African Urology (AU) is a peer reviewed, open access and multilingual journal publishing original research articles in all aspects of the prevention, diagnosis and management of urological disorders.
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As we start a new year, I wish to share some key highlights of your Association’s activities during 2025.
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The epidemiological transition of prostate cancer in Morocco: a critical analysis of the mortality-incidence gap (2018–2025)
Prostate cancer (PCa) has emerged as the leading malignancy among Moroccan men. This brief communication analyses recent data (2018–2025) to outline the epidemiological transition of PCa in Morocco, characterised by a 77% surge in incidence over a 30-year trajectory. Despite improved diagnostic capabilities, the mortality-to-incidence ratio (MIR) (0.49) remains significantly higher than in high-Human Development Index (HDI) countries (< 0.20). This analysis highlights the urgent need for structured early-detection strategies to address the crisis of late-stage diagnosis in the North African context.
Prevalence and factors associated with erectile dysfunction among men attending Mulago Hospital’s urology clinic: a cross-sectional study
Background: Erectile dysfunction (ED) is a significant public health concern, affecting men’s quality of life and relationships. Despite its global burden, epidemiological data on ED in Uganda, particularly among men seeking care at specialised clinics, remain limited. This study aimed to determine ED prevalence and associated factors among men attending the urology clinic at Mulago National Referral Hospital (Mulago Hospital). Methods: A cross-sectional study was conducted over three months at the urology clinic, enrolling 384 men aged 35–60 years. Data on socio-demographic characteristics, clinical history, and lifestyle factors were collected using a structured questionnaire. The Sexual Health Inventory for Men (SHIM) was used to assess ED severity. Logistic regression analysis was performed to identify factors associated with ED. Results: The prevalence of ED was 65.3% (95% confidence interval [CI] 60.3 to 69.9). Multivariate analysis showed significant associations between ED and age (adjusted odds ratio (AOR) 1.023, 95% CI 1.000 to 1.054; p = 0.05), chronic alcohol use (AOR 2.690, 95% CI 1.565 to 4.625; p = 0.00), urethral stricture (AOR 3.874, 95% CI 1.44 to 10.392; p = 0.01), and lower urinary tract symptoms (LUTS) (AOR 2.094, 95% CI 1.250 to 3.505; p = 0.01). Conclusion: ED is highly prevalent among men attending Mulago Hospital’s urology clinic. These findings highlight the need for routine ED screening, early intervention, and public health strategies to address modifiable risk factors.
Outcomes of hypospadias repair in a university hospital in Dakar, Senegal
Background: Hypospadias is a congenital abnormality due to hypoplasia of the ventral penile tissues. Hypospadias surgery has benefited from a better understanding of penile anatomy and improved instrumentation. In sub-Saharan Africa, particularly in Senegal, hypospadias surgery remains a challenge due to limited equipment. Our study aimed to evaluate the results of hypospadias surgery at a referral centre in a resource-limited country. Patients and methods: This was a retrospective descriptive study of 126 patients treated at our centre over six years. The most used surgical techniques were Duplay, Snodgrass, Mathieu, and Duckett. Results: The postoperative complication rate was 39.7%. Urethrocutaneous fistula was the most common complication (24%). Other complications included suture release (8.7%), meat stenosis (4%), residual curvature with an unsatisfactory aesthetic appearance (3%). After a follow-up of 3–24 months, outcomes were good in 54% of cases, intermediate in 9.5%, and failed in 36.5%. Results for anterior forms were better compared with those for midshaft and posterior forms (p = 0.002). The good results were predominant in patients aged 0–6 years. There was no statistical difference in urine drainage type. Conclusion: Hypospadias surgery is challenging in developing countries, with high rates of complications. To improve results, it is necessary to improve equipment and postoperative care.
