Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by ot...Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ED. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ED) seen at the University Hospital of Abeche. Erectile function was assessed using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed to take part in the study. Only 40 patients correctly completed the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented 74%. Diabetes was poorly controlled in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.展开更多
Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mo...Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mortality remains very high despite therapeutic advances. Our aim was to report on the epidemiological, diagnostic and therapeutic aspects of gangrene of the external genitalia, and to identify prognostic factors. Patients and Method: This was a 5-year retrospective descriptive study, from February 2016 to February 2021, of cases of gangrene of the external genitalia admitted to and treated in the Urology Department of Abeche University Hospital. Results: We collected 49 cases of gangrene of the external genitalia. The mean age of patients was 42 ± 16.81, with extremes of 20 and 81 years. The age group most concerned was between 20 and 29. The most frequent reasons for consultation were suppuration of the external genitalia and scrotal swelling. The average consultation time was 19.05 ± 16.02 days. The most common comorbidity was diabetes (35.9%). The most frequent pathological antecedents were urinary tract infections and endourethral maneuvers, reported in 40.5% and 38.7% respectively. Urogenital aetiology was predominant in 54.7%, and idiopathic in 35.9%. Lesions involved the scrotum in 60.6%, the scrotum and penis in 16.5%, and the penis alone in 5.7% of cases. Lesions extended to the perineum in 13.6% of cases, and to the abdomen in 3.6%. Vascular filling via the central venous line was performed in 58.6% of cases, and via the peripheral venous line in 41.4%. 3rd-generation cephalosporins and associated imidazoles were the most commonly used antibiotics. Necrosectomy was performed in 37 patients (73.4%), debridement combined with bypass cystostomy in 26.6% of cases. Colostomy was performed in 4% of cases. 90.8% of patients were cured and 9.2% died. The average hospital stay was 30 ± 75 days. Conclusion: The gangrene of the external genitalia is a medical and surgical emergency which has become 展开更多
Introduction: Prevention of obstetric fistula (OF) remains a challenge in Chad where its incidence is 464 cases/year. The present study aims to determine the knowledge and attitudes of nursing staff towards obstetric ...Introduction: Prevention of obstetric fistula (OF) remains a challenge in Chad where its incidence is 464 cases/year. The present study aims to determine the knowledge and attitudes of nursing staff towards obstetric fistula. Patients and Method: This was a cross-sectional, descriptive and analytical study including nursing staff at the Abéché University Hospital. The survey took place from March to May 2023 and the sampling was exhaustive. Data collection was done using a form including a questionnaire on sociodemographic parameters, knowledge and attitudes. Participation in the study was voluntary and individual. Results: Participation in the study was 76.11%. Emergency department staff were the most represented, followed by gynecology-obstetrics staff with 34.4% and 20.91% of cases respectively. Nurses represented 53.17% of participants followed by doctors (23.52%). An exact definition of obstetric fistula was reported by 7.84% of participants and it was partial in 80.39%. The level of knowledge of risk factors was considered good in 12.41%. Exact knowledge of clinical signs was reported by 74.5% of cases. Among the participants, 1.96% reported that the treatment of obstetric fistula is traditional. Knowledge about means of prevention was considered good by 13.72% (n = 21), and attitudes by 26.79%? Obstetric fistula knowledge was influenced by profession (doctor, p = 0.011) and attitudes by service (p = 0.004) and profession (doctor, p = 0.001). Conclusion: Obstetric fistula is a curable disease whose prevention remains possible and requires good knowledge of the disease and the promotion of safe motherhood. This study should serve as a basis for the establishment of the obstetric fistula module in the curriculum of healthcare personnel and the promotion of continuing training for its eradication.展开更多
Introduction: Acute large bursae (ALB) are a frequent reason for emergency consultations. The aim of this study was to investigate the prevalence, clinical course, treatment and evolution of ALB at Abeche University H...Introduction: Acute large bursae (ALB) are a frequent reason for emergency consultations. The aim of this study was to investigate the prevalence, clinical course, treatment and evolution of ALB at Abeche University Hospital. Patients and Method: This was a 45-month cross-sectional study from January 2020 to September 2023. Male patients of any age who had been admitted to and treated for acute large bursae at the Abeche University Hospital were included. Sociodemographic, clinical and therapeutic variables were studied. Results: Acute large bursae accounted for 7.92% of emergency admissions. The average age was 39.40 years. 60.27% of patients came from rural areas. The average consultation time was 4 days, ranging from a few hours to 18 days. The main reason for consultation was pain. Strangulated inguino-scrotal hernia was the most common, followed by acute orchi-epididymitis, accounting for 41.8% and 26% of cases respectively. Traditional treatment prior to consultation was attempted in 13.7% of cases. All patients were treated as emergencies, 41 of whom had received medical treatment. Of the patients treated surgically, orchidopexy was performed in all. Parietal suppuration and anaemia occurred in 6.2% and 4.8% of cases respectively. Conclusion: A accounts for a significant proportion of our emergency care activity. However, patients are seen with a delay, which jeopardises the functional prognosis of the testicle and intestine.展开更多
