Journal of the West African College of Surgeons最新文献

{"title":"Colonoscopy findings in patients with haematochezia in Benin (South-South Nigeria): A 9-year prospective study.","authors":"Omorodion Omoruyi Irowa, Peter Ikponmwosa Agbonrofo, Vincent Isibor Odigie","doi":"10.4103/jwas.jwas_126_23","DOIUrl":"10.4103/jwas.jwas_126_23","url":null,"abstract":"<p><strong>Background: </strong>Colonoscopy is an important armamentarium in the investigation of haematochezia. Patients with haematochezia are very anxious about the presence of blood in their faeces. They are usually referred for diagnostic colonoscopy based on the presence of blood in stool or anaemia.</p><p><strong>Aims/objectives: </strong>To highlight the causes of haematochezia in patients over a 9-year prospective period in the Premier tertiary health centre in the South-South zone of Nigeria.</p><p><strong>Materials and methods: </strong>All Consecutive patients seen in our surgical services (June 1, 2009, to May 30, 2018) requiring colonoscopy for haematochezia were entered into a proforma. The demographics, findings at colonoscopy, and outcome of colonoscopy were analysed.</p><p><strong>Results: </strong>Three hundred and sixty-five colonoscopies were done during the study period; of these, 44% (160 patients) had a colonoscopy for haematochezia. Mean age of patients was 54.7 years. Age range was 16-86 years. Cluster age group was fifth to seventh decade (62.5%). The male-to-female ratio was 2:1. Causes of haematochezia were Haemorrhoids 32.5%, large bowel cancer 23.8%, diverticular disease 10%, inflammatory disease of the bowel 6.3%, polyps 3.8%. About 15% of the patients had more than one colonic site of bleeding. The most common subsites for colon cancer were rectum and sigmoid colon (79.6%), in 11 patients (6.8%) was the tumour within reach of the examining finger. Repeat colonoscopy occurred in 3 patients (0.8%). The most common complication of colonoscopy was bleeding (0.8%). Two patients (0.5%) had colonic perforation.</p><p><strong>Conclusion: </strong>Forty-four percent (44%) of colonoscopy in Benin, South-South Nigeria has haematochezia as its indication. The cluster age group is the fifth to seventh decade. One in four patients had colon cancer and in 6.8% the tumour was within reach of the examining finger. It is the authors' opinion that colonoscopy should be routinely done in patients with haematochezia in South-South Nigeria.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of shoulder joint derangements with magnetic resonance imaging in adult Nigerians.","authors":"Bukunmi Michael Idowu, Stephen Olaoluwa Onigbinde, Babalola Ishmael Afolabi, Oghenetejiri Denise Ogholoh, Nkem Nnenna Nwafor, Tolulope Adebayo Okedere","doi":"10.4103/jwas.jwas_144_23","DOIUrl":"10.4103/jwas.jwas_144_23","url":null,"abstract":"<p><strong>Objectives: </strong>Shoulder pain secondary to various aetiologies is a common musculoskeletal complaint worldwide, and Magnetic Resonance Imaging (MRI) is the most accurate imaging method for evaluating shoulder pain in all age groups. While the patterns of shoulder MRI abnormalities in various demographics have been reported, data on sub-Sahara African populations are still sparse. This study aims to describe the imaging features and spectrum of shoulder joint pathologies on MRI in adult Nigerians.</p><p><strong>Materials and methods: </strong>This was a retrospective review of the shoulder MRI of 100 adult Nigerians (with and without trauma) from September 2020 to December 2021. Their clinical data and shoulder MRI findings were extracted and analysed. Statistical significance was set at <i>P</i> ≤ 0.05.</p><p><strong>Results: </strong>There were 64 males and 36 females aged 18-82 years. Right shoulder MRI was done in 53 subjects (53%), while the left shoulder was studied in 47 (47%). Supraspinatus tendinopathy (73%), acromioclavicular joint arthropathy (68%), and subacromial-subdeltoid (SASD) bursitis (64%) were the most frequently detected pathologies. Other demonstrated derangements include glenohumeral joint effusion (24%), long head of biceps tendon sheath effusion (18%), labral abnormalities (16%), subcoracoid bursitis (4%), Hill Sach's deformity (3%), anterior glenohumeral dislocation (2%), fatty degeneration of the supraspinatus/infraspinatus muscles (2%), adhesive capsulitis (1%), and other bony abnormalities (contusion, erosion, subchondral cysts). There was no significant difference in the frequency of shoulder abnormalities between the male and female subjects.