Management of urinary tract stones in Ghana: a national review and practice audit
Background: Urinary stone disease (USD), defined as the formation of hard mineral and salt deposits (stones) within the urinary tract, remains a growing concern in Ghana, reflecting both traditional risk factors and emerging lifestyle changes. In response, the Ghana Association of Urological Surgeons (GAUS) conducted a national review of practice patterns to assess the progress in adopting modern treatment modalities and identify persistent challenges. Methods: A retrospective survey was carried out across urological centres in Ghana from January to December 2023. Data were collected using a standardised template that captured patient demographics, stone location, and treatment modalities. The findings were analysed and compared with global trends, particularly regarding economic and infrastructural contexts. Results: A total of 268 cases were reported from five of the six teaching hospitals and four private hospitals in the country (66.4% male, mean age 46.3 years). Upper urinary tract stones (kidney, ureter, renal pelvis) accounted for 232 cases, 99.6% of which were treated using endoscopic or non-invasive methods. These included ureteroscopy (URS) with laser fragmentation (91 cases), percutaneous nephrolithotomy (PCNL, 61 cases), extracorporeal shock wave lithotripsy (ESWL, 30 cases), double J (DJ) stenting (seven cases), and medical expulsive therapy (MET, 42 cases). Only one open pyelolithotomy was recorded. Conversely, 77.8% of lower urinary tract stones (32 bladder, four urethral) were managed by open surgery, reflecting the frequent need to simultaneously address underlying pathologies, such as benign prostatic hyperplasia (BPH) or strictures. Discussion: Ghana’s endourological capability for upper urinary tract stone management has reached global standards, with the absence of open ureteric procedures highlighting effective skill distribution and inter-facility referrals. However, lower tract stone management remains surgically invasive due to anatomical, logistical, and economic realities. Key systemic challenges include equipment maintenance costs, reliance on external vendors, and limitations in biomedical engineering support. Conclusion: Ghana has achieved significant milestones in modern urological care for USD, especially in the upper urinary tract. Addressing the remaining gaps, particularly in equipment sustainability and minimally invasive access for lower tract stones, requires a coordinated policy and investment framework.
Assessment of knowledge among healthcare workers and resource availability for diagnosing Wilms tumour in northern Tanzania
Background: Survival rates of Wilms tumour patients in northern Tanzania are low (32.6%), largely due to late-stage diagnoses compounded by a lack of knowledge about Wilms tumour among healthcare workers. This study aimed to assess healthcare workers’ knowledge and resource availability for diagnosing Wilms tumour. Methods: This study employed a cross-sectional, quantitative design, encompassing healthcare facilities in northern Tanzania. The study population was doctors, nurses, and radiographers directly involved in paediatric care. The sample size was 121, chosen through purposive sampling to ensure data saturation. Structured questionnaires covered demographics, knowledge assessment, and resource availability. Data analysis was conducted using IBM SPSS Statistics version 25. Results: Healthcare workers exhibited varying knowledge levels about Wilms tumour. Doctors had a good grasp of the tumour’s characteristics and treatment options, but had gaps in their understanding of prognosis. Nurses displayed reasonable knowledge, but needed improvement in understanding prognosis and some treatment options. Radiographers had limited knowledge, particularly regarding treatment options. Ultrasound, a critical diagnostic tool, was consistently available at all healthcare facilities. Conclusion: Overall, the healthcare workers had good knowledge, and resources such as ultrasound were available, which is an initial tool for early Wilms tumour diagnosis. We recommend strengthening ultrasound use through targeted training and protocols to improve early diagnosis of Wilms tumour. Furthermore, Wilms tumour-focused modules should be incorporated into continuing medical education, with expanded access to advanced imaging, such as computed tomography (CT)/magnetic resonance imaging (MRI).
Percutaneous nephrolithotomy training during COVID-19: Progress made with Telemedicine at the university clinic of Urology and Andrology of CNHU-HKM
Background: Percutaneous nephrolithotomy is one of the recommended techniques for treating kidney stones. Teleassistance was introduced at the University Clinic of Urology and Andrology of CNHU-HKM following the emergence of COVID-19. It has enabled the continuation of skills transfer to Beninese urologists despite international travel restrictions. This study evaluates its outcomes. Patients and Methods: A descriptive cross-sectional study of 14 PCNL procedures performed with telementoring over an 8-month period (August 2020 to March 2021) at CNHU-HKM. Variables studied included CT scan characteristics of stones, mentors’ contribution to the mentee, and procedure outcomes. Results: The mean patient age was 50.82 years (range: 25–69 years). Mentors were located at a minimum distance of 7,000 km (Eastbourne, United Kingdom) and a maximum distance of 11,822 km (Guangzhou, China) from Cotonou. The mean stone size was 20 mm (range: 12–46 mm). Seven patients had stones located in multiple calyces simultaneously. Mentor assistance was requested for renal puncture and dilation in 3 and 4 cases respectively, while their help proved particularly useful for nephroscopy and stone fragmentation in 5 cases for each of these steps. Eight patients achieved stone-free status, while in 6 others, the procedure was either incomplete or unsuccessful. Conclusion: PCNL remains the reference surgery for large staghorn renal stones and constitutes a demanding procedure. Teleassistance can facilitate training of urologists in developing countries in this technique, particularly during periods of health restrictions.
