Video transmission of urology surgeries: proof of concept in a resource-constrained environment
Video capture is widely used to transmit, record and archive, open and minimal access procedures across a variety of interventional disciplines. It is used as an educational tool for operators, trainees, and observers, for audit and monitoring of performance indicators and for medicolegal purposes.
The use of penile fasciocutaneous island flaps in the repair of complex anterior urethral strictures in Kumasi, Ghana
Managing urethral strictures entails numerous treatment options such as dilation, direct vision internal urethrotomy (DVIU) and reconstructive surgical procedures. The use of flaps or grafts is required in patients with longer and complex anterior urethral strictures. Staged urethroplasty which is also an option of treatment in such cases is associated with increased morbidity, financial burden, and problems with psychosocial adjustment.
A five-year review of presentation and management outcome of acute testicular torsion in two Nigerian referral centres
Undescended testes (UDT) is the absence of at least one testicle from the scrotum. Approximately one-third of premature boys have at least a unilateral UDT, compared to 2–8% incidence in full-term boys, which makes cryptorchidism the most common anomaly in boys. Spontaneous descent of the testis after six months of age occurs very rarely, therefore the “watchful waiting” strategy is not justified in these boys. Unilateral UDT is four times more common than bilateral UDT. Locally there is a paucity of data surrounding patients with UDT. At what age these patients first present and the waiting time till surgery is unknown. The incidence and prevalence of unilateral versus bilateral UDT and if this compares to international data is also not known. This study can illuminate an African perspective on this worldwide condition.
The utility of PSA density and free PSA in the prostate biopsy decision pathway in a South African population
Prostate cancer is the most common cancer in South African men, apart from skin cancer. Serum prostate-specific antigen (PSA) testing of asymptomatic men has been used since the late 1980s as a screening test for prostate cancer, with the aim of detecting prostate cancer while it is still amenable to cure. However, controversy around this practice has intensified recently because evidence has not indicated that screening for prostate cancer saves lives. Moreover, prostate cancer screening is associated with potential harm including complications from biopsies or from treatment of clinically insignificant disease. The diagnosis of prostate cancer is ultimately made based upon histopathology obtained through a prostate biopsy. This is an invasive procedure and carries risks including bleeding, infection, urinary retention and, rarely, death.
A case report of ureteroureterostomy for a complete duplex system of the kidney with an ectopic ureter
Duplex anomalies are common and more frequently recognised in females. Presentation depends on the exact anatomical configuration of the abnormality. The anomalies can be associated with ectopic ureters, ureteroceles, obstruction, vesicoureteral reflux (VUR), urinary tract infections (UTIs), incontinence, and varying degrees of renal function loss. There are multiple surgical approaches to correct these disorders when sequelae are sufficient to warrant intervention. There is, however, limited high-quality evidence to justify a certain approach over another. Traditional opinion has favoured an upper pole nephrectomy (UPN) for an upper moiety with poor function.
Focus on fosfomycin trometamol
Fosfomycin, a phosphonic acid derivative and a naturally-occurring antibiotic, was disco vered in 1969 when it was successfully cultured from Streptomyces spp. Fosfomycin is in an antimicrobial class of its own and is structurally unrelated to any other agent currently approved for clinical use. Fosfomycin was initially developed as a calcium salt for oral use and a sodium salt for intravenous use. The tromethamine salt (also known as trometamol) is water soluble and provides markedly improved oral bioavailability compared to the calcium salt.
Focus on solifenacin
Overactive bladder syndrome (OAB) is a chronic medical condition that can have a major effect on quality of life. OAB causes a frequent and sudden urge to urinate that may be difficult to control and can also lead to urinary incontinence. First-line treatment starts with behavioural therapies such as bladder training, pelvic floor muscle exercises, and fluid management. After lifestyle interventions, anticholinergic drugs are the next step in treating OAB. Antimuscarinics are the drug class of choice for OAB symptoms and have proven efficacy.