Introduction: Urinary calculosis is the presence of stones in the urinary tract. It is more common in adults than in children. The aetiologies are multiple and depend on age. The management of calculi in children requ...Introduction: Urinary calculosis is the presence of stones in the urinary tract. It is more common in adults than in children. The aetiologies are multiple and depend on age. The management of calculi in children requires an active aetiological search because of the frequency of hereditary abnormalities which are at the origin of recurrences. The aim of our study was to report the epidemiological, clinical and therapeutic aspects of urinary lithiasis in children in the context of our practice. Aim: To report the epidemiological, clinical and therapeutic aspects of urinary lithiasis in children in our practice context. Patients and Method: This was a retrospective descriptive study carried out in the Urology Department of the University Hospital of Abeche from January 2013 to December 2019. Thirty files of patients aged 0 to 15 years operated on for urinary lithiasis were retained. The variables studied for each patient were: age, sex, clinical, para-clinical and therapeutic aspects. Results: We selected 30 cases. Patients ranged in age from 0 to 15 years, with an average age of 5.5 years. There were 26 boys and 4 girls. 62% of the patients were from rural areas. The antecedents were bilharziasis, urinary tract infections, congenital malformation, trauma and bladder lithiasis. Clinical symptoms were dominated by acute urinary retention (n = 16) and dysuria (n = 14). Urine cytobacteriological tests were positive in 16 cases. The diagnosis was made in the majority of cases by ultrasound and/or unprepared abdomen (UA). The location of lithiasis was mainly the bladder (n = 16). Treatment was surgical in 96.7% of cases, with cystolithotomy predominating. Therapeutic results were satisfactory in 90% of cases. Conclusion: Urinary calculi in children are less common than in adults. In our region, stones are most often found in the bladder. Open surgery is still the preferred method of treatment in our practice.展开更多
<strong>Introduction:</strong> Buschke Lowenstein Tumor (BLT) is a tumor, belonging to the group of verrucous carcinomas. It is endowed with an unpredictable potential of recurrence and degeneration. The a...<strong>Introduction:</strong> Buschke Lowenstein Tumor (BLT) is a tumor, belonging to the group of verrucous carcinomas. It is endowed with an unpredictable potential of recurrence and degeneration. The aim of the work is to present the anatomical and therapeutic characteristics of BLT at the University Hospital of National Reference of N’Djamena in Chad. <strong>Patients and Method:</strong> Prospective descriptive study of 13 patients with BLT, from May 2009 to April 2019 in the department of urology was included. The patients more than 15, carriers of TBL located at: external genitalia, perineum and anal margin whose clinical, paraclinical assessment allowed the diagnosis of BLT, management and follow-up at the said service. Respect for the patient’s identity and consent, the patient’s consent is obtained and the anonymity of the photographs is observed. <strong>Result:</strong> A total of 13 patients had BLT, 11 males and 2 females. The average age of the patients was 32.5 years. The lesions were cauliflower-like and located on the vulva (n = 2), the penis, the perineum, the anorectal region in men (n = 11). Serology was positive for: HIV (n = 3), chlamydia (n = 4). The management was surgical by cauterization and excision. Cystoscopy and rectoscope were normal. The cure was obtained in all patients. Two patients had a recurrence at 5 months requiring a second successful cure. <strong>Conclusion:</strong> BLT is a frequent pathology in the urology department of the University Hospital of National Reference of N’Djamena in Chad. The surgical treatment by “cauterization exeresis” gives a better treatment.展开更多
<strong>Introduction:</strong> Penile cancer is a rare primary malignancy that occurs in patients in their 60s and 70s. The aim of the study was to describe the anatomical aspects of penile cancer and to r...<strong>Introduction:</strong> Penile cancer is a rare primary malignancy that occurs in patients in their 60s and 70s. The aim of the study was to describe the anatomical aspects of penile cancer and to report the difficulties of its management. <strong>Materials and Methods:</strong> This was a retrospective descriptive study of patients with penile tumors from January 2007 to December 2019. Patients of sexual age with an ulcerated lesion of the penis, who came to our department and whose clinical and paraclinical workup led to the diagnosis of penile cancer, were included. The variables studied were clinical, paraclinical and therapeutic. <strong>Results:</strong> In 12 years, we diagnosed and managed 8 patients with penile cancer, an incidence of 0.7 per year. The reason for consultation was the chronic ulcerating wound of the penis with a “cauliflower” aspect. The first medical consultation was late (n = 8) after a long latency period lost to traditional healers. The lesion was located in the glans penis (n = 6) and/or in the corpus cavernosum (n = 2). Histological analysis of the cores concluded to a squamous cell carcinoma. Patients were classified as T2N+M+ (n = 3) and T2N0M0 (n = 5). One patient had accepted partial amputation of the penis. <strong>Conclusion:</strong> Penile cancer is a rare tumor. Partial amputation of the penis is the only alternative in our practice context, an alternative often refuted.展开更多
文摘Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ED. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ED) seen at the University Hospital of Abeche. Erectile function was assessed using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed to take part in the study. Only 40 patients correctly completed the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented 74%. Diabetes was poorly controlled in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.