Quality of life after retropubic radical prostatectomy in Conakry: Functional and psychosocial impact
Introduction: Radical prostatectomy remains the standard treatment for localised prostate cancer. However, it carries the risk of functional complications, mainly urinary incontinence and erectile dysfunction. This pioneering prospective study aimed to evaluate the functional and psychosocial impact one year after radical prostatectomy in the newly established context of urologic oncologic surgery in Conakry. Methods: This was a prospective, descriptive study conducted in two centres from 25 October 2021 to 24 October 2024. It included 22 patients with non-metastatic prostate cancer who underwent radical prostatectomy with a 12-month postoperative follow-up. Urinary and sexual functions were assessed using validated questionnaires: ICS (incontinence), IIEF-5 (erectile function), EQS (erection quality), and TSS (sexual satisfaction). Data are presented as mean (±) and frequency (%). Results: The mean age of patients was 65.5 ± 4.2 years. Before surgery, all patients were continent (ICS score = 0) and 86.36% had no erectile dysfunction. At 12 months, persistent incontinence was observed in 36.36% of patients, whereas 31.82% had severe erectile dysfunction. Half of the patients (50.0%) reported overall sexual dissatisfaction. The psychosocial impact was notable: 31.82% avoided places of worship and 59.09% avoided family gatherings due to functional sequelae. Conclusion: This preliminary study shows that despite progressive improvement in continence, urinary and sexual sequelae of radical prostatectomy persist at one year and significantly impair quality of life. Multidisciplinary care adapted to the sociocultural context is necessary.
Male infertility: epidemiological and etiological profile at Aristide Le Dantec Hospital, Senegal
Objective: The aim of this study is to determine the epidemiological and etiological profiles of male infertility in the hospital setting at the Aristide Le Dantec University Hospital in Dakar. Patients and methods: This is a retrospective, descriptive study of patients seen in consultation at the HALD urology department for couple infertility over a period of four years. The parameters studied were sociodemographic data, lifestyle, clinical data, echography and blood test results. Results: Three hundred and fifty-seven (357) patients were included in our study, with a prevalence of 3.5%. The average age of the patients was 38, with extremes of 22 and 70. The 30–39 age group was the most represented (52.4%). Infertility was primary in 81% of cases. Monogamous patients accounted for 87.7% of the patients. The average duration of infertility was 6.1 years. Thermal and chemical exposure was reported in 24 and 12 patients, respectively. Smoking was noted in 12% of cases. Varicocele was the most common abnormality (65.5%) on clinical examination. Sperm analysis was abnormal in 73.1% of cases, with oligoasthenozoospermia being the most common abnormality (31.93%), followed by azoospermia (21.6%). Causes and/or risk factors for male infertility were found in 230 patients (70.3%), with a predominance of varicocele followed by urogenital infections. Conclusion: The causes of male infertility are multiple and sometimes plural in the same individual, justifying a methodical clinical and paraclinical investigation to identify them and choose a therapeutic option where possible. Further investigation is necessary in view of the increase in the rate of idiopathic infertility.
Evolving chemical composition of kidney stones in Jamaica: a biochemical analysis from 2019 to 2021 compared with historical data
Purpose: This study aimed to investigate possible shifts in influencing factors causing kidney stones in Jamaica by comparing the chemical composition of kidney stones over different time periods. Materials and methods: The study had 59 participants. There were no initial exclusion criteria, and all patients scheduled for kidney stone surgery during the study period were considered. Demographic, medical condition, and lifestyle data were collected from participants, along with kidney stone samples. Biochemical testing was done according to Wootton’s method (1974). Seven biochemical compounds were tested: calcium (Ca), phosphate (PO4), oxalate (Ox), uric acid (UA), bicarbonate (HCO3), magnesium (Mg), and cystine (Cyst). Results were compared with previous studies from Jamaica. Results: Calcium and phosphate were the most abundant compounds identified in the stone samples, with cystine identified the least. Oxalate and UA were identified in 66.1% and 52.5% of stone samples, respectively. In this study, mixed CaPO4 was identified in 71.2% of stones, followed by mixed CaOx (66.1%) and mixed CaOxPO4 (57.6%). The 71.2% of mixed CaPO4 stones identified in this study was significantly higher than those identified by Choo-Kang (36.5%) and Tapper et al. (42.4%), who both examined kidney stone composition in Kingston, Jamaica. Conclusion: Compared with earlier studies, the increased prevalence of mixed cation-anion stones in Kingston, Jamaica, suggests evolving aetiological factors influencing stone formation, potentially driven by changes in diet, lifestyle, or environmental factors.
