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
Retroperitoneal liposarcoma is a rare malignant tumour with an incidence of 2.5 per million people annually. It is the most common type of all the retroperitoneal malignant tumours. Early diagnosis of the tumour is di...Retroperitoneal liposarcoma is a rare malignant tumour with an incidence of 2.5 per million people annually. It is the most common type of all the retroperitoneal malignant tumours. Early diagnosis of the tumour is difficult because of absence of specific clinical presentation. Symptoms would only occur if the tumour exhibits pressure on the surrounding organs. It usually occurs between the fourth to sixth decades of life affecting both genders equally. Histological subtypes include: well-differentiated, poorly differentiated, myxoid, round cell and pleomorphic. Radiological imaging useful in diagnosis include: ultrasonography, computed tomography and magnetic resonance imaging. Complete surgical resection of the tumour and the adjacent viscera involved or organs remained the mainstay of treatment. Radiotherapy plays a role in reducing the risk of recurrence but its effect on the overall survival of patients is not known. The case presented is a 48-year-old male patient with retroperitoneal liposarcoma, treated by complete surgical resection of the tumour and right hemicolectomy and currently on follow-up for possible recurrence.展开更多
Introduction: Diabetic ulcers are one of the main causes of morbidity and hospitalisation and thereby affecting the quality of life of persons suffering from the condition. The aim of the study was to assess the level...Introduction: Diabetic ulcers are one of the main causes of morbidity and hospitalisation and thereby affecting the quality of life of persons suffering from the condition. The aim of the study was to assess the level of satisfaction of persons who underwent treatment for diabetic ulcers using negative pressure produced from locally available materials. Materials and Methods: Creating negative pressure using locally available materials such as sterilized foam, tubes with diameter between 0.5 and 0.8 cm, transparent adhesive plaster and a suction machine. Results: Thirty-seven patients were enrolled in the current study;70.3% (n = 26) were known diabetic patients on regular treatment while 29.7% (n = 11) were diagnosed when they presented for the first time with ulcers. Patients were made to grade their level of satisfaction with therapy involving these locally used materials. Out of the 37 patients, 35 (94.6%) stated their therapy was excellent while 1 (2.7%) said the therapy was good;therapy was discontinued in one patient (2.7%) who had some complication. Conclusion: Desirable outcomes were obtained when patients were treated using negative pressure wound therapy (NPWT) produced using locally manufactured materials. Patients were able to pay for the therapy since the cost was reasonably low.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
Introduction: Tropical pyomyositis refers to bacterial infection that affects skeletal muscles causing single or multiple abscesses filled with pus. Aim: The study seeks to find out the effectiveness in the use of pri...Introduction: Tropical pyomyositis refers to bacterial infection that affects skeletal muscles causing single or multiple abscesses filled with pus. Aim: The study seeks to find out the effectiveness in the use of primary closure and vacuum drainage in the treatment of pyomyositis. Materials and Methods: The study was conducted between March 1, 2007 and February 28, 2014 at the Komfo Anokye Teaching Hospital, Kumasi, Ghana on patients with pyomyositis. Results: Seventy-seven patients comprising 58 (75.32%) males and 19 (24.68%) females were included in the study with their ages ranging from 15 to 68 years. There was improvement in patient’s healing outcome. Conclusion: Primary wound closure and vacuum drainage provides patients with much satisfaction and better outcome as well and it is also effective.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Retroperitoneal liposarcoma is a rare malignant tumour with an incidence of 2.5 per million people annually. It is the most common type of all the retroperitoneal malignant tumours. Early diagnosis of the tumour is difficult because of absence of specific clinical presentation. Symptoms would only occur if the tumour exhibits pressure on the surrounding organs. It usually occurs between the fourth to sixth decades of life affecting both genders equally. Histological subtypes include: well-differentiated, poorly differentiated, myxoid, round cell and pleomorphic. Radiological imaging useful in diagnosis include: ultrasonography, computed tomography and magnetic resonance imaging. Complete surgical resection of the tumour and the adjacent viscera involved or organs remained the mainstay of treatment. Radiotherapy plays a role in reducing the risk of recurrence but its effect on the overall survival of patients is not known. The case presented is a 48-year-old male patient with retroperitoneal liposarcoma, treated by complete surgical resection of the tumour and right hemicolectomy and currently on follow-up for possible recurrence.
文摘Introduction: Diabetic ulcers are one of the main causes of morbidity and hospitalisation and thereby affecting the quality of life of persons suffering from the condition. The aim of the study was to assess the level of satisfaction of persons who underwent treatment for diabetic ulcers using negative pressure produced from locally available materials. Materials and Methods: Creating negative pressure using locally available materials such as sterilized foam, tubes with diameter between 0.5 and 0.8 cm, transparent adhesive plaster and a suction machine. Results: Thirty-seven patients were enrolled in the current study;70.3% (n = 26) were known diabetic patients on regular treatment while 29.7% (n = 11) were diagnosed when they presented for the first time with ulcers. Patients were made to grade their level of satisfaction with therapy involving these locally used materials. Out of the 37 patients, 35 (94.6%) stated their therapy was excellent while 1 (2.7%) said the therapy was good;therapy was discontinued in one patient (2.7%) who had some complication. Conclusion: Desirable outcomes were obtained when patients were treated using negative pressure wound therapy (NPWT) produced using locally manufactured materials. Patients were able to pay for the therapy since the cost was reasonably low.
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Introduction: Tropical pyomyositis refers to bacterial infection that affects skeletal muscles causing single or multiple abscesses filled with pus. Aim: The study seeks to find out the effectiveness in the use of primary closure and vacuum drainage in the treatment of pyomyositis. Materials and Methods: The study was conducted between March 1, 2007 and February 28, 2014 at the Komfo Anokye Teaching Hospital, Kumasi, Ghana on patients with pyomyositis. Results: Seventy-seven patients comprising 58 (75.32%) males and 19 (24.68%) females were included in the study with their ages ranging from 15 to 68 years. There was improvement in patient’s healing outcome. Conclusion: Primary wound closure and vacuum drainage provides patients with much satisfaction and better outcome as well and it is also effective.
