Pub Date : 2023-11-25DOI: 10.1186/s12301-023-00392-0
Cephas A. Akpabio, Rachael P. Ebuh, Oluwaseun E. Fatunla, Henrietta O. Awobode, Chiaka I. Anumudu
Squamous cell carcinoma has been attributed to chronic schistosomiasis and is the predominant type of bladder cancer in schistosomiasis endemic areas. The aim of this study was to assess early promoter DNA methylation in selected genes implicated in schistosomiasis-associated bladder cancer (SABC). A total of 159 urine samples were collected from school-aged children in Eggua Community of Ogun State and examined by microscopy for Schistosoma haematobium eggs. From this sample, a subset of 34 (21.1%) urine samples positive for S. haematobium, age and sex-matched with negative urine control samples, and 16 formalin-fixed paraffin-embedded bladder cancer tissues obtained from the University College Hospital were subjected to DNA isolation and bisulphite DNA conversion. Quantitative methylation-specific PCR was used to determine the methylation status of APC, RARβ2, RASSF1A, and TIMP3 in the samples. High degrees of methylation of RARβ2(67.7%), RASSF1A (38.2%), and TIMP3(52.9%) was more common in urogenital schistosomiasis (UGS)-positive urine samples than negative urine (control) samples and in bladder cancer tissues. Promoter DNA methylation in the positive urine samples was 1.4-fold, 13.3-fold, 3.4-fold, and 3.8-fold higher in APC, RARβ2, RASSF1A, and TIMP3, respectively, than in the matched controls. The odds of promoter methylation were likely to increase with age group for APC (OR: 1.615) and TIMP3(OR: 2.000); sex for TIMP3(OR: 2.644); and haematuria for RARβ2(OR: 1.094), RASSF1A (OR: 1.143), and TIMP3(OR: 1.842), although there were no significant associations. Conclusions: Gene promoter DNA methylation in tumour suppressor genes was observed in schistosomiasis cases. Hence, promoter DNA methylation may occur during active schistosomiasis in children. This result may serve as an early non-invasive biomarker to detect and hint at the risk of developing SABC later in life.
{"title":"DNA methylation profiles in urothelial bladder cancer tissues and children with schistosomiasis from Eggua, Ogun State, Nigeria","authors":"Cephas A. Akpabio, Rachael P. Ebuh, Oluwaseun E. Fatunla, Henrietta O. Awobode, Chiaka I. Anumudu","doi":"10.1186/s12301-023-00392-0","DOIUrl":"https://doi.org/10.1186/s12301-023-00392-0","url":null,"abstract":"Squamous cell carcinoma has been attributed to chronic schistosomiasis and is the predominant type of bladder cancer in schistosomiasis endemic areas. The aim of this study was to assess early promoter DNA methylation in selected genes implicated in schistosomiasis-associated bladder cancer (SABC). A total of 159 urine samples were collected from school-aged children in Eggua Community of Ogun State and examined by microscopy for Schistosoma haematobium eggs. From this sample, a subset of 34 (21.1%) urine samples positive for S. haematobium, age and sex-matched with negative urine control samples, and 16 formalin-fixed paraffin-embedded bladder cancer tissues obtained from the University College Hospital were subjected to DNA isolation and bisulphite DNA conversion. Quantitative methylation-specific PCR was used to determine the methylation status of APC, RARβ2, RASSF1A, and TIMP3 in the samples. High degrees of methylation of RARβ2(67.7%), RASSF1A (38.2%), and TIMP3(52.9%) was more common in urogenital schistosomiasis (UGS)-positive urine samples than negative urine (control) samples and in bladder cancer tissues. Promoter DNA methylation in the positive urine samples was 1.4-fold, 13.3-fold, 3.4-fold, and 3.8-fold higher in APC, RARβ2, RASSF1A, and TIMP3, respectively, than in the matched controls. The odds of promoter methylation were likely to increase with age group for APC (OR: 1.615) and TIMP3(OR: 2.000); sex for TIMP3(OR: 2.644); and haematuria for RARβ2(OR: 1.094), RASSF1A (OR: 1.143), and TIMP3(OR: 1.842), although there were no significant associations. Conclusions: Gene promoter DNA methylation in tumour suppressor genes was observed in schistosomiasis cases. Hence, promoter DNA methylation may occur during active schistosomiasis in children. This result may serve as an early non-invasive biomarker to detect and hint at the risk of developing SABC later in life.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"179 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138496269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-25DOI: 10.1186/s12301-023-00398-8
Serhat Sekmek, Gökhan Ucar, Irfan Karahan, Dogan Bayram, Selin Aktürk Esen, Ismet Seven, Mehmet Ali Nahit Sendur, Dogan Uncu
Bladder cancer surgery is critical for treatment, and systemic treatment before or after cystectomy may be necessary. We aimed to investigate the efficacy and response to neoadjuvant and adjuvant treatments. Data on 93 patients with resectable muscle-invasive bladder cancer were analyzed retrospectively. Patients who received neoadjuvant and adjuvant chemotherapies were included. The neoadjuvant treatment group was divided into pathological responders and non-responders. Overall survival and disease-free survival were calculated. The median age was 61.5 years; there were 6 female and 87 male patients. Baseline characteristics were similar between the groups. While there was no difference in OS between the neoadjuvant and adjuvant treatment groups (20 months vs. not reached), DFS was significantly higher in the adjuvant group (20.6 vs. 25.3 months). While there was no significant difference in DFS between the responders and non-responders to neoadjuvant treatment (20.6 vs. 19.1 months), OS was significantly longer in the responders (Not reached vs. 12.3 months). Our results concluded that neoadjuvant and adjuvant chemotherapies have similar survival rates, but no response was associated with poor outcomes. Determining the group for patient selection may be helpful for optimal management.