Epidemiological profile of bladder outlet obstruction among adult males at a tertiary hospital in northern Tanzania
Purpose: Bladder outlet obstruction (BOO) in men frequently causes emergency visits and negatively affects their quality of life (QoL). Its prevalence increases with longer life expectancy, yet limited research exists on its frequency and aetiological patterns in our local context, highlighting a knowledge gap. Materials and methods: A three-year retrospective, hospital-based, cross-sectional study was conducted among 1 879 adult male patients who attended the urology clinic at Kilimanjaro Christian Medical Centre (KCMC) between January 2021 and December 2023. The extracted files were assessed to confirm the BOO diagnosis using clinical history, physical examination, and imaging investigations. Aetiological BOO patterns were recorded. All data were cleaned and analysed using IBM SPSS Statistics version 25. Ethical clearance was obtained from the College Research Ethics and Review Committee of the Kilimanjaro Christian Medical University College. Results: Overall, 3 464 files were extracted and reviewed between January 2021 and December 2023, of which 1 879 males (54%) had urinary BOO. Patients had a median age of 72 years (interquartile range [IQR] 64–80), and most (73.5%) presented with lower urinary tract symptoms (LUTS). The most common BOO aetiology was benign prostatic hyperplasia (BPH) (57%), followed by urethral stricture disease (USD) (20%). USD was the most common aetiology among adult males aged < 60 years. Conclusion: More than half of adult males attending our urology clinic may be experiencing BOO. The most common BOO aetiology in this population is BPH in men aged ≥ 60 years, and USD in adult men aged < 60 years. Adult men aged < 60 years should be screened for USD.
Open radical prostatectomy in a context of limited resources: complications and barriers to optimal management - analysis of 35 cases in Southern Benin
Introduction: Prostate cancer represents the most common urological malignancy in sub-Saharan Africa. Radical prostatectomy constitutes the gold standard treatment for localised disease; however, African data on its complications remain limited. This study aims to analyse the perioperative and functional complications of open radical prostatectomy in two Beninese university hospital centres and to compare our results with international standards. Patients and Methods: A retrospective cohort study including all patients who underwent retropubic radical prostatectomy for localised prostate cancer between January 2018 and June 2022 (allowing a minimum follow-up of 6 months until December 2022) at CNHU-HKM in Cotonou and CHUDOP in Porto-Novo. Exclusion criteria comprised incomplete clinical documentation and postoperative follow-up of less than 6 months. Preoperative data (PSA, Gleason score, D’Amico classification), intraoperative and postoperative parameters were collected. Complications were classified according to the Clavien-Dindo classification. Statistical analysis was performed using Epi Info software version 7.2.5.0. Results: Thirty-five patients were included (mean age: 65 ± 7.3 years). The majority presented with low-risk cancer according to D’Amico criteria (74.3%), with a Gleason score of 6 (77.1%) and median PSA of 14.6 ng/ml. All patients underwent retropubic radical prostatectomy with bilateral nerve-sparing under general anaesthesia. Ilio-obturator lymph node dissection was performed in 48.6% of patients. No major intraoperative complications occurred. Mean operative time was 187 ± 43 minutes. Mean blood loss was 520 ± 180 ml, with a transfusion rate of 11.4%. Mean length of hospital stay was 11.1 ± 7.1 days. Early postoperative complications (Clavien grade I-II) affected 68.6% of patients: lymphocele (8.6%), deep vein thrombosis (2.9%), wound infection and urinary tract infection (2.9% each). Two surgical reinterventions (Clavien grade IIIb) were required for anastomotic leak (5.7%). Functional complications at 6 months included: ejaculatory dysfunction (81.4%), urinary incontinence (66.6%), complete erectile dysfunction (48.1%). Conclusion: This first Beninese series, although limited by its small sample size and retrospective design, provides preliminary data on the feasibility of open radical prostatectomy in a resource-limited setting. The absence of major intraoperative complications, while encouraging, must be interpreted with caution given the sample size and selection bias toward low-risk cancers. The observed functional morbidity underscores the imperative need to develop structured perioperative rehabilitation programs. In the absence of minimally invasive techniques, optimisation of perioperative management and improved patient selection represent the most realistic avenues for short-term improvement.