</p><p><strong>Conclusion: </strong>Acromioclavicular joint arthropathy, SASD bursitis, and rotator cuff disorders were the dominant pathologies in the participants' shoulders.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency department visits following transurethral resection of prostate in the elderly: Does duration of postoperative catheterization count?","authors":"Nasir Oyelowo, Abdullahi Sudi, Mudi Awaisu, Musliu Adetola Tolani, Ahmad Tijani Lawal, Muhammed Ahmed, Ahmad Bello, Hussaini Yusuf Maitama","doi":"10.4103/jwas.jwas_151_23","DOIUrl":"10.4103/jwas.jwas_151_23","url":null,"abstract":"<p><strong>Background: </strong>Elderly patients with benign prostatic hyperplasia are increasingly having minimally invasive surgeries due to their safety. There is also a drive to minimize the duration of postoperative catheterization following transurethral resection of the prostate to reduce hospital stay and encourage early ambulation. These are desirable in the elderly to improve outcomes. Can early catheter removal be done safely in the geriatrics without an increase in presentation to the emergency department with complications? We compare the emergency presentation of elderly patients who had early and delayed catheter removal following transurethral resection of the prostate.</p><p><strong>Materials and methods: </strong>This was a retrospective review of transurethral resection of the prostate in the elderly (≥70 years) within 2 years in a single hospital. All the patients had monopolar transurethral resection of the prostate and were categorized based on the duration of postoperative catheterization as either early (third postoperative day) or delayed (> third postoperative day). The duration of catheterization was based on surgeon preference. Patients with intraoperative complications were excluded. Data on clinical presentation, comorbidities, and presentation at the emergency department were retrieved and analysed.</p><p><strong>Results: </strong>Forty-one patients were studied with the mean age of patients being 76 ± 4 years. Twenty patients had early catheter removal and 21 had delayed catheter removal. A total of nine patients presented to the emergency department within the 30-day postoperative period with either bleeding urinary retention or incontinence requiring re-catheterization, six had early catheter removal, and three had delayed catheter removal. The catheter duration, preoperative ASA status prostate volume, and preoperative indwelling catheter were not statistically significant determinants of presentation to the emergency department in these elderly men. The presence of comorbidities assessed using the Charlson Comorbidity Index was a statistically significant variable to presentation at the emergency department after surgery <i>P</i> = 0.006.</p><p><strong>Conclusion: </strong>Early catheter removal is safe in elderly patients following transurethral resection of the prostate, however, there is a risk of presentation to the emergency department with complications, especially in patients with comorbidities.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of inflammatory cytokines in maternal serum for assessing the outcome of threatened miscarriage.","authors":"Hakeem A Lawal, Gbolahan O Obajimi, Yusuf O Bello, Abdul Fatai Onifade, Muideen A Jimoh, Ayodele O Arowojolu, Imran O Morhason-Bello","doi":"10.4103/jwas.jwas_136_23","DOIUrl":"10.4103/jwas.jwas_136_23","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates the use of pro- and anti-inflammatory cytokines in predicting the outcome of pregnancy complicated by threatened miscarriage.</p><p><strong>Materials and methods: </strong>Of the 140 eligible pregnant women recruited for the study, maternal serum levels of selected inflammatory cytokines (IL-2, IFNγ, IL-4, and IL-13) for 70 women with threatened miscarriage were analysed for this study. Serum concentrations were measured using the enzyme-linked immunosorbent assay (ELISA) kit. Inevitable miscarriage or ongoing pregnancy was used as the outcome, whereas serum levels of selected inflammatory cytokines, women's sociodemographic characteristics, gynaecologic history, and clinical history were used as the explanatory variables. The Student's <i>t</i> test was used to compare the cytokine profiles between women with inevitable miscarriages and women with normal ongoing pregnancy after 13 weeks of gestation. Poisson regression models were performed to investigate the factors associated with inevitable miscarriage.