Evaluation of Endo-Urological Surgical Activity in the Urology Department at Ngor Health Center

Abstract

Introduction : Endo-urology has revolutionized urology in recent decades, enabling less invasive procedures to be performed. The temporary redeployment of the urology department of the Aristide Le Dantec university hospital to the Ngor health center has enabled this peripheral health facility to receive endo-urological surgical equipment. The aim of our work was to evaluate the practice of endo-urological surgery at the Ngor health center, with particular emphasis on the clinical profile of patients and surgical indications. Material and Methods : This was a retrospective descriptive study conducted in the urology department of the Ngor health center over a 12-month period, from January 1, 2023 to December 31, 2023, collating 78 records of patients operated on endo-urologically. Data analysis was performed using Excel 2016 software. The parameters studied were: Global parameters (frequency, age, gender, different endo-urological procedures) and specific parameters (frequency, age, indications and morbidity). Results : During our study period, out of 259 surgical procedures performed in the operating theatre of the urology department of the Ngor health center, 78 patients (30.1%) underwent endourological surgery. The mean age was 53.9 ± 14.3 years (24 and 83 years). The sex ratio was 2.4. JJ stent insertion was the predominant procedure performed in 25 patients (32%). Trans-urethral resection of prostate (TURP) was performed in 18 patients (23.1%). The mean age of patients undergoing TURP was 71 years. Bladder retention was the main indication for TURP in 10 patients. All patients were able to resume micturition after removal of the catheter. The main intraoperative complication was significant hemorrhage, with difficulties in achieving satisfactory hemostasis in 3 patients. Trans-urethral resection of bladder (TURB) was performed in 15 patients (19.2%). Mean age was 56 years (25 and 77 years). The majority of patients were male (n = 12). Bladder tumour was the main indication in all our patients. Intraoperative complications included 2 cases of bladder perforation. EUS was performed in 6 patients. The average age was 56 (30 and 73 years). Bulbar urethral stricture was the indication in all our patients. JJ stent was mainly indicated in female patients (n = 13). Ureterohydronephrosis was the main indication for JJ catheterization in 13 patients. It was bilateral in 5 patients. It was effective in 2 patients with a history of pregnancy. Technical incidents were reported: difficulty in catheterizing the ureteral meatus (1 patient) due to invasion of the ureteral meatus, and a false route (1 patient). URS was performed in 14 patients (17.9%). The mean age was 42 years (28 and 66 years). The sex ratio was 1. Ureteroscopy (URS) represented 17.9% of all endo-urological activity. Ureteral lithiasis was the only indication in all patients. Lithiasis was ureteral in 9 patients and renal in 5. JJ catheterization was performed in 10 patients. Lithoclast lithotripsy was effective in 9 patients. Peri-operative morbidity was 5%. Complications related to URS were noted in 4 patients. In 2 patients, a false ureteral route was reported during the procedure. Acute pyelonephritis was observed in 2 patients. Conclusion : These results underline the importance of popularizing endoscopy in our context. Despite the high cost of techniques and equipment, demand is increasing due to the high frequency of urological disorders, particularly prostatic pathologies and lithiasis.