膀胱癌手术是治疗的关键,膀胱切除术前后的全身治疗可能是必要的。我们的目的是探讨新辅助治疗和辅助治疗的疗效和反应。回顾性分析93例可切除的肌肉浸润性膀胱癌患者的资料。包括接受新辅助和辅助化疗的患者。新辅助治疗组分为病理应答组和无应答组。计算总生存期和无病生存期。中位年龄为61.5岁;女性6例,男性87例。两组的基线特征相似。虽然新辅助治疗组和辅助治疗组之间的OS没有差异(20个月vs.未达到),但辅助治疗组的DFS明显更高(20.6 vs. 25.3个月)。虽然对新辅助治疗有反应者和无反应者的DFS没有显著差异(20.6个月对19.1个月),但有反应者的OS明显更长(未达到vs. 12.3个月)。我们的研究结果表明,新辅助化疗和辅助化疗具有相似的生存率,但没有反应与不良预后相关。确定患者选择组可能有助于最佳管理。
{"title":"Comparison of responses to neoadjuvant and adjuvant chemotherapies in muscle-invasive bladder cancer","authors":"Serhat Sekmek, Gökhan Ucar, Irfan Karahan, Dogan Bayram, Selin Aktürk Esen, Ismet Seven, Mehmet Ali Nahit Sendur, Dogan Uncu","doi":"10.1186/s12301-023-00398-8","DOIUrl":"https://doi.org/10.1186/s12301-023-00398-8","url":null,"abstract":"Bladder cancer surgery is critical for treatment, and systemic treatment before or after cystectomy may be necessary. We aimed to investigate the efficacy and response to neoadjuvant and adjuvant treatments. Data on 93 patients with resectable muscle-invasive bladder cancer were analyzed retrospectively. Patients who received neoadjuvant and adjuvant chemotherapies were included. The neoadjuvant treatment group was divided into pathological responders and non-responders. Overall survival and disease-free survival were calculated. The median age was 61.5 years; there were 6 female and 87 male patients. Baseline characteristics were similar between the groups. While there was no difference in OS between the neoadjuvant and adjuvant treatment groups (20 months vs. not reached), DFS was significantly higher in the adjuvant group (20.6 vs. 25.3 months). While there was no significant difference in DFS between the responders and non-responders to neoadjuvant treatment (20.6 vs. 19.1 months), OS was significantly longer in the responders (Not reached vs. 12.3 months). Our results concluded that neoadjuvant and adjuvant chemotherapies have similar survival rates, but no response was associated with poor outcomes. Determining the group for patient selection may be helpful for optimal management.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"179 1‐2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138496270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-22DOI: 10.1186/s12301-023-00397-9
Basheer N. Elmohamady, Rabea Goma, Tarek Gharib, Mohamed K. Mostafa, Islam Nouh
The purpose of this study was to compare the surgical, functional, and oncological outcomes between open partial nephrectomy (OPN) and laparoscopic partial nephrectomy (LPN). This prospective, randomized study was performed on patients who underwent partial nephrectomy under general anesthesia. Patients were randomized using the closed envelope method to either LPN or OPN. Baseline demographics and surgical, functional, and oncological outcomes were compared. A per-protocol analysis was used. Randomized study was conducted on 166 patients. The LPN, in comparison to the OPN group, was associated with significantly shorter hospital stay (3 vs. 4 days), less blood transfusion (10% vs. 12%), longer operative time (134 min vs. 124 min), lower visual analog pain score (7 vs. 8), and lower estimated GFR (70.7 ± 17.5 vs. 72.3 ± 14.7). Oncological and functional results were comparable between LPN and OPN. However, LPN was superior to open surgery because of less hospital stay, visual analog pain score, and blood loss.