</p><p><strong>Results: </strong>The result revealed significantly higher pro-inflammatory cytokines, IL-2 (<i>P</i> < 0.001), and IFNγ (<i>P</i> < 0.001) in women with a pregnancy that resulted in an inevitable miscarriage than in those that resulted in an ongoing pregnancy. The incidence rate of inevitable miscarriage increased by 16% (IRR = 1.16, 95% CI: 0.58-2.32) for a unit increase in IL-2 and by 25% (IRR = 1.25, 95% CI: 1.09-1.43) when adjusted for sociodemographic characteristics, gynaecology, and clinical history.</p><p><strong>Conclusion: </strong>The IL-2 was the best biomarker for predicting the outcome of threatened pregnancy with a sensitivity of 80% and a specificity of 70% at 1.30 pg/mL cut-off point.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the effects of pre-emptive oxycodone, diclofenac, and gabapentin on postoperative pain after tibia fracture surgery: A randomized clinical trail.","authors":"Ramin Abrishami, Mehri Farhang Ranjbar, Amirreza Modir, Seyyed Kamal Hejazi","doi":"10.4103/jwas.jwas_143_23","DOIUrl":"10.4103/jwas.jwas_143_23","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain (POP) is one of the most common and most important types of pain.</p><p><strong>Objectives: </strong>The aim of this study was to compare the effects of pre-emptive oxycodone, diclofenac, and gabapentin on postoperative pain (POP) among patients with tibia fracture surgery.</p><p><strong>Materials and methods: </strong>This double-blind three-group randomised controlled trial was conducted in 2023. Participants were 111 candidates for tibia fracture surgery under general anaesthesia. They were randomly allocated to oxycodone, gabapentin, and diclofenac groups through block randomisation. Baseline arterial oxygen saturation, heart rate, and blood pressure were documented before surgery and POP and sedation status were measured during postoperative recovery and 2, 4, 6, 12, and 24 h after surgery. Postoperative opioid analgesic use was also documented. The data were analysed using the SPSS software (v. 20.0) at a significance level of less than 0.05.</p><p><strong>Results: </strong>Groups did not significantly differ from each other respecting participants' baseline age, gender, body mass index, arterial oxygen saturation, heart rate, blood pressure, and surgery duration (<i>P</i> > 0.05). Moreover, there were no significant differences among the groups respecting POP and sedation status at different measurement time points (<i>P</i> > 0.05), except for six hours after surgery at which the POP mean score in the gabapentin group was significantly less than the other two groups (<i>P</i> = 0.001). Among-group differences respecting postoperative use of opioid analgesics and medication side effects were also insignificant (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Pre-emptive oxycodone, diclofenac, and gabapentin significantly reduce POP among patients with tibia fracture surgery, though gabapentin may produce more significant analgesic effects. All these three medications can be used for pre-emptive analgesia. Of course, the best pre-emptive analgesic agent is determined based on the opinion of the treating physician.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Domestic violence against women with infertility attending gynaecological clinics in Northern Nigeria: A multi-centre study.","authors":"Adewale Olufemi Ashimi, Muhammad Baffah Aminu, Folorunsho Benard Adewale, Aisha Abdurrahman, Yunus Eze Muhammad","doi":"10.4103/jwas.jwas_156_23","DOIUrl":"10.4103/jwas.jwas_156_23","url":null,"abstract":"<p><strong>Background: </strong>Due to the high premium placed on childbearing, infertility puts a lot of stress on the family which may result in aggressive and irrational behaviour if not properly managed. Domestic violence (DV) against infertile women is a public health issue but under-reported especially in northern Nigeria.</p><p><strong>Objectives: </strong>This study sought to identify the prevalence, pattern, and response to DV.