文摘Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mortality remains very high despite therapeutic advances. Our aim was to report on the epidemiological, diagnostic and therapeutic aspects of gangrene of the external genitalia, and to identify prognostic factors. Patients and Method: This was a 5-year retrospective descriptive study, from February 2016 to February 2021, of cases of gangrene of the external genitalia admitted to and treated in the Urology Department of Abeche University Hospital. Results: We collected 49 cases of gangrene of the external genitalia. The mean age of patients was 42 ± 16.81, with extremes of 20 and 81 years. The age group most concerned was between 20 and 29. The most frequent reasons for consultation were suppuration of the external genitalia and scrotal swelling. The average consultation time was 19.05 ± 16.02 days. The most common comorbidity was diabetes (35.9%). The most frequent pathological antecedents were urinary tract infections and endourethral maneuvers, reported in 40.5% and 38.7% respectively. Urogenital aetiology was predominant in 54.7%, and idiopathic in 35.9%. Lesions involved the scrotum in 60.6%, the scrotum and penis in 16.5%, and the penis alone in 5.7% of cases. Lesions extended to the perineum in 13.6% of cases, and to the abdomen in 3.6%. Vascular filling via the central venous line was performed in 58.6% of cases, and via the peripheral venous line in 41.4%. 3rd-generation cephalosporins and associated imidazoles were the most commonly used antibiotics. Necrosectomy was performed in 37 patients (73.4%), debridement combined with bypass cystostomy in 26.6% of cases. Colostomy was performed in 4% of cases. 90.8% of patients were cured and 9.2% died. The average hospital stay was 30 ± 75 days. Conclusion: The gangrene of the external genitalia is a medical and surgical emergency which has become
文摘Introduction: Prevention of obstetric fistula (OF) remains a challenge in Chad where its incidence is 464 cases/year. The present study aims to determine the knowledge and attitudes of nursing staff towards obstetric fistula. Patients and Method: This was a cross-sectional, descriptive and analytical study including nursing staff at the Abéché University Hospital. The survey took place from March to May 2023 and the sampling was exhaustive. Data collection was done using a form including a questionnaire on sociodemographic parameters, knowledge and attitudes. Participation in the study was voluntary and individual. Results: Participation in the study was 76.11%. Emergency department staff were the most represented, followed by gynecology-obstetrics staff with 34.4% and 20.91% of cases respectively. Nurses represented 53.17% of participants followed by doctors (23.52%). An exact definition of obstetric fistula was reported by 7.84% of participants and it was partial in 80.39%. The level of knowledge of risk factors was considered good in 12.41%. Exact knowledge of clinical signs was reported by 74.5% of cases. Among the participants, 1.96% reported that the treatment of obstetric fistula is traditional. Knowledge about means of prevention was considered good by 13.72% (n = 21), and attitudes by 26.79%? Obstetric fistula knowledge was influenced by profession (doctor, p = 0.011) and attitudes by service (p = 0.004) and profession (doctor, p = 0.001). Conclusion: Obstetric fistula is a curable disease whose prevention remains possible and requires good knowledge of the disease and the promotion of safe motherhood. This study should serve as a basis for the establishment of the obstetric fistula module in the curriculum of healthcare personnel and the promotion of continuing training for its eradication.
文摘Introduction: Acute large bursae (ALB) are a frequent reason for emergency consultations. The aim of this study was to investigate the prevalence, clinical course, treatment and evolution of ALB at Abeche University Hospital. Patients and Method: This was a 45-month cross-sectional study from January 2020 to September 2023. Male patients of any age who had been admitted to and treated for acute large bursae at the Abeche University Hospital were included. Sociodemographic, clinical and therapeutic variables were studied. Results: Acute large bursae accounted for 7.92% of emergency admissions. The average age was 39.40 years. 60.27% of patients came from rural areas. The average consultation time was 4 days, ranging from a few hours to 18 days. The main reason for consultation was pain. Strangulated inguino-scrotal hernia was the most common, followed by acute orchi-epididymitis, accounting for 41.8% and 26% of cases respectively. Traditional treatment prior to consultation was attempted in 13.7% of cases. All patients were treated as emergencies, 41 of whom had received medical treatment. Of the patients treated surgically, orchidopexy was performed in all. Parietal suppuration and anaemia occurred in 6.2% and 4.8% of cases respectively. Conclusion: A accounts for a significant proportion of our emergency care activity. However, patients are seen with a delay, which jeopardises the functional prognosis of the testicle and intestine.
