Search PubMed⌕ Search

Biomedical subjects

S M Gueye

Publications and source records attributed to S M Gueye.

At least 19 recordsLinked to original sources
PubMed2003

Clinical characteristics of prostate cancer in African Americans, American whites, and Senegalese men.

OBJECTIVES: To describe the clinical features of prostate cancer in Senegalese men and compare these features with those found in African-American and white American men. METHODS: We identified an unselected series of 121 patients with prostate cancer diagnosed at two hospitals in Dakar, Senegal between 1997 and 2002. Medical record abstractions were undertaken to evaluate the prostate tumor characteristics, patient age at diagnosis, prostate-specific antigen (PSA) levels, and reason for referral. In addition, these characteristics were compared with a sample of 455 U.S. white men and 60 African-American men with prostate cancer who were studied as part of a prostate cancer case-control study. RESULTS: Senegalese men had a significantly worse tumor stage than Americans (41.3% versus 18.8%, P <0.001), a significantly worse mean PSA level at diagnosis (mean PSA 72.7 ng/mL versus 9.0 ng/mL in Americans; P <0.001), and were diagnosed at a significantly later age than U.S. men (69 years versus 61 years, P <0.001). U.S. men were most likely to be diagnosed with prostate cancer after an elevated PSA test, and Senegalese men were most often diagnosed after presenting for prostate-related symptoms. CONCLUSIONS: These observations are not unexpected given the differences in the patterns of prostate cancer screening and health care in the United States compared with Senegal. However, our data provide descriptive information about the characteristics of prostate cancer diagnosed in Senegal and highlight differences in the characteristics and detection of these tumors across populations with very different healthcare systems.

Adult↗
PubMed2002

[Ureterocele in adults. Five case reports].

The authors report five cases of ureterocele during six years. Mean age of the patients was 34.2 +/- 11.1 years. There were four female and one male. Pain (N = 3) and dysuria (N = 3) were the most common symptoms at examination. Diagnosis was made by ultrasound (N = 3), IVU (N = 3) or cystoscopy (N = 1). Ureteroceles were bilateral in four cases, unilateral in one case and were always intravesical with single ureter. Two patients presented lithiasis enclosed in the ureterocele. Only four patients had been operated. Surgical treatment was ureterocelectomy with ureteral reimplantation according to Cohen procedure. With mean follow-up of 10.6 +/- 4.7 months results were stable without complications.

Adult↗
PubMed2002

Ethnic differences in the frequency of prostate cancer susceptibility alleles at SRD5A2 and CYP3A4.

OBJECTIVES: Ethnic differences in prostate cancer incidence are well documented, with African-Americans having among the highest rates in the world. Ethnic differences in genotypes for genes associated with androgen metabolism including SRD5A2 and CYP3A4 also may exist. The aim of this study was to evaluate differences in these genotypes by ethnicity. METHODS: We studied cancer-free controls representative of four groups: 147 African Americans, 410 Caucasian-Americans, 129 Ghanaians, and 178 Senegalese. PCR-based genotype analysis was undertaken to identify two alleles (V89L, A49T) at SRD5A2 and *1B allele at CYP3A4. RESULTS: Differences were observed for V89L (variant frequency of 30% in Caucasians, 27% in African Americans, 19% in Ghanaians, and 18% in Senegalese, p = 0.002) and were observed for CYP3A4*1B (variant frequencies of 8% in Caucasians, 59% in African Americans, 81% in Ghanaians, and 78% in Senegalese, p = 0.0001). Pooled data combining the present data and previously published data from from Asian, Hispanic, and Arab cancer-free controls showed significant ethnic differences for SRD5A2 and CYP3A4 polymorphisms. Overall, Asians were least likely to have alleles associated with increased prostate cancer risk, while Africans were most likely to have those alleles. CONCLUSIONS: These results suggest that ethnicity-specific differences in genotype frequencies exist for SRD5A2 and CYP3A4. Africans and African-Americans have the highest frequency of those alleles that have previously been associated with increased prostate cancer risk. Future studies should address whether allele frequency differences in part explain differences in prostate cancer incidence in these populations.

Black People↗
PubMed2000

[Penile emergencies].