{"title":"Laparoscopic versus open partial nephrectomy: prospective randomized study for assessment of surgical, functional, and oncological outcomes","authors":"Basheer N. Elmohamady, Rabea Goma, Tarek Gharib, Mohamed K. Mostafa, Islam Nouh","doi":"10.1186/s12301-023-00397-9","DOIUrl":"https://doi.org/10.1186/s12301-023-00397-9","url":null,"abstract":"The purpose of this study was to compare the surgical, functional, and oncological outcomes between open partial nephrectomy (OPN) and laparoscopic partial nephrectomy (LPN). This prospective, randomized study was performed on patients who underwent partial nephrectomy under general anesthesia. Patients were randomized using the closed envelope method to either LPN or OPN. Baseline demographics and surgical, functional, and oncological outcomes were compared. A per-protocol analysis was used. Randomized study was conducted on 166 patients. The LPN, in comparison to the OPN group, was associated with significantly shorter hospital stay (3 vs. 4 days), less blood transfusion (10% vs. 12%), longer operative time (134 min vs. 124 min), lower visual analog pain score (7 vs. 8), and lower estimated GFR (70.7 ± 17.5 vs. 72.3 ± 14.7). Oncological and functional results were comparable between LPN and OPN. However, LPN was superior to open surgery because of less hospital stay, visual analog pain score, and blood loss.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"180 1‐2","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138496268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renal leiomyoma is an extremely rare benign tumour of the kidney. It is mostly asymptomatic. Our aim was to report the first case of symptomatic renal leiomyoma in Nigeria which was suspected to be renal cell carcinoma and our objective was to document the clinical, radiological, histological and treatment of this rare lesion. We describe a 46-year-old woman with a two-week history of right flank pain and intermittent haematuria. The examination was remarkable for the ballotable right kidney. Abdominopelvic sonogram and computed tomography were suggestive of cystic right renal mass with suspicion of right renal cell carcinoma. She had surgical resection of the mass and histopathological analysis showed renal leiomyoma. We have illustrated our experience on the first case of symptomatic renal leiomyoma masquerading as cystic renal cell carcinoma in Nigeria. A high index of suspicion is required for accurate diagnosis. This may go a long way in considering kidney-sparing surgery rather than radical nephrectomy.
{"title":"Huge Renal Leiomyoma Masqurading as Cystic Renal Cell Carcinoma: a case report","authors":"Najeem Adedamola Idowu, Ayoade Adebayo Adekunle, Mumini Wemimo Rasheed, Peter Olalekan Odeyemi","doi":"10.1186/s12301-023-00395-x","DOIUrl":"https://doi.org/10.1186/s12301-023-00395-x","url":null,"abstract":"Renal leiomyoma is an extremely rare benign tumour of the kidney. It is mostly asymptomatic. Our aim was to report the first case of symptomatic renal leiomyoma in Nigeria which was suspected to be renal cell carcinoma and our objective was to document the clinical, radiological, histological and treatment of this rare lesion. We describe a 46-year-old woman with a two-week history of right flank pain and intermittent haematuria. The examination was remarkable for the ballotable right kidney. Abdominopelvic sonogram and computed tomography were suggestive of cystic right renal mass with suspicion of right renal cell carcinoma. She had surgical resection of the mass and histopathological analysis showed renal leiomyoma. We have illustrated our experience on the first case of symptomatic renal leiomyoma masquerading as cystic renal cell carcinoma in Nigeria. A high index of suspicion is required for accurate diagnosis. This may go a long way in considering kidney-sparing surgery rather than radical nephrectomy.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"180 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138496267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-11DOI: 10.1186/s12301-023-00391-1
Zhino Noori Hussein, Rawa Bapir, Rawa M. Ali, Esmaeel Aghaways, Nali H. Hama, Rezheen J. Rashid, Wirya N. Sabr, Ari M. Abdullah, Zana Baqi Najmadden, Berun A. Abdalla, Fahmi Hussein Kakamad, Dashty Anwar Abdulkareem
Abstract Backgrounds Primary scrotal lipomas are benign fatty tumors that develop from adipocytes of the scrotum. The exact cause of their development is unknown. They are typically painless and may exhibit symptoms of heaviness and discomfort. Case presentation A 9-year-old boy presented with a painless scrotal mass that had been present since birth. The mass was located in the left hemiscrotum. Ultrasound showed an enlarged left testicle with an abnormal outline and heterogeneous texture. Magnetic resonance imaging demonstrated a mass arising from the left hemiscrotum with no invasion of the testis. Under general anesthesia and through a scrotal incision, the mass was excised. Histopathological examination revealed a lipoma. Conclusion Primary scrotal lipomas are benign lesions with an unclear pathogenesis. They are very uncommon in the pediatric age group. Ultrasound is the first-line modality for diagnosing lipomas; however, it may provide ambiguity. MRI provides a more accurate assessment of the mass. Surgical excision of the mass is the standard treatment for primary scrotal lipomas.