</p><p><strong>Materials and methods: </strong>This was a descriptive cross-sectional study carried out at three tertiary health facilities; one in each of the geopolitical zones in northern Nigeria. Using a pretested interviewer-administered questionnaire; the prevalence, pattern, and response to DV were determined among 422 respondents who were attending the gynaecological clinics of the three health facilities. The data obtained was entered into SPSS version 22.0 and analysed.</p><p><strong>Results: </strong>The prevalence of DV among women with infertility in the previous year was 39.8% (167/422). Among the survivors, 92.8% (155/167), 35.3% (59/167), and 10.7% (18/167) had experienced psychological aggression, physical assault, and sexual violence, respectively. A significant number of respondents who reported DV were Christians (<i>P</i> = 0.01). Of them, 77 (46.1%) never discussed the issue with anyone, 72 (43.1%) informed their family, and 30 (18.0%) sought help from the husband's family.</p><p><strong>Conclusion: </strong>The prevalence of DV among women with infertility is high, psychological aggression is the most typical form of DV experienced while about half have never reported the incidence to anyone. Screening infertile women for DV during their visit to the gynecological clinics would be beneficial; those found to have experienced DV should be counselled and supported appropriately.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of painful blind eye in Africa: A review.","authors":"Dumebi Hedwig Kayoma, Darlingtess Abies Oronsaye","doi":"10.4103/jwas.jwas_164_23","DOIUrl":"10.4103/jwas.jwas_164_23","url":null,"abstract":"<p><strong>Background: </strong>Painful blind eye conditions in Africa constitute a compelling area of concern within public health, presenting substantial complexities for healthcare systems and the individuals afflicted. This comprehensive review delves into recent research and advancements concerning the management of these conditions across the African region. Drawing upon contemporary studies and data, we scrutinise the multifaceted aspects, including prevalence rates, causative factors, and regional variations.</p><p><strong>Objective: </strong>To review existing articles on the current state of the management of blind painful eye conditions in Africa.</p><p><strong>Materials and methods: </strong>Articles regarding the subject were obtained from Google Scholar, AJOL, and PubMed using the keywords, painful, blind eye (PBE), Africa.</p><p><strong>Results: </strong>Forty-four relevant articles were reviewed. They were further categorized into epidemiology, management approaches and challenges to management.</p><p><strong>Conclusion: </strong>The management of the PBE poses a huge challenge and can either be medical or surgical. Collaborative efforts should be targeted at preventing the causes of a PBE. As the burden of painful blind eye conditions continues to exert a profound impact across Africa, this article underscores the pressing need for collaborative efforts involving governments, non-governmental organisations, and international entities. By prioritising awareness and enhancing healthcare accessibility, we collectively strive towards the alleviation of suffering and the prevention of avoidable visual impairment in this region.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile of gastroduodenal perforation patients admitted in a rural tertiary care hospital: An observational cross-sectional study.","authors":"Gourab Bose, Amit Ray, Shah Nawaz Ali, Kaushik Ishore","doi":"10.4103/jwas.jwas_140_23","DOIUrl":"10.4103/jwas.jwas_140_23","url":null,"abstract":"<p><strong>Background: </strong>Gastro-duodenal perforation is a common surgical emergency that remains a formidable health burden worldwide with significant morbidity and mortality. Ulcer disease remains the most common cause of gastro-duodenal perforation. Diagnosing the presence of <i>H. pylori</i> can help eradicate the infection from the community at large and thereby reduce the chances of gastro-duodenal perforation.</p><p><strong>Aims: </strong>To assess the clinical presentation of gastro-duodenal perforation patients and to evaluate the detection of <i>Helicobacter pylori</i> infection by available investigations.