African Journals Online
The African Journal of Urology

Vol. 7, No. 3, September 2001
ABSTRACTS

E.H. ABDEL GOAD AND Z.B. BERECZKY

The aim of this article is to enhance the knowledge of urologists in using the internet. We reviewed the literature and added our experience in the use of the internet for educational material, research and for teaching purposes. In this article, the attempt has been made to provide an overview of the current technological knowledge on which our colleagues can build on. We also demonstrate in this article how the internet can help in the advancement of urology in Africa. Our aim is to raise awareness of the types of resources available to urologists in our continent and to motivate the use of such resources.

EGYPTIAN MULTICENTER STUDY GROUP*

Objectives To assess the efficacy and safety of doxazosin, a selective ₁-adrenoceptor antagonist, in the treatment of benign prostatic hyperplasia (BPH).

Patients and Methods A total of 333 patients, 50 years or older, were included in this 12-week, multicenter (30 investigational sites), baseline placebo-controlled study. The diagnosis was based on clinical manifestations, digital rectal examination and uroflowmetry. The treatment duration included a 2-week placebo washout phase and a 12-week active treatment phase (6 visits). Twenty-one patients were lost to follow-up during the placebo run-in phase and 312 patients completed the study. During the active treatment phase, the starting dose was 1 mg/day for 2 weeks that was titrated to 2 mg/day for 5 weeks. Titration was further increased to 4 mg/day when there was no increase in the peak flow rate (Qmax) ³ 3 ml/sec and/or no reduction in the mean International Prostate Symptoms Score (IPSS) ³ 30%. The blood pressure was assessed at baseline and at each subsequent visit.

Results At the end of the treatment phase, doxazosin showed a remarkable effect on the efficacy parameters with IPSS improving from 19.55 ± 5.27 to 9.25 ± 3.77 (p < 0.0001). The peak flow rate (Qmax) increased from 8.92 ± 3.51 to 13.27 ± 7.41 (p < 0.0001) and the average mean flow (Qmean) rate increased from 4.56 ± 2.53 to 6.65 ± 5.85 (p < 0.0001). Doxazosin caused a mean reduction in blood pressure in hypertensive patients (n=131) of 13.5 / 7.5 mmHg (p < 0.0001), while clinically insignificant changes were observed in the blood pressure of normotensive patients (n=181). In those patients the mean reduction in blood pressure was 4.2 / 2.5 mmHg (p<0.0001). Adverse events were experienced by 24 patients (7.69%) in the form of heachache, dizziness, fatigue and somnolence, which were generally mild to moderate in intensity. Only 4 patients (1.28%) were withdrawn due to side effects (dizziness, somnolence or fatigue).

Conclusion Doxazosin is an effective agent for the treatment of BPH and is well tolerated by the majority of patients.

*A. Abdel Aziz, M.D.; I. Abdel-Hafeez, M.D.;A. Abdel-Hakim, M.D.; M. Abdel-Malek, M.D.; A. Abdel-Meguid, M.D.; M. Abo-Elhassan, M.D.; U. Abo-Farha, M.D.; M. Abo-Guindy, M.D.; A. Arafa, M.D.; A. Ashamallah, M.D.; A. Baghat, M.D.; M. Elakkad, M.D.; H. El-Bialy, M.D.; H. El-Damanhoury, M.D.; M.Eldomairy, M.D.; A.Elkasaby, M.D.; A. Gaafar, M.D.; M. Gaballah, M.D.; B. Hathut, M.D.; A. Ibrahim, M.D.; I. Khalaf, M.D.; M. Moaatamed, M.D.; Sh. Morad, M.D.; R. Moustafa, M.D.; M. Rafik, M.D.; M. Abdel-Azeem, M.D.; H. Rashwan, M.D.;S. Mohamed, M.D.; A. Salama, M.D.; M. Shalaby, M.D.; I. Shoukry, M.D.; H. Torky, M.D.

LA FISTULE UROGENITALE AU NIGER: ASPECTS EPIDEMIOLOGIQUES ET CONSEQUENCES

G. SANDA, I. NAFIOU ET A. MOUNKAILA

Les auteurs rapportent les résultats d’une enquête nationale sur les fistules obstétricales. Divers aspects de cette pathologie invalidante sont passés en revue: le profil des patientes (âge, parité, provenance, conditions de déroulement et complications de l’accouchement), le type de fistules et les conséquences génitales et sociales de leur survenue. La fistule urogénitale se rencontre essentiellement chez des jeunes femmes habitant dans des zones rurales enclavées, éloignées de formations sanitaires. La meilleure stratégie préventive reste l’amélioration de la couverture obstétricale et l’accessibilité des formations sanitaires de premier niveau et la prompte référence des parturientes à risque à l’échelon supérieur.

Objective The evaluation of the results of a nationwide survey on obstetric fistulae carried out in Niger.

Patients and Methods Various aspects such as patients‘ profile, conditions and complications of labour, types and social consequences of obstetric fistulae are discussed.

Results The survey revealed that obstetric fistulae most often occur in very young women living in remote rural areas lacking adequate hygienic and medical facilities.

Conclusion The best preventive strategy will be the implementation of an adequate number of emergency obstetric units and a prompt referral for obstetric intervention of all patients with prolonged and obstructed labour.

L’OPERATION DE NESBIT DANS LE TRAITEMENT DE LA COUDURE DE VERGE A PROPOS DE 39 CAS

P.G. KONAN, A. GELET, B. CUZIN, X. MARTIN ET J.M. DUBERNARD

Objectifs L’évaluation des résultats à long terme de l’opération de Nesbit dans le traitement de la coudure de verge.

Patients et Méthodes Trente-neuf cas de coudure de verge (20 coudures congénitales et 19 coudures secondaires à la maladie de Lapeyronie) ont été opérés dans le service d’urologie de l’Hôpital Edouard Herriot de Lyon sur une période de 10 ans. L’opération de Nesbit a été pratiqué dans 74% des cas, et dans les autres cas, une variante de celle-ci. Le principe de l’opération de Nesbit est simple. Il consiste à exciser une pastille ovalaire d’albuginée et de corps caverneux au sommet de l’angle de la coudure. Résultats Le redressement de la verge a été obtenu et maintenu dès la première intervention dans 97% des cas après 6 mois. La correction est toujours stable à 10 ans. Un seul cas de raccourcissement important de la verge (2 cm) a été noté.

Conclusion L’opération de Nesbit est une intervention fiable, bien codifiée actuellement. Elle donne entre les mains entraînées d’excellents résultats.

Objective To evaluate the efficacy of the Nesbit procedure in the treatment of penile curvature. Patients and Methods Our series included 39 penile curvatures (20 congenital and 19 in Peyronie’s disease) operated at the urological department of Edouard Herriot Hospital of Lyon / France during a period of 10 years. The Nesbit procedure was performed in 74% of cases and a variant of the procedure in the remaining cases. The principle of the Nesbit procedure is easy: An oval cut-off pastille is made in the albuginea and the cavernous corpus at the vertex of the curvature.

Results A six months‘ follow-up proved that we had succeeded to obtain and maintain penile straightening at the first operation in 97% of cases. Ten years later, the correction was still lasting. Only one case of important shortening of the penis (2 cm) occurred.

Conclusion The Nesbit procedure is a reliable operation offering an excellent outcome.