{"title":"Primary scrotal lipoma in a pediatric patient: a case report with current literature review","authors":"Zhino Noori Hussein, Rawa Bapir, Rawa M. Ali, Esmaeel Aghaways, Nali H. Hama, Rezheen J. Rashid, Wirya N. Sabr, Ari M. Abdullah, Zana Baqi Najmadden, Berun A. Abdalla, Fahmi Hussein Kakamad, Dashty Anwar Abdulkareem","doi":"10.1186/s12301-023-00391-1","DOIUrl":"https://doi.org/10.1186/s12301-023-00391-1","url":null,"abstract":"Abstract Backgrounds Primary scrotal lipomas are benign fatty tumors that develop from adipocytes of the scrotum. The exact cause of their development is unknown. They are typically painless and may exhibit symptoms of heaviness and discomfort. Case presentation A 9-year-old boy presented with a painless scrotal mass that had been present since birth. The mass was located in the left hemiscrotum. Ultrasound showed an enlarged left testicle with an abnormal outline and heterogeneous texture. Magnetic resonance imaging demonstrated a mass arising from the left hemiscrotum with no invasion of the testis. Under general anesthesia and through a scrotal incision, the mass was excised. Histopathological examination revealed a lipoma. Conclusion Primary scrotal lipomas are benign lesions with an unclear pathogenesis. They are very uncommon in the pediatric age group. Ultrasound is the first-line modality for diagnosing lipomas; however, it may provide ambiguity. MRI provides a more accurate assessment of the mass. Surgical excision of the mass is the standard treatment for primary scrotal lipomas.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"53 22","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135041598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-11DOI: 10.1186/s12301-023-00394-y
Imane H. S. Benyamina, Obadia V. Nyongole, Fransia A. Mushi, Daniel W. Kitua, Aubrey Otieno, Ally H. Mwanga
Abstract Background Urological complications are not uncommon among people living with HIV and are often the initial clinical manifestation of HIV and AIDS. These complications, when presenting with bothersome lower urinary tract symptoms (LUTS), can significantly impact the Quality of life (QoL) of affected individuals. We, therefore, conducted a study aiming at determining the prevalence of bothersome LUTS, identifying factors influencing the severity of these symptoms, and examining their influence on the QoL among people living with HIV on antiretroviral treatment (ART). Methods A cross-sectional study was conducted among randomly selected adult HIV-positive patients who attended the Care and Treatment Center at Muhimbili National Hospital, located in Dar es Salaam, Tanzania, from September 2021 to February 2022. Data was collected using a questionnaire that incorporated the American version of the International Prostate Symptom Score (IPSS). The IPSS was utilized to assess the severity of LUTS and their influence on the QoL. Descriptive statistics were used to summarize the results, and ordinal regression analysis was employed to assess the factors influencing the severity of LUTS. Results The prevalence of LUTS in the study population was 57.8%, with mild symptoms (mean IPSS 3.92 ± 1.92) being the most common manifestation. The mean age of the study participants who presented with LUTS was 47.89 ± 12.05 years, and the majority were females (55.6%). Factors that were significantly associated with increased severity of LUTS included male sex (OR 2.75; 95% CI 1.59–4.75; p < 0.001), age above 49 years (OR 3.02; 95% CI 1.49–6.16; p = 0.002), ART use for over 10 years (OR 3.03; 95% CI 0.9–6.10; p = 0.021), and HIV stage IV (OR 2.42; 95% CI 0.9–3.4; p = 0.047). The majority of the study participants reported an above-average QoL, with only 9.7% of them reporting unhappy-terrible experiences with urinary symptoms. However, a statistically significant (p < 0.001) inverse correlation between QoL and the severity of LUTS was observed. Conclusions In light of these findings, policymakers and healthcare providers should integrate routine assessment and management of LUTS into the care protocols tailored for these high-risk groups. This proactive approach holds the potential to enhance the QoL and overall welfare of people living with HIV.
