intrauterine contraceptive device migration into the urinary bladder of a 33 year old African woman at the Komfo Anokye Teaching Hospital, Kumasi, Ghana.Case reportA 33 year old African woman presented with persistent urinary tract infection of 7 months duration despite appropriate antibiotic treatments. An abdominal ultrasonography revealed a urinary bladder calculus which was found to be an intrauterine contraceptive device on removal at cystoscopy. She got pregnant whilst having the intrauterine contraceptive device in place and delivered at term.ConclusionThe presence of recurrent or persistent urinary tract infection in any woman with an intrauterine contraceptive device should raise the suspicion of intravesical migration of the intrauterine contraceptive device.
BackgroundCircumcision is a common minor surgical procedure and it is performed to a varying extent across countries and religions. Despite being a minor surgical procedure, major complications may result from it. In Ghana, although commonly practiced, circumcision-related injuries have not been well documented. This study is to describe the scope of circumcision-related injuries seen at the Komfo Anokye Teaching Hospital in Kumasi, Ghana.MethodsThe study was conducted at the Urology Unit of the Komfo Anokye Teaching Hospital in Kumasi. Consecutive cases of circumcision-related injuries seen at the unit over an 18 month period were identified and included in the study. Data was collected using a structured questionnaire. Data was entered and analysed using SPSS version 16. Charts and tables were generated using Microsoft Excel.ResultsA total of 72 cases of circumcision-related injuries were recorded during the 18 month period. Urethrocutaneous fistula was the commonest injury recorded, accounting for 77.8 % of cases. Other injuries recorded were glans amputations (6.9 %); iatrogenic hypospadias (5.6 %), and epidermal inclusion cysts (2.8 %). The majority of children were circumcised in health facilities (75 %) and nurses were the leading providers (77.8 %). The majority of circumcisions were conducted in the neonatal period (94.7 %).ConclusionCircumcision-related injuries commonly occurred in the neonatal period. Most of the injuries happened in health facilities. The most common injury recorded was urethrocutaneous fistula but the most tragic was penile amputation. There is the need for education and training of providers to minimise circumcision-related injuries in Ghana.
This is a report on the technique of neoglans reconstruction in a patient with amputated glans penis following guillotine neonatal circumcision. A 4 cm long and 2 cm wide lower lip oral mucosa graft was harvested and used to graft the distal 2 cm of the corporal bodies after 2 cm of the distal penile skin had been excised. One edge of the lower lip oral mucosa graft was anastomosed to the urethral margins distally and proximally to the skin. At six months of followup, patient had both satisfactory cosmetic and functional outcomes.
Objective: To evaluate open nephrectomies performed in adults over a five year period at the Komfo Anokye Teaching Hospital (KATH) and to compare our experience with findings in the literature. Materials and Methods: This was a prospective, cross-sectional, hospital based study of all adults undergoing nephrectomy from October 2012 to September 2017 at KATH. We obtained data on patient demographics, clinical presentation, laboratory and imaging results, laterality of the disease, and indication for nephrectomy, complications and histopathology of nephrectomy specimen. The data was analyzed using PASW Statistics for Windows, Version 19.0. Chicago: SPSS Inc. Results: Thirty three (33) adult nephrectomies were performed over the study period. There were 18 males (54.50%) and 15 females (45.50%) with an age range of 16 years to 80 years. The modal age range for renal malignancies was 31-40 years accounting for 36.40% of adult nephrectomies. Flank pain (75.80%), haematuria (54.60%) and flank mass (51.50%) were the predominant presenting complaints. Malignant renal tumours accounted for 22 (66.70%) of the nephrectomies followed by neglected Pelvi-Ureteric Junction Obstruction (PUJO)-7 (21.20%); two (6.10%) nephrectomies were due to trauma and one (3.00%) for emphysematous pyelonephritis. Conclusion: Renal cell carcinoma constitutes the main indication for adult nephrectomy at KATH followed by neglected PUJO. Most of the patients with renal tumours were young and also presented late.
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