文摘Introduction: Urinary calculosis is the presence of stones in the urinary tract. It is more common in adults than in children. The aetiologies are multiple and depend on age. The management of calculi in children requires an active aetiological search because of the frequency of hereditary abnormalities which are at the origin of recurrences. The aim of our study was to report the epidemiological, clinical and therapeutic aspects of urinary lithiasis in children in the context of our practice. Aim: To report the epidemiological, clinical and therapeutic aspects of urinary lithiasis in children in our practice context. Patients and Method: This was a retrospective descriptive study carried out in the Urology Department of the University Hospital of Abeche from January 2013 to December 2019. Thirty files of patients aged 0 to 15 years operated on for urinary lithiasis were retained. The variables studied for each patient were: age, sex, clinical, para-clinical and therapeutic aspects. Results: We selected 30 cases. Patients ranged in age from 0 to 15 years, with an average age of 5.5 years. There were 26 boys and 4 girls. 62% of the patients were from rural areas. The antecedents were bilharziasis, urinary tract infections, congenital malformation, trauma and bladder lithiasis. Clinical symptoms were dominated by acute urinary retention (n = 16) and dysuria (n = 14). Urine cytobacteriological tests were positive in 16 cases. The diagnosis was made in the majority of cases by ultrasound and/or unprepared abdomen (UA). The location of lithiasis was mainly the bladder (n = 16). Treatment was surgical in 96.7% of cases, with cystolithotomy predominating. Therapeutic results were satisfactory in 90% of cases. Conclusion: Urinary calculi in children are less common than in adults. In our region, stones are most often found in the bladder. Open surgery is still the preferred method of treatment in our practice.
文摘<strong>Introduction:</strong> Buschke Lowenstein Tumor (BLT) is a tumor, belonging to the group of verrucous carcinomas. It is endowed with an unpredictable potential of recurrence and degeneration. The aim of the work is to present the anatomical and therapeutic characteristics of BLT at the University Hospital of National Reference of N’Djamena in Chad. <strong>Patients and Method:</strong> Prospective descriptive study of 13 patients with BLT, from May 2009 to April 2019 in the department of urology was included. The patients more than 15, carriers of TBL located at: external genitalia, perineum and anal margin whose clinical, paraclinical assessment allowed the diagnosis of BLT, management and follow-up at the said service. Respect for the patient’s identity and consent, the patient’s consent is obtained and the anonymity of the photographs is observed. <strong>Result:</strong> A total of 13 patients had BLT, 11 males and 2 females. The average age of the patients was 32.5 years. The lesions were cauliflower-like and located on the vulva (n = 2), the penis, the perineum, the anorectal region in men (n = 11). Serology was positive for: HIV (n = 3), chlamydia (n = 4). The management was surgical by cauterization and excision. Cystoscopy and rectoscope were normal. The cure was obtained in all patients. Two patients had a recurrence at 5 months requiring a second successful cure. <strong>Conclusion:</strong> BLT is a frequent pathology in the urology department of the University Hospital of National Reference of N’Djamena in Chad. The surgical treatment by “cauterization exeresis” gives a better treatment.
文摘<strong>Introduction:</strong> Penile cancer is a rare primary malignancy that occurs in patients in their 60s and 70s. The aim of the study was to describe the anatomical aspects of penile cancer and to report the difficulties of its management. <strong>Materials and Methods:</strong> This was a retrospective descriptive study of patients with penile tumors from January 2007 to December 2019. Patients of sexual age with an ulcerated lesion of the penis, who came to our department and whose clinical and paraclinical workup led to the diagnosis of penile cancer, were included. The variables studied were clinical, paraclinical and therapeutic. <strong>Results:</strong> In 12 years, we diagnosed and managed 8 patients with penile cancer, an incidence of 0.7 per year. The reason for consultation was the chronic ulcerating wound of the penis with a “cauliflower” aspect. The first medical consultation was late (n = 8) after a long latency period lost to traditional healers. The lesion was located in the glans penis (n = 6) and/or in the corpus cavernosum (n = 2). Histological analysis of the cores concluded to a squamous cell carcinoma. Patients were classified as T2N+M+ (n = 3) and T2N0M0 (n = 5). One patient had accepted partial amputation of the penis. <strong>Conclusion:</strong> Penile cancer is a rare tumor. Partial amputation of the penis is the only alternative in our practice context, an alternative often refuted.