The three main penile emergency situations have been examined so as to better define the clinical and therapeutic aspects. In the present study, a fracture of the penis (n = 12) occurred following a coital accident in 8 cases. In general, a clinical diagnosis was made and emergency surgical treatment appeared to be the most efficient means of preventing possible erectile malfunction. Mutilation of the penis was observed (n = 12) following traditional circumcision or circumcision performed by paramedical staff; or was due to self-inflicted mutilation and pyschiatric disorder (n = 6), and in one case to sexual deviation (n = 1) This category of accidents could be more adequately managed by the psychiatric treatment of certain patients and by better training of the personnel carrying out the circumcision. Priapism (n = 42) was due to sickle cell disease in 50% of cases, and relapse was noted in 10% of patients.

Adult↗
PubMed2000

[Vesico-uterine fistulae. Report of 5 cases].

The authors report 5 cases of uterovesical fistula (UVF) and analyse some of the clinical and therapeutic aspects of this disease. The mean age of these 5 patients was 31.2 +/- 6.9 years. The trauma responsible for the fistula was caesarean section in every case. The presenting complaints were dominated by cyclic haematuria (n = 5). Intravenous urography did not contribute to the diagnosis, while hysterosalpingography demonstrated the UVF in 3 out of 4 cases. Treatment was surgical for all patients and consisted of closure of the fistula in 3 cases and hysterectomy in 2 cases. With a mean follow-up of 2 +/- 1.2 years, no pregnancies were reported in the 3 patients treated by closure of the fistula. On the other hand, the urinary results were satisfactory with good continence and resolution of the cyclic haematuria. The authors emphasize the importance of prevention of UVF by well conducted caesarean section.

Adult↗
PubMed2000

[Fibrinolytic syndrome during surgery for benign prostatic hypertrophy (50 cases in the urology service at the Aristide le Dantec University Hospital Center)].

Prostate's surgery is an haemorrhagic one owing to difficulties of surgical haemostasis and anomalies of the blood coagulation. The aim of this study to assess haemostasis anomalies after protatectomy for benign prostatic hyperplasia (BPH). We have performed a prospective study including 50 men of more of 55 years old. All of them underwent suprapubic open prostatectomy. Significant pertubation of haemostasis, particularly fibrinolysis has been found. We have noticed fibrin degradation product in 88% of cases after intervention versus 62% before (p < 0.001) and a decrease of plasminogen rate in 94.4% of operated patients versus 82% before. The older the patient were, more important were the pertubations. Moreover, the anomalies were most important when the duration of surgery lasted more than one hour and when the BPH was voluminous. However, the disturbance of haemostasis was rarely associated to clinical symptoms. So, we do not recommend any therapeutic when clinical symptoms are absent. Biological screening the day of surgery, the day after and one week later are necessary to prevent haemorrhage.

Academic Medical Centers↗
PubMed1999

[Simultaneous treatment of benign prostatic hypertrophy and inguinal hernia: an old procedure revisited].

The association of benign prostatic hyperplasia (BPH) and inguinal hernia still pose the problem of the chronology of their repair. Indeed, first hernial repair without removing the cervicoprostatic obstruction exposes to a high rate of recurrence due to the dysuria. The objective of this work was to report our experience about the simultaneous cure of the BPH and inguinal hernia. We have performed a retrospective study including a non consecutive series of 92 patients presenting both BPH and inguinal hernia. Studied parameters was age, occupation, clinical symptoms, the procedure and operative continuations. Mean age was 70.22 years old, range from 57 to 90 years old. Past history of inguinal hernia repair was found in 18.5%. 19.13% had hernial recurrence while 6.5% had contralateral hernia. Main clinical features were inguinal mass (43.5%) and acute urinary retention (11.9%). The average weight of prostatic tumor was 87.1 g. Surgery was performed under spinal anaesthesia in 96.8%. All patients underwent suprapubic transvesical prostatectomy. Hernial repair was done according to Bassini procedure in 82.6%, Mac Way procedure in 14.2% and Forgues procedure in 3.2%. The overall morbidity rate was 15.2%. The hernial recurrence rate was 7.6%. There was no postoperative mortality. The simultaneous repair of BPH and inguinal hernia offers some advantages. First of all, it reduces considerably the anaesthetic risk owing to the importance of cardiovascular diseases in aging patients. On and other hand, the low recurrence rate of the hernia and the substantial savings are adjunct advantages. We conclude that simultaneous repair of BPH and inguinal hernia is simple, safe and economic.

Aged↗
PubMed1998

[Malignant kidney tumors in adults in Senegal: diagnostic and therapeutic problems].