背景泌尿系统并发症在HIV感染者中并不少见,往往是HIV和AIDS的初始临床表现。这些并发症,当出现麻烦的下尿路症状(LUTS)时,可以显著影响患者的生活质量(QoL)。因此,我们进行了一项研究,旨在确定令人烦恼的LUTS的患病率,确定影响这些症状严重程度的因素,并检查它们对接受抗逆转录病毒治疗(ART)的艾滋病毒感染者生活质量的影响。方法在2021年9月至2022年2月期间,随机选择在坦桑尼亚达累斯萨拉姆Muhimbili国立医院护理和治疗中心就诊的成年艾滋病毒阳性患者进行横断面研究。数据的收集采用了美国版的国际前列腺症状评分(IPSS)问卷。IPSS用于评估LUTS的严重程度及其对生活质量的影响。采用描述性统计对结果进行总结,并采用有序回归分析评估影响LUTS严重程度的因素。结果研究人群中LUTS患病率为57.8%,以轻度症状(平均IPSS 3.92±1.92)为最常见的表现。出现LUTS的研究参与者的平均年龄为47.89±12.05岁,大多数为女性(55.6%)。与LUTS严重程度增加显著相关的因素包括男性(OR 2.75;95% ci 1.59-4.75;p & lt;0.001),年龄大于49岁(OR 3.02;95% ci 1.49-6.16;p = 0.002),使用抗逆转录病毒治疗超过10年(OR 3.03;95% ci 0.9-6.10;p = 0.021)和HIV IV期(OR 2.42;95% ci 0.9-3.4;P = 0.047)。大多数研究参与者报告了高于平均水平的生活质量,只有9.7%的人报告了泌尿系统症状的不愉快经历。然而,统计学上显著(p <0.001),生活质量与LUTS严重程度呈负相关。根据这些发现,决策者和卫生保健提供者应将LUTS的常规评估和管理纳入为这些高危人群量身定制的护理方案中。这种积极主动的方法有可能提高艾滋病毒感染者的生活质量和整体福利。
{"title":"Investigating bothersome lower urinary tract symptoms among people living with HIV on antiretroviral therapy: prevalence, influencing factors, and quality-of-life implications","authors":"Imane H. S. Benyamina, Obadia V. Nyongole, Fransia A. Mushi, Daniel W. Kitua, Aubrey Otieno, Ally H. Mwanga","doi":"10.1186/s12301-023-00394-y","DOIUrl":"https://doi.org/10.1186/s12301-023-00394-y","url":null,"abstract":"Abstract Background Urological complications are not uncommon among people living with HIV and are often the initial clinical manifestation of HIV and AIDS. These complications, when presenting with bothersome lower urinary tract symptoms (LUTS), can significantly impact the Quality of life (QoL) of affected individuals. We, therefore, conducted a study aiming at determining the prevalence of bothersome LUTS, identifying factors influencing the severity of these symptoms, and examining their influence on the QoL among people living with HIV on antiretroviral treatment (ART). Methods A cross-sectional study was conducted among randomly selected adult HIV-positive patients who attended the Care and Treatment Center at Muhimbili National Hospital, located in Dar es Salaam, Tanzania, from September 2021 to February 2022. Data was collected using a questionnaire that incorporated the American version of the International Prostate Symptom Score (IPSS). The IPSS was utilized to assess the severity of LUTS and their influence on the QoL. Descriptive statistics were used to summarize the results, and ordinal regression analysis was employed to assess the factors influencing the severity of LUTS. Results The prevalence of LUTS in the study population was 57.8%, with mild symptoms (mean IPSS 3.92 ± 1.92) being the most common manifestation. The mean age of the study participants who presented with LUTS was 47.89 ± 12.05 years, and the majority were females (55.6%). Factors that were significantly associated with increased severity of LUTS included male sex (OR 2.75; 95% CI 1.59–4.75; p < 0.001), age above 49 years (OR 3.02; 95% CI 1.49–6.16; p = 0.002), ART use for over 10 years (OR 3.03; 95% CI 0.9–6.10; p = 0.021), and HIV stage IV (OR 2.42; 95% CI 0.9–3.4; p = 0.047). The majority of the study participants reported an above-average QoL, with only 9.7% of them reporting unhappy-terrible experiences with urinary symptoms. However, a statistically significant (p < 0.001) inverse correlation between QoL and the severity of LUTS was observed. Conclusions In light of these findings, policymakers and healthcare providers should integrate routine assessment and management of LUTS into the care protocols tailored for these high-risk groups. This proactive approach holds the potential to enhance the QoL and overall welfare of people living with HIV.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"22 17","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135041686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-08DOI: 10.1186/s12301-023-00396-w
S. Rajkiran Raju, Jobin Pathrose, Dyan D’Souza, Attibele Mahadevaiah Shubha
Abstract Background Duplex kidneys represent an embryologic maldevelopment at time of renogenesis resulting in a spectrum of bifurcation anomalies of the reno-ureteric system. Though most are antenatally detected, recurrent urinary tract infections (UTIs), abdominal mass due to obstruction and incontinence are other common manifestations. Upper moiety ureter is usually obstructed and the lower moiety is refluxing. Management is guided by the percentage function of each of the moieties. A non-functioning system warrants a heminephrectomy. We report a toddler with right flank mass and a provisional diagnosis of right duplex system following investigations but met with a cryptic cause at