Low-flow priapism: results of surgical treatment on erectile function in Abidjan, Ivory Coast, from 2018 to 2022
Introduction: Low-flow priapism, or venous priapism, is defined as an abnormally prolonged erection (lasting more than 3 to 4 hours) that is irreducible and sometimes painful, occurring after orgasm or in the absence of any sexual desire or stimulation. The increasing frequency of priapism and the difficulties in treating it motivated us to conduct this study, the objective of which was to present the functional results after surgical treatment. Patients and methods: We conducted a retrospective descriptive study of patients hospitalised in the urology department of the Cocody Abidjan University Hospital - Ivory Coast between January 2018 and December 2022 for low-flow priapism. We included in the study all patients who underwent surgery for low-flow priapism and who had good erectile function prior to surgery. Erectile function was assessed using the International Index of Erectile Function (IIEF5). Results: The average age of the patients was 32.35 years. Sickle cell patients accounted for 39.13% of cases. The average time to admission was 50.74 ± 45.50 hours (the duration range was 6 hours). The average time to treatment was 239.13 +/- 171.73 min or 4 hours by doctors (the duration range was 1 hour). After a 24-month follow-up, 34.78% of patients had mild erectile dysfunction, 34.78% had moderate erectile dysfunction, and 30.44% had severe erectile dysfunction. Conclusion: Priapism should be considered a major andrological emergency requiring immediate treatment. The prognosis depends mainly on the age of the patient and the delay in treatment. Treating risk factors and early intervention are the best ways to avoid this condition, which compromises the functional prognosis of the penis.
A retrospective review of nephrectomies at a tertiary hospital in northern Ghana
Background: Nephrectomy is the surgical removal of a diseased kidney or the removal of a kidney for transplantation. Benign and malignant kidney conditions may necessitate kidney removal to reduce morbidity and prevent death. Healthcare accessibility and affordability are relatively poor in Africa, alongside limited human resources for diagnosing and managing medical conditions. Kidney conditions, which can be treated to prevent loss of kidney function, may be undiagnosed or untreated, leading to the loss of kidney function and nephrectomy. We evaluated the common reasons for non-trauma-related nephrectomy at a tertiary hospital in northern Ghana. The study aimed to provide baseline information to improve patient care and prevent kidney function loss leading to nephrectomy. Materials and methods: The retrospective, descriptive study evaluated the operative records of patients who underwent open nephrectomy at the only teaching hospital in northern Ghana from 2014 to 2024. Results: The median age of the study subjects was 28 years, with an almost equal number of males (50.4%) and females (49.6%). The most common indication for nephrectomy at our centre was loss of kidney function from treatable causes, mainly pelvi-ureteric junction (PUJ) obstruction (34.9%) and renal/ureteric stones (19.3%). Renal cell carcinoma and Wilms’ tumour each constituted 15.7% of nephrectomy indications. Conclusion: Nephrectomy is a common surgical procedure performed in northern Ghana; however, the indications are commonly due to treatable conditions. Thus, improvements in healthcare will significantly reduce the need for nephrectomies in our area.
Correlation between prostate MRI results and histopathological examination of prostate biopsy cores in patients followed in the CNHU-HKM University Urology-Andrology Clinic
Introduction: Multiparametric MRI currently plays an important role in the detection and localisation of prostate tumour foci. Materials and Methods: This was a descriptive and analytical study. The study was conducted from June 1, 2021, to June 31, 2023. All patients with a lesion classified as at least PIRADS 3 on prostate MRI who underwent a prostate biopsy were included. Results: A total of 213 patients were included, with a mean age of 66.18 years. Elevated PSA levels (78.81%, n = 170) and/or abnormalities on digital rectal examination (45.54%, n = 96) were the indications for MRI. The mean prostate volume on MRI was 67.77 cm³. Suspicious lesions on MRI were present in 155 (72.76%). Prostate cancer was identified by prostate biopsy in 70.86% (n = 107) of cases, of which 62.60% (n = 72) were clinically significant. Locoregional involvement was present in 68 patients (31.92%). The presence of prostate cancer and its clinical significance were also discussed. The presence of prostate cancer, its clinical significance, and its loco-regional extension were associated with PIRADS lesions on prostate MRI, with p-values of p = 0.0002, p = 0.02, and p = 0.004 respectively. Conclusion: Multiparametric prostate MRI is therefore a good diagnostic tool for assessing the locoregional extent of prostate tumours.