The aim of this study was to analyze problems posed by adult renal malignant tumors both in the diagnostical and therapeutical viewpoints. We have performed a retrospective study including 48 cases of confirmed renal cancer. Have been included adult patients who presented a cancer of the kidney operated or not. Studied parameters were age, sex, clinical signs, complementary explorations i.e. biology, renal ultrasonography, IVU, Computerized tomography, the operative indication and the prognosis. We have used Robson's staging to classify our patients. The average age was 51 years with extremes of 18 and 83 years. However 60% of them were less than 50 years. Adenocarcinoma was the main histological form encountered. It has been found in 93% of cases. The flank mass has been the mode of discovery in 70.8% of cases. The classic symptomatic triad associating hematuria, pain and the renal mass has been found in 20.8% of cases. Ultrasonography and Intravenous urography (IVU) have allowed to pose the diagnosis in 93.75% of cases. Patients were often referred very late with an average delay of consultation of 14 month. So, 25% of them presented with metastasis at the moment of the diagnosis. Radical nephrectomy was performed in 60% of cases. 40% of patients have not been operated due to the advanced evolution of the tumor. The global mortality to 1 year was estimated at 38%. We conclude that renal malignant tumors in the adulthood, in our practice, presents some particularities. Indeed, patients are referred late when clinical symptoms are sufficiently evocative to suspect the diagnosis. At these advanced stages, there is no curative therapeutic. So, a precocious diagnosis is necessary in order to propose to patients radical nephrectomy which remains the only efficient therapeutical procedure of the localized renal cancer in the adulthood.

Adolescent↗
PubMed1998

[Peyronie's disease and peripheral neuropathies].

The association between Peyronie's disease and diabetes mellitus or Dupuytren's disease is well described in the literature with a certain frequency. Through our 10 patients with Peyronie's disease, when have noticed that only one of them is undergoing diabetes mellitus and no one has Dupuytren's disease. But 7 of them presented clinical and/or electromyographical signs of peripheral neuropathy. So after clinical examination in neurology and urology, we performed measurement of motor conduction velocity of tibial posterior nerves and peroneal nerves, then, we measured sensitive vetocity of sural nerves and dorsal nerve of the penis and we studied the cortical somesthesic evoked potential of the internal hontous nerve and the sympathetic evoked response of the skin. So we hypothesize that peripheral neuropathy with or without autonomic disorders might be an etiological co-factor of Peyronie's disease.

Adult↗
PubMed1998

[Epididymal manifestations of urogenital tuberculosis].

OBJECTIVE: To define the epidemiological, anatomical, clinical and therapeutic aspects of tuberculous epididymitis in adults in the tropics. MATERIAL AND METHODS: This was a retrospective study of 11 cases of confirmed and treated tuberculous epididymitis. RESULTS: The most frequently affected age-group was 40-49 years. The commonest expression was that of a chronic epididymal nodule. The diagnosis was confirmed by histological examination of the epididymectomy specimen (10 cases) and bacteriology in one case. Combination antituberculous chemotherapy was systematically administered and epididymectomy was performed in all patients. CONCLUSION: The diagnosis of tuberculous epididymitis is often very difficult in the absence of a history of recent or active tuberculosis. However, this diagnosis must be considered in any case of chronic epididymal nodule, particularly in a context of infertility. The very mutilating treatment consists of epididymectomy in chronic forms, which also constitutes a diagnostic confirmation procedure, hence the value of prevention based on eradication of tuberculosis.

Adult↗
PubMed1998

[Erectile dysfunction in diabetics. Epidemiological profile in Senegal].

OBJECTIVE: The objective of this study was to report the epidemiological profile of erectile dysfunction in a population of diabetic men. MATERIAL AND METHODS: This was a prospective study including 431 diabetic patients seen in the outpatients department. 69 of these patients suffered from erectile dysfunction. A control group of 138 patients was randomly selected according to age from among the remaining 362 patients. Each patient was submitted to complete clinical examination. The medical and surgical history, particularly vascular, neurological, endocrine and urological, was recorded. The patient's smoking and drinking habits and treatment with any antidiabetic or other drugs were also recorded. Statistical analysis was performed according to the case-control method. The limit of significance was p < 0.05. RESULTS: The overall prevalence of erectile dysfunction was 16%. This rate is lower than those reported in the literature. Among the various risk factors, only complications of diabetes, especially neurological complications, were clearly correlated with the risk of erectile dysfunction (p = 0.0004). Similarly, the prevalence of erectile dysfunction increased with the duration of diabetes (p = 0.049). CONCLUSION: The prevalence of erectile dysfunction in diabetic patients often appears to be overestimated in the literature. Methodological biases would explain the marked variation of reported prevalence rates. In contrast, our study confirms previous reports that neurological factors play a predominant role.