surgery thereby altering the management. Case presentation A 2 ½ years girl with progressively increasing right abdominal mass for 6 weeks was found to have 12 × 10 cm right non-tender flank mass. Ultrasonography, contrast tomography and nuclear scans showed a right duplex system with obstructed, poorly functioning lower moiety. A lower moiety heminephrectomy was planned but at surgery, a densely adherent cystic structure displacing the right kidney superiorly was noted. On decompressing, the ureter was found to enter the cyst with discontinuation for a length of 6cms before being traced distally to its entry into the bladder. Retrograde pyelogram confirmed mid-ureteral transection and cystic urinoma. The cyst was excised and the ureter reconstructed with an appendicular interposition graft. Child recovered uneventfully and at 8 months follow up is well with good drainage across the conduit. Conclusion The case highlights a rare presentation of mid-ureteral transection with urinoma masquerading as a duplex system and its satisfactory management.
{"title":"“Duplex sans duplex: a cryptic cause”: a case report","authors":"S. Rajkiran Raju, Jobin Pathrose, Dyan D’Souza, Attibele Mahadevaiah Shubha","doi":"10.1186/s12301-023-00396-w","DOIUrl":"https://doi.org/10.1186/s12301-023-00396-w","url":null,"abstract":"Abstract Background Duplex kidneys represent an embryologic maldevelopment at time of renogenesis resulting in a spectrum of bifurcation anomalies of the reno-ureteric system. Though most are antenatally detected, recurrent urinary tract infections (UTIs), abdominal mass due to obstruction and incontinence are other common manifestations. Upper moiety ureter is usually obstructed and the lower moiety is refluxing. Management is guided by the percentage function of each of the moieties. A non-functioning system warrants a heminephrectomy. We report a toddler with right flank mass and a provisional diagnosis of right duplex system following investigations but met with a cryptic cause at surgery thereby altering the management. Case presentation A 2 ½ years girl with progressively increasing right abdominal mass for 6 weeks was found to have 12 × 10 cm right non-tender flank mass. Ultrasonography, contrast tomography and nuclear scans showed a right duplex system with obstructed, poorly functioning lower moiety. A lower moiety heminephrectomy was planned but at surgery, a densely adherent cystic structure displacing the right kidney superiorly was noted. On decompressing, the ureter was found to enter the cyst with discontinuation for a length of 6cms before being traced distally to its entry into the bladder. Retrograde pyelogram confirmed mid-ureteral transection and cystic urinoma. The cyst was excised and the ureter reconstructed with an appendicular interposition graft. Child recovered uneventfully and at 8 months follow up is well with good drainage across the conduit. Conclusion The case highlights a rare presentation of mid-ureteral transection with urinoma masquerading as a duplex system and its satisfactory management.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"103 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135390044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-03DOI: 10.1186/s12301-023-00388-w
Richard Menzies-Wilson, Sophie Bashall, Rowland Rees, Sally Deverill
Abstract Background Atypical melanocytic naevus (AMN) of the urethral meatus is very rare with only a handful of reported cases. It is important to note that the rarity of AMN in the penis may contribute to a delay in diagnosis and treatment, as well as a lack of awareness among healthcare providers. This is the first case report to describe workup and management of AMN of the urethral meatus of a male, making it a valuable contribution to the literature. Case presentation A Caucasian male patient in his fourth decade presented with a several month history of a pigmented lesion on his glans penis. The differential diagnosis was of malignant melanoma but after biopsy and specialist pathological review, atypical melanocytic naevus was diagnosed. A punch biopsy, followed by two wide local excisions, was undertaken for complete excision and evaluation of the lesion. Conclusion Since AMN cannot be clinically distinguished from malignant melanoma, timely histological evaluation of the lesion is essential for workup. In this case, site and visibility of the lesion, expedient biopsy, and tissue analysis resulted in identification and excision of the naevus early enough for penis preserving surgery to be performed.