Prevalence of male infertility, characteristics of semen parameters, and endocrine profiles at Kilimanjaro Christian Medical Centre: a five-year retrospective study
Purpose: Globally, male infertility is a public health concern. Semen analysis and endocrine profile evaluation are crucial diagnostic tools that uncover factors contributing to infertility. This study aimed to determine the prevalence of male infertility by examining patterns and characteristics of semen parameters and endocrine profiles among men attending the fertility clinic at Kilimanjaro Christian Medical Centre (KCMC) in northern Tanzania. Materials and methods: A descriptive study spanning five years (2017–2022) involved 482 semen samples from men seeking fertility services at KCMC, a zonal referral hospital. Data were sourced from the pathology laboratory registry book, medical records with hospital numbers, and the electronic health management system for demographic details. Endocrine profiles were obtained via data intensive systems and applications. After excluding 229 samples with single semen samples or analyses conducted elsewhere, 253 eligible semen samples were analysed, using privacy-preserving serial numbers for data extraction. Results: Among the analysed samples, 192 (75.9%) exhibited abnormal semen parameters. Asthenozoospermia was the most common abnormality, present in 125 subjects (49.4%), followed by necrozoospermia, teratozoospermia, and oligozoospermia. Azoospermia was found in 48 subjects (19%). Regarding hormonal profiles, low testosterone (TT) was the most frequent abnormality, affecting 197 (77.9%). High follicle-stimulating hormone (FSH) levels were detected in 66 subjects (26.1%), while luteinising hormone (LH) levels were within the normal range for 251 subjects (99.2%). Notably, a significant proportion of subjects (193, 76.3%) with low TT had normal LH levels. Conclusion: A high prevalence of male infertility was noted through significant findings of semen abnormalities, with a predominance of asthenozoospermia and abnormal endocrine profiles. Most had low TT and normal LH levels.
Anatomoclinical, therapeutic and medico-legal aspects of post-traumatic ruptures of the urethra in Conakry
Objective: To report the anatomoclinical aspects and management of post-traumatic urethral ruptures as well as the medico-legal evaluation of victims in Conakry. Material and methods: This was a descriptive study with retrospective data collection over a ten-year period, conducted between January 1, 2013, and December 31, 2022, inclusively. It was carried out at two practice sites of the authors in Conakry. During this period, it collected all patients followed for post-traumatic urethral rupture with an exploitable medical file. The European Association of Urology classification was adopted for lesion typing. The parameters studied were: age, profession, reason for admission, circumstances of occurrence, mechanisms of occurrence, type of rupture, site of rupture, associated lesions, therapeutic attitude, treatment results, and medico-legal evaluation. Results: Post-traumatic urethral ruptures represented 12.7% of all pelvi-perineal traumas recorded in surgical emergencies. The mean age was 29.7 ± 11.3 years with extremes of 5 and 68 years. Urethrorrhagia (74.5%) and acute urinary retention (62.3%) were the most common urological reasons for consultation. Functional impairment of the lower limbs was present in 80.2% of patients. The circumstances of trauma occurrence were dominated by traffic accidents (54.7%). In 41.5% of cases, urethral rupture occurred by shearing. It was complete in 79.2% of cases and predominantly affected the posterior urethra (75.5%). Pelvic fracture was the most common associated lesion (72.6%). Late urethral repair was the most observed therapeutic approach. It consisted of urethroplasty by resection anastomosis in 75.5% of patients previously diverted by cystostomy. Endoscopic internal urethrotomy concerned 14.1% of patients. Immediate surgical repair of the urethra was performed in only 9.4% of cases. The therapeutic outcomes were favourable in the majority of cases (82.1%). Erectile dysfunction, infertility, and urethral stenosis were the evolutionary sequelae associated. The evaluation of total temporary incapacity (TTI) revealed a mean disability duration of 88.2 days, with 75.5% of patients presenting TTI greater than 35 days. Permanent partial incapacity (PPI) concerned 21.7% of patients with a mean PPI of 5.75%, mainly due to sequelae associated with therapeutic outcomes. Conclusion: Post-traumatic urethral ruptures require a multidisciplinary approach to optimise management and compensation of victims.
