Background: Open prostatectomy (OP) is still relatively common in developing countries and remains a useful benchmark against which the minimal access surgical techniques are compared. This study aims to document the ...Background: Open prostatectomy (OP) is still relatively common in developing countries and remains a useful benchmark against which the minimal access surgical techniques are compared. This study aims to document the indications and outcomes of OP in a typical developing economy. Method: The records of patients with benign prostate hyperplasia (BPH) who had OP in our university teaching hospital between July 2004 and June 2014 were retrospectively reviewed. Some analyzed parameters include the demographic characteristics, indications, pre-operative work-up, anaesthetic techniques, OP type, complications, histopathology results and follow-up duration. Results: A total of 247 cases were studied. Mean age was 67 years while the commonest surgery indication was recurrent acute urinary retention. Average prostate specific antigen (PSA) was 8.4 ng/ml while hypertension was the most common comorbidity (44.1%). Regional anaesthesia was mainly used (79.4%) while retropubic prostatectomy was the commonest OP type done (58.7%). The enucleated specimen weighed above 60 g in 91.9% of cases. All our patients were able to micturate spontaneously with urine stream above 20 mls/second on follow-up one week after discharge. Mean duration of hospital admission and follow-up were 7 days and 9 months respectively. Complications occurred in 90 patients (36.4%), of which surgical site infections were the commonest (9.8%). There was 0.4% mortality. Histopathology results showed BPH (95.5%), (incidental) prostate adenocarcinoma (2.4%) or prostatic intra-epithelial neoplasia (2.1%). Conclusion: OP remains an important therapeutic option for management of BPH in developing countries partly due to relatively large prostate size and presence of BPH complications from late presentationin many patients. The surgery is efficient and has relatively low morbidity and minimal mortality.展开更多
Background: Macular holes are the common cause of visual impairment especially in the elderly and have a variety of etiological factors. The advances in the management of macular holes are encouraging and are now avai...Background: Macular holes are the common cause of visual impairment especially in the elderly and have a variety of etiological factors. The advances in the management of macular holes are encouraging and are now available in developing countries although scarce, where hitherto;patients seek attention outside their country. The need to understand this disease has therefore become pertinent in all retina clinics. Objective: To evaluate the pattern of presentation of macular holes and its management in a retina clinic in South South Nigeria. Methods: A 5 year retrospective, non comparative review of 24 consecutive cases presenting to a retinal clinic was carried out. Relevant information was extracted from the medical records and analyzed. Results: Three hundred and sixty four cases were seen between January 2009 and December 2013. Twenty four cases had macular holes and ten (41.7%) had bilateral presentation with a total of 34 eyes. The incidence of macular holes was 6.6%. The mean age was 46 years (SD ± 13.42) with a female preponderance, 5:1. Idiopathic holes formed the bulk of the cases 14(58.3%);others were trauma 4(16.7%), posterior uveitis 2, (8.3%), chemotherapy 2 (8.3%), Solar retinopathy and retinitis pigmentosa 1 (4.2%). Nineteen (55.9%) of the 34 eyes were visually impaired (BCVA <6/18). Nineteen eyes had full thickness holes (55.9%) requiring surgery, however only 3(12.5%) of these could afford to have surgery with one reoperation. Four patients (16.7%) had complications in form of retinal detachments at presentation. Conclusion: This study has shown that the incidence of macular holes in the developing world is significant and resources to manage these cases are grossly lacking. Specialist training, with government subsidizing costs will alleviate these difficulties and reduce visual loss from macular holes.展开更多
文摘Background: Open prostatectomy (OP) is still relatively common in developing countries and remains a useful benchmark against which the minimal access surgical techniques are compared. This study aims to document the indications and outcomes of OP in a typical developing economy. Method: The records of patients with benign prostate hyperplasia (BPH) who had OP in our university teaching hospital between July 2004 and June 2014 were retrospectively reviewed. Some analyzed parameters include the demographic characteristics, indications, pre-operative work-up, anaesthetic techniques, OP type, complications, histopathology results and follow-up duration. Results: A total of 247 cases were studied. Mean age was 67 years while the commonest surgery indication was recurrent acute urinary retention. Average prostate specific antigen (PSA) was 8.4 ng/ml while hypertension was the most common comorbidity (44.1%). Regional anaesthesia was mainly used (79.4%) while retropubic prostatectomy was the commonest OP type done (58.7%). The enucleated specimen weighed above 60 g in 91.9% of cases. All our patients were able to micturate spontaneously with urine stream above 20 mls/second on follow-up one week after discharge. Mean duration of hospital admission and follow-up were 7 days and 9 months respectively. Complications occurred in 90 patients (36.4%), of which surgical site infections were the commonest (9.8%). There was 0.4% mortality. Histopathology results showed BPH (95.5%), (incidental) prostate adenocarcinoma (2.4%) or prostatic intra-epithelial neoplasia (2.1%). Conclusion: OP remains an important therapeutic option for management of BPH in developing countries partly due to relatively large prostate size and presence of BPH complications from late presentationin many patients. The surgery is efficient and has relatively low morbidity and minimal mortality.
文摘Background: Macular holes are the common cause of visual impairment especially in the elderly and have a variety of etiological factors. The advances in the management of macular holes are encouraging and are now available in developing countries although scarce, where hitherto;patients seek attention outside their country. The need to understand this disease has therefore become pertinent in all retina clinics. Objective: To evaluate the pattern of presentation of macular holes and its management in a retina clinic in South South Nigeria. Methods: A 5 year retrospective, non comparative review of 24 consecutive cases presenting to a retinal clinic was carried out. Relevant information was extracted from the medical records and analyzed. Results: Three hundred and sixty four cases were seen between January 2009 and December 2013. Twenty four cases had macular holes and ten (41.7%) had bilateral presentation with a total of 34 eyes. The incidence of macular holes was 6.6%. The mean age was 46 years (SD ± 13.42) with a female preponderance, 5:1. Idiopathic holes formed the bulk of the cases 14(58.3%);others were trauma 4(16.7%), posterior uveitis 2, (8.3%), chemotherapy 2 (8.3%), Solar retinopathy and retinitis pigmentosa 1 (4.2%). Nineteen (55.9%) of the 34 eyes were visually impaired (BCVA <6/18). Nineteen eyes had full thickness holes (55.9%) requiring surgery, however only 3(12.5%) of these could afford to have surgery with one reoperation. Four patients (16.7%) had complications in form of retinal detachments at presentation. Conclusion: This study has shown that the incidence of macular holes in the developing world is significant and resources to manage these cases are grossly lacking. Specialist training, with government subsidizing costs will alleviate these difficulties and reduce visual loss from macular holes.