{"title":"Atypical compound melanocytic naevus of the urethral meatus case report","authors":"Richard Menzies-Wilson, Sophie Bashall, Rowland Rees, Sally Deverill","doi":"10.1186/s12301-023-00388-w","DOIUrl":"https://doi.org/10.1186/s12301-023-00388-w","url":null,"abstract":"Abstract Background Atypical melanocytic naevus (AMN) of the urethral meatus is very rare with only a handful of reported cases. It is important to note that the rarity of AMN in the penis may contribute to a delay in diagnosis and treatment, as well as a lack of awareness among healthcare providers. This is the first case report to describe workup and management of AMN of the urethral meatus of a male, making it a valuable contribution to the literature. Case presentation A Caucasian male patient in his fourth decade presented with a several month history of a pigmented lesion on his glans penis. The differential diagnosis was of malignant melanoma but after biopsy and specialist pathological review, atypical melanocytic naevus was diagnosed. A punch biopsy, followed by two wide local excisions, was undertaken for complete excision and evaluation of the lesion. Conclusion Since AMN cannot be clinically distinguished from malignant melanoma, timely histological evaluation of the lesion is essential for workup. In this case, site and visibility of the lesion, expedient biopsy, and tissue analysis resulted in identification and excision of the naevus early enough for penis preserving surgery to be performed.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135868443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.1186/s12301-023-00389-9
Farooq Hameed, Adeel Anwaar
Abstract Background Posterior urethral valve (PUV) is a congenital disorder typically presenting in the neonatal period and is associated with the obstruction of the urinary tract. Cobb’s collar is congenital narrowing of bulbar urethra in infants. It can lead to significant morbidity, which may include irreversible renal failure if left untreated. Case presentation A 21-month-old child presented with acute retention of urine and distended lower abdomen. His baseline tests were normal. Ultrasound KUB showed grossly enlarged bladder with almost 1100-ml residual urine. Foley’s catheterization attempted but failed. Urgent cystoscopy was planned where congenital anterior urethral stricture with posterior urethral valves was seen. DVIU done for urethral stricture followed by fulguration of posterior urethral valves. The patient was discharged from hospital the next day. Conclusion A congenital narrowing of the bulbar urethra is uncommon. Though it is rare, it can occur concomitantly with PUV. If this double pathology is missed can result in serious consequences. Children with recurrent urinary tract infections should be ruled out for anterior urethral strictures.
{"title":"A case report of Cobb’s collar with posterior urethral valves: a rare entity","authors":"Farooq Hameed, Adeel Anwaar","doi":"10.1186/s12301-023-00389-9","DOIUrl":"https://doi.org/10.1186/s12301-023-00389-9","url":null,"abstract":"Abstract Background Posterior urethral valve (PUV) is a congenital disorder typically presenting in the neonatal period and is associated with the obstruction of the urinary tract. Cobb’s collar is congenital narrowing of bulbar urethra in infants. It can lead to significant morbidity, which may include irreversible renal failure if left untreated. Case presentation A 21-month-old child presented with acute retention of urine and distended lower abdomen. His baseline tests were normal. Ultrasound KUB showed grossly enlarged bladder with almost 1100-ml residual urine. Foley’s catheterization attempted but failed. Urgent cystoscopy was planned where congenital anterior urethral stricture with posterior urethral valves was seen. DVIU done for urethral stricture followed by fulguration of posterior urethral valves. The patient was discharged from hospital the next day. Conclusion A congenital narrowing of the bulbar urethra is uncommon. Though it is rare, it can occur concomitantly with PUV. If this double pathology is missed can result in serious consequences. Children with recurrent urinary tract infections should be ruled out for anterior urethral strictures.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.1186/s12301-023-00390-2
Moncef Al Barajraji, Serge Holz, Ilan Moussa, Michel Naudin, Pamart Didier