Pyeloureteral junction syndrome: experience at the Douala General Hospital
Background: Pyeloureteral junction syndrome (PUJS) is a frequent upper urinary tract malformation. We report the experience at Douala General Hospital (DGH) in diagnosing and managing PUJS. Methods: This was a retrospective study from January 2015 to June 2025 (10 years) that included all adult and paediatric patients who underwent surgery for PUJS. Results: During the study period, 18 cases of PUJS underwent surgery, of which 61.1% were men, with an average age of 34.1 years (range 4–72). The main presenting complaints were flank pain (83.34%) and recurrent urinary tract infections (16.67%), all evolving within five years before surgery. Ultrasound, coupled with a computed tomography (CT) scan, was performed to confirm the PUJS diagnosis. Anderson–Hynes open pyeloplasty was performed in all patients, followed by double-J stent placement spanning the anastomosis. In one case, the uncrossing of a lower polar vessel was done, followed by pyeloplasty. For the patient with bilateral PUJS, the most symptomatic side (left) was treated first and the other side was treated six months later. One patient had a nephrectomy for a type IV non-functional kidney. The renal compartment was drained with a negative pressure drain, and all drains were removed within 48–72 hours postoperatively. The average surgery time was 124 minutes (range 97–161), while the average hospital stay was five days. Postoperative outcomes were simple, with resolution of clinical and biological signs at six- and 12-month follow-up visits. Conclusion: Done properly, Anderson–Hynes open pyeloplasty has a success rate of over 90% and remains the gold standard in settings where laparoscopy and robotics are not readily available.
The place of endoscopic surgery in the management of urological pathologies in the urology department of the university hospital Pr Bocar S Sall in Kati
Introduction: Urological endoscopy is a minimally invasive medical procedure that allows for the visual exploration of the interior of a cavity in the urinary tract. It is performed through the natural orifices. This endoscopy allows for various types of endoscopic surgery. The objective of this study was to evaluate the practice of endoscopic surgery at the Pr Bocar Sidy Sall University Hospital in Kati. Patients and Methods: This was a retrospective descriptive study conducted from January 1, 2024, to December 31, 2024 (one year). All patients, regardless of their pathology, who underwent surgery using endoscopic techniques were included in this study. Data were entered and analysed using Word 2016, Excel 2016, and SPSS version 21.0. Results: We identified 258 cases of endoscopic surgery during this study period. Of a total of 357 urological surgeries performed, 258 (72%) were endoscopic, while only 99 (28%) were open. The various endoscopic procedures performed were: transurethral resection of the prostate (34.3%), laser ureteroscopy (28.3%), transurethral resection of the bladder (18.2%), placement of a double-J stent (8.5%), endoscopic internal urethrotomy (2.3%), cervicoprostatic incision (1.2%), and intravesical lithotripsy (0.8%). Conclusion: Endoscopic surgery is a safe and reliable technique for performing various surgical procedures in urology.
Patient satisfaction and associated factors after urethroplasty for urethral stricture disease in northern Tanzania: a prospective cohort study
Purpose: Patient satisfaction after urethroplasty is underexplored, as traditional outcome assessments rely on objective measures, like imaging and invasive tests, overlooking patients’ perspectives and the associated factors that influence their overall experience. Materials and methods: A prospective cohort study was conducted between August 2024 and July 2025 at Kilimanjaro Christian Medical Centre (KCMC), a tertiary referral hospital in northern Tanzania. Male patients undergoing urethroplasty for urethral stricture disease were consecutively enrolled using convenience sampling. Preoperative and three-month postoperative assessments were done using the Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM) tool. Data on demographics, clinical characteristics, symptoms, postoperative treatment satisfaction at three months, and quality of life (QoL) were collected using a Swahili-translated questionnaire. Data were analysed using IBM SPSS version 25, with paired t-tests and relative risk used to assess changes and associations. Results: A total of 32 male patients (mean age 54 ± 19 years) underwent urethroplasty. Trauma was the most common cause (75%), and the bulbar urethra was the most affected site (78%). At the three-month follow-up, 81.3% of patients reported being very satisfied with their surgical outcomes, while 18.7% were dissatisfied. Among satisfied patients, significant improvements were observed in lower urinary tract symptom (LUTS) severity, QoL, and urine stream (p < 0.001). Dissatisfaction was associated with age ≥ 45 years, immediate postoperative complications, stricture recurrence, and lower USS-PROM score reductions in LUTS and QoL domains (p < 0.05). Conclusion: Most patients reported high satisfaction with urethroplasty outcomes. However, dissatisfaction was linked to older age, complications, and poor symptom improvement. Our findings underscore the value of incorporating patient-reported outcome measures (PROM) in routine postoperative follow-up.
Clear cell renal cell carcinoma: atypical imaging presentation of Wunderlich syndrome
Renal cell carcinomas (RCC) are primary malignant adenocarcinomas derived from the tubular epithelium. These encompass several distinct histological varieties, including clear cell, papillary, clear cell papillary, chromophobe renal cell, and other rare ones. The incidence of RCC is rising, largely attributable to the increased use of cross-sectional imaging and advances in imaging techniques. This case report describes an atypical imaging manifestation of RCC, histologically confirmed as a clear cell subtype, presenting atypically with Wunderlich syndrome.
