Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they mig...Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy postoperatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bulbar urethral strictures. The repair methods employed were anastomotic urethroplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethroplasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Complications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the procedure should not be denied solely based on age.展开更多
We reported a case of a 30-year-old man who reportedly sustained electrical burns and fell from a high voltage electric pole about 50 meter high onto a metal that caused impalement injury. In addition, he sustained fu...We reported a case of a 30-year-old man who reportedly sustained electrical burns and fell from a high voltage electric pole about 50 meter high onto a metal that caused impalement injury. In addition, he sustained full-thickness burns of the right upper limb (7%), the right hemithorax, the perineum (sparing the penis), the anterior abdominal wall and the lateral aspect of both thighs. There was 43% burned surface area in total. Radiographic examination revealed a slender curved object extending from his perineum into the pelvis. The management of this case was a challenging one which was described in this article.展开更多
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: ...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.展开更多
文摘Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy postoperatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bulbar urethral strictures. The repair methods employed were anastomotic urethroplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethroplasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Complications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the procedure should not be denied solely based on age.
文摘We reported a case of a 30-year-old man who reportedly sustained electrical burns and fell from a high voltage electric pole about 50 meter high onto a metal that caused impalement injury. In addition, he sustained full-thickness burns of the right upper limb (7%), the right hemithorax, the perineum (sparing the penis), the anterior abdominal wall and the lateral aspect of both thighs. There was 43% burned surface area in total. Radiographic examination revealed a slender curved object extending from his perineum into the pelvis. The management of this case was a challenging one which was described in this article.
文摘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.