Abstract Background During robotic-assisted radical prostatectomy (RARP) for prostate cancer (PCa), few attention is given to pre-prostatic fat tissue (PPT) even during pelvic lymph node dissection (PLND). However, the rare potential involvement of PPT lymph nodes (LN) by PCa metastasis has already been reported by several authors and may influence therapeutic strategy in intermediate and high-risk patients. We present the case of a 69-year-old man who underwent RARP with extended PLND (ePLND) for aggressive PCa with massive pre-prostatic nodal metastasis, sampled during prostate biopsies. We sought to report this case for the particular preoperative images and reinforce benefits of resecting PPT during PLND for PCa.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Moncef] Last name [Al Barajraji].Ok Case presentation A 69-year-old man consulted our department for high serum prostate specific antigen level (57 ng/mL). He had familial history of PCa only at first degree. On digital rectal evaluation, induration of left prostatic lobe was felt. Transrectal ultrasonography showed hypoechogenic lesion in left prostatic lobe with supra-centimetric nodule in PPT. Pelvic magnetic resonance revealed two lesions in the peripheral zone with a 19-mm nodule on right paramedian side of PPT (see Fig. 1). Transrectal ultrasound-guided prostate biopsies were performed, including the nodule. On left side, 2 biopsies out 6 showed Gleason 10 prostate cancer. On right side, all biopsies showed Gleason 9 prostate cancer. The PPT nodule showed Gleason 9 prostate cancer. Prostate specific membrane antigen (PSMA) positron emission tomography computed tomography scan showed hypermetabolic expression from left prostate lesions and PPT nodule. Transperitoneal RARP with ePLND was performed including PPT. Histopathological study revealed advanced prostate cancer with lymphovascular invasion and ECE (see Fig. 2). Evaluation of ePLND material showed metastasis in on pelvic LN and 23 mm nodal metastasis in PPT (see Fig. 2). Therefore, adjuvant therapy was initiated. Please check the edit made in the article title.OPk Conclusions PPT resection is not part of routine RARP with ePLND for PCa. However, this tissue might contain LN harbouring metastasis independently from pelvic LN, indicating adjuvant therapy in case of upstaging. Considering the low morbidity of resecting PPT and its facility, it should always been resected and sent for analysis in intermediate and high-risk PCa.
{"title":"Massive pre-prostatic nodal metastasis from localized aggressive prostate cancer removed during robotic-assisted radical prostatectomy with extended pelvic lymph node dissection: a case report with brief literature review","authors":"Moncef Al Barajraji, Serge Holz, Ilan Moussa, Michel Naudin, Pamart Didier","doi":"10.1186/s12301-023-00390-2","DOIUrl":"https://doi.org/10.1186/s12301-023-00390-2","url":null,"abstract":"Abstract Background During robotic-assisted radical prostatectomy (RARP) for prostate cancer (PCa), few attention is given to pre-prostatic fat tissue (PPT) even during pelvic lymph node dissection (PLND). However, the rare potential involvement of PPT lymph nodes (LN) by PCa metastasis has already been reported by several authors and may influence therapeutic strategy in intermediate and high-risk patients. We present the case of a 69-year-old man who underwent RARP with extended PLND (ePLND) for aggressive PCa with massive pre-prostatic nodal metastasis, sampled during prostate biopsies. We sought to report this case for the particular preoperative images and reinforce benefits of resecting PPT during PLND for PCa.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Moncef] Last name [Al Barajraji].Ok Case presentation A 69-year-old man consulted our department for high serum prostate specific antigen level (57 ng/mL). He had familial history of PCa only at first degree. On digital rectal evaluation, induration of left prostatic lobe was felt. Transrectal ultrasonography showed hypoechogenic lesion in left prostatic lobe with supra-centimetric nodule in PPT. Pelvic magnetic resonance revealed two lesions in the peripheral zone with a 19-mm nodule on right paramedian side of PPT (see Fig. 1). Transrectal ultrasound-guided prostate biopsies were performed, including the nodule. On left side, 2 biopsies out 6 showed Gleason 10 prostate cancer. On right side, all biopsies showed Gleason 9 prostate cancer. The PPT nodule showed Gleason 9 prostate cancer. Prostate specific membrane antigen (PSMA) positron emission tomography computed tomography scan showed hypermetabolic expression from left prostate lesions and PPT nodule. Transperitoneal RARP with ePLND was performed including PPT. Histopathological study revealed advanced prostate cancer with lymphovascular invasion and ECE (see Fig. 2). Evaluation of ePLND material showed metastasis in on pelvic LN and 23 mm nodal metastasis in PPT (see Fig. 2). Therefore, adjuvant therapy was initiated. Please check the edit made in the article title.OPk Conclusions PPT resection is not part of routine RARP with ePLND for PCa. However, this tissue might contain LN harbouring metastasis independently from pelvic LN, indicating adjuvant therapy in case of upstaging. Considering the low morbidity of resecting PPT and its facility, it should always been resected and sent for analysis in intermediate and high-risk PCa.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136104406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}