Ureterocystoplasty in a teenage boy: a case report
Bladder augmentation may be required for patients with a small, high-pressure bladder and associated incontinence, particularly if related to renal injury. Ureterocystoplasty (UC) using a dilated ureter expands capacity without bowel incorporation risks. We report a teenage boy with spina bifida, an associated neuropathic, high-pressure bladder, and an obstructed, dysplastic left kidney. Via two extraperitoneal incisions, the kidney was removed, and UC was performed. Postoperatively, the patient achieved continence without anticholinergics on intermittent catheterisation. This case highlights the technique’s versatility, suitability for older patients, and advantages in avoiding bowel-related complications, reducing the sepsis risk by removing a redundant system, and lowering the hypertension risk through nephrectomy.
Burden of urolithiasis in Chad: epidemiological, diagnostic, and management trends
Introduction: Urolithiasis is a common condition with a steadily increasing global prevalence. Its epidemiology varies across regions, influenced by multiple factors, and it represents a major public health problem due to its severe complications, impact on quality of life, and high economic burden. In sub-Saharan Africa, available data remain limited and likely underestimated, although the disease seems to occur more frequently. Hence, a better understanding of the urolithiasis burden and its determinants is essential to guide prevention and management strategies. This study aims to assess the situation in Chad by reviewing available data. Methods: Study selection, in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, was based on searches in PubMed, Google Scholar, AJOL (African Journals Online), and manual screening without time restriction. Included studies addressed urolithiasis in Chad and were published in English or French, with standardised data extraction (population, diagnosis, and treatment). Data extraction was validated by two independent reviewers. Analyses were conducted according to data homogeneity, combining qualitative and quantitative approaches. Results: An initial search identified 406 studies, from which 26 duplicates were removed. After applying the inclusion criteria, four articles published between 2015 and 2023 were included in the final qualitative synthesis. The mean urolithiasis prevalence was estimated at 4.6%. Overall, the review included 590 patients, with a mean age of 5.5–36 years and a male predominance (7.3:1 sex ratio). Dysuria was the main presenting complaint, while urinary tract infection was reported in 44.4% of patients. Plain radiography and ultrasound were the primary diagnostic modalities. Most stones were located in the lower urinary tract (n = 496, 84.5%), and all interventions employed open surgery. Postoperative complications (wound suppuration and vesicocutaneous fistula) were reported across all studies, with rates varying among authors. One study reported a mean hospital stay of 18 days. Conclusion: Urolithiasis in Chad predominantly affects young individuals, including children, with limited diagnostic resources and primarily invasive treatment. The high frequency of complications highlights the need to improve management. Further research is essential to optimise care and reduce the urolithiasis burden.
Surgical treatment of erectile dysfunction with malleable penile prosthesis: first experience in Benin
Introduction: Erectile dysfunction (ED) is a common condition affecting patients’ quality of life. When first- and second-line treatments fail, penile prosthesis implantation is an effective option. This study reports the first penile prosthesis implantation performed in Benin, including complete preoperative evaluation and postoperative follow-up. Observation: A 58-year-old patient with severe ED for two years, resistant to medical therapy, underwent implantation of a malleable penile prosthesis (ZSI 100D9 Zephyr Surgical Implants, Geneva, Switzerland) under general anaesthesia via a penoscrotal approach. The patient had several comorbidities, including hypertension, a history of pulmonary embolism (treated with Préviscan in 2021), chronic venous insufficiency, and haemorrhoidal disease. The patient did not smoke or consume alcohol. Hormonal evaluation, including testosterone, was normal, confirming vasculogenic ED. The postoperative course included penile oedema, phlyctaenae formation, minor secondary suppuration, and fibrous ring formation, all managed with 14% bicarbonate dressings and topical Baneocin. Corticosteroid therapy was initiated on day 10 after confirming the absence of infection, with strict glycaemic control. At five months postoperatively, the patient reported total satisfaction after the first sexual intercourse despite mild penile pain. Conclusion: This first penile prosthesis implantation in Benin represents a significant advancement in ED management, demonstrating feasibility in resource-limited settings, and highlighting the importance of thorough preoperative assessment and patient education. It provides educational value for urologists and encourages patient awareness of this therapeutic alternative.