Biomedical subjects
Publications and source records attributed to A Mensah.
Obstetrical vesicovaginal fistulas are still very common in third world countries, due to the difficulties of medical care. With this series of 123 cases seen over 6 years, we analyze their epidemiological, pathological and therapeutical aspects. A simplified classification is proposed.
Penile carcinoma is rare in Senegal representing 0.35% of all cancers and 0.97% of cancers in the male adult. Neonate circumcision widely used in this country seems to prevent this disease. With this series of 11 cases, clinical and therapeutical aspects are reviewed.
Fourteen pediatric cases of posterior urethral valves in patients aged 6 months to 14 years (with four infants and ten older children) are reported. The main symptoms were vesical, including dysuria, acute urinary retention and dribbling. One patient presented with diarrhea, vomiting and dribbling. Urethral valves were looked for as part of the evaluation for urinary lithiasis in one patient, and in another urinary lithiasis developed following the diagnosis of urethral valves. In half the cases, onset of symptoms occurred within one year of birth. Urethrocystography allowed to evidence the valves and to evaluate repercussions on the bladder including hyperplasia (7 cases) and diverticula (2 cases). The intravenous urogram disclosed bilateral ureterohydronephrosis in eight cases. Pathogens recovered from the urine included Klebsiella (3 patients), Pseudomonas (4 patients), Proteus (one patient), and E. coli (one patient). Most patients were treated by catheter lamination under antimicrobial therapy. Two patients died from renal failure. Results were considered satisfactory in nine cases with follow-ups ranging from 1 month to 4 years. Three patients were lost to follow-up. Early diagnosis is essential and management should rely mainly on endoscopic resection which reduces the length of the hospital stay and the risk of infection.
The authors report the first malignancy composed of interstitial testicular cells in a Senegalese man. Interesting features of this case include occurrence in a 58-year-old adult, short duration of the disease, development of metastases before discovery of the primary tumor, severity of pain, and absence of feminization.
The authors present 3 cases of vesical tumours discovered during pregnancy, which, according to literature, very rarely happens. These women from the low socio-economic strata had many children and were seen at a late stage when diagnosis of vesical tumours is easily distinguished from haematuria, recurrent cysts and hypogastric tumours. The prognostic is bad, resulting most frequently in death due to kidney failure with purulent peritonitis from perforation of the tumour or its evolving towards the vertebral metastasis, and chronic suffering for the foetus. The need for early discovery through urinary indications is stressed, as is the need for public health education and easy accessibility to the medical services.
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Description of a case of ectopic pregnancy during the last 3 months with a living, malformed and underdeveloped neonate. Possible treatment is discussed: where as in our case there is a secondary ectopic pregnancy (i.e.a pregnancy started primarily in the tube and still in vascular contact with it but secondarily ectopic) removal of placenta following ligation of the main vessels arising from the tube is possible and recommended. In the much rarer primary ectopic pregnancy with primary nidus in the abdomen, removal of the placenta is dangerous and not advised because of the danger of diffuse hemorrhage.
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