Adolescent↗
PubMed1996

[Neurologic aspects of vesico-vaginal fistula of obstetrical origin].

OBJECTIVE: To study the electromyographic alterations of the urethral sphincter, perineal muscles and lower limbs observed in women with obstetric vesicovaginal fistula. METHODS: We compared a group of 22 women with obstetric vesicovaginal fistula with a control group of 10 women without fistula. Each woman underwent a neurological examination of the perineum and lower limbs and electromyography of the lower limbs and urethral sphincter. According to the classification proposed by MENSAH, the fistulas were classified as simple (54.5%), complex (31.8%) and complicated (13.6%). RESULTS: Twenty women with VVF presented a peripheral nerve lesion. Five of these patients had a clinical and electromyographic lesion; while the other fifteen patients had a subclinical lesion. 68.18% of the fistula patients presented a clinical neuropathy in the perineum. This lesion was detected on electromyography in all patients with fistula. The severity of this denervation lesion ranged from moderate (36.37%) to severe (63.63%). No neurological lesions were detected in the control group. The degree of denervation has more severe in young women (21-25 years) and in primiparous women. In contrast, the severity of denervation did not appear to be related to the history of the fistula. The risk of treatment failure increased proportionally to the severity of denervation. 73% of fistulas with severe denervation remained "unsuturable", or required multiple operations with disappointing results in the form of persistent vesicosphincteric dysfunction. CONCLUSION: Although the psychosocial impairment and upper urinary tract repercussions have been well evaluated, the peripheral neurological lesion has always been underestimated in the management of obstetric vesicovaginal fistulas. The authors consider that the fistula is only the apparent manifestation of "neurovesical damage", which remains the decisive factor in the prognosis and which largely explains the high frequency of treatment failure.

Adult↗
PubMed1996

[Epididymal manifestations of urogenital tuberculosis].

The morbidity of tuberculous epididymitis is due to the risk of male infertility secondary to vasal or epididymal obstruction or testicular necrosis. The aim of this study was to emphasize the epidemiological, clinical and therapeutical aspects of tuberculous epididymitis in adult. About eleven cases of epididymal localisation of urogenital tuberculosis, it appears that the diagnosis of the condition is rather difficult and often necessitate pathological exam of a specimen of epididymectomy. In other aspects, if antituberculous drugs are always effective in initial stages, surgery is usually radical, and rarely conservative. The latter procedures are vasovasostomy or vasoepididymostomy whose results are very hazardous.

Adult↗
PubMed1994

[Delayed emergency repair of traumatic ruptures of the posterior urethra].

The management of posterior urethral injuries is still a matter of controversies. Some authors recommend a primary or delayed emergency repair procedure, while others prefer late repair. The analysis of our series of fifteen cases showed that when patients are treated by delayed emergency operation, the results are usually good. However, when repair is performed later, results are less satisfactory, and the rate of impotence is higher. We conclude that delayed emergency repair operation is the procedure of choice in the management of ruptured posterior urethra.

Adolescent↗
PubMed1993

[Duckett's+ simple surface or double surface? Comparison of 2 urethroplasty procedures. Report of 91 hypospadias].

The results and complications of the treatment of hypospadias were studied in relation to the two pedicle foreskin mucosal flap techniques described successively by Duckett, "single surface" and "double surface". 91 urethroplasties were performed: 58 "single surface" and 33 "double surface" Duckett urethroplasties. The children were operated between the ages of 18 months and 16 years with a mean age of 4 years. 75% of children had a good result on long-term follow-up. In the case of major complications, essentially fistula, distal necrosis àf the urethra or stricture, a single reoperation increased the percentage of good results to almost 98% for the entire series. However, when the two procedures were compared, a good result was obtained immediately in 81% of cases for the "single surface" operation versus 66% for the "double surface" operation. The fistula rate was 27.2% with the "double surface" flap versus 13.7% with the "single surface" flap and the distal stricture rate was 15.1% with the "double surface" flap versus 3.4% with the "single surface" flap. In the light of these results, Duckett's "double surface" procedure has been abandoned in favour of the "single surface" flap.

Adolescent↗