</p><p><strong>Materials and methods: </strong>A descriptive observational study was conducted among 80 patients presenting with clinical features suggestive of gastro-duodenal perforation and confirmed by clinical, radiological basis and operative findings admitted at a rural tertiary care hospital during 2019-2020. Detailed history was taken from the patient/party, clinically examined, and blood/tissue samples were investigated. The patients were managed with standard treatment modality in the studied institute. Data were collected, compiled, and entered MS Excel and analyzed using appropriate software. Descriptive analysis was done in the form of proportion for categorical variables, mean or median for continuous variables.</p><p><strong>Result: </strong>Cases of gastro-duodenal perforations were more among middle to later age of life, mostly affecting married male patients hailed from rural area and unskilled workers. History of intake of spicy food, prolonged starvation, history of NSAID use were common among them. Majority of the patients had history of pain abdomen in the past suggesting of PUD and history of taking variety group of acid reducing agents. Most of them presented with epigastric pain, vomiting, abdominal distension along with other signs of peritonitis. Obliteration of liver dullness and free gas under right dome of diaphragm was also noted in large proportion among them. Majority of cases were found positive for <i>H. pylori</i> on Histology (85%), followed by rapid urease test (RUT) (80%) and a positivity of 72.5% and 68.8% on serum IgG and IgA antibody respectively. Rapid Urease Test was more sensitive as well as specific in diagnosing of <i>H. pylori</i> than antibody detection test.</p><p><strong>Conclusion: </strong>Early detection of <i>H. pylori</i> infection and treatment with potent anti <i>H. pylori</i> therapy postoperatively has been found to be adequate.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical iridectomy: A stop-gap for penetrating keratoplasty in a resource-limited setting.","authors":"Samuel Enejo Ocheni, Daniel Ikechukwu Oseji, Emmanuel Olu Megbelayin, Feyi Grace Adepoju","doi":"10.4103/jwas.jwas_132_23","DOIUrl":"10.4103/jwas.jwas_132_23","url":null,"abstract":"<p><p>Corneal opacities are a major source of corneal morbidity in Africa and many resource-limited parts of the world. Unfortunately, there is a dearth of specialist corneal services either from lack of manpower or non-availability of materials and tools. This makes penetrating keratoplasty inaccessible from prohibitive cost or lack of donors. The index case was a 45-year-old indigent female farmer who presented with a right atrophic eye and defective vision on the left eye due to stick injury from farm work. Examination revealed a 2/60 eccentric vision and extensive adherent leukoma on the left eye. Superonasal optical iridectomy was done and vision improved to 6/18 with correction at sixth postoperative week. In conclusion, optical iridectomy, in selected patients, can restore useful vision.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of post-decompressive haematuria in rapid versus gradual bladder decompression in patients with chronic urinary retention.","authors":"Peter Olalekan Odeyemi, Najeem Adedamola Idowu","doi":"10.4103/jwas.jwas_5_24","DOIUrl":"10.4103/jwas.jwas_5_24","url":null,"abstract":"<p><strong>Background: </strong>Chronic urinary retention (CUR) is a common urological emergency. Initial management involves the drainage of the bladder by urethral catheterisation. Relief of CUR may be associated with post-decompressive haematuria. The two primary methods of emptying the obstructed bladder are rapid and gradual emptying. The method of relief of CUR to reduce this complication has been debated for decades.</p><p><strong>Objective: </strong>To compare the risk of post-decompressive haematuria following rapid versus gradual urinary bladder decompression in patients with CUR.</p><p><strong>Materials and methods: </strong>This was a prospective, randomised study in which patients with CUR were randomised into two groups: group A and group B. Group A had rapid urinary decompression with an 18 Fr urethral catheter attached to a urine bag, whereas group B had gradual decompression using a urethral catheter attached to an intravenous fluid-giving set, which was then attached to the urine bag. Post-decompressive haematuria in each group was assessed at designated times and documented based on a research protocol.</p><p><strong>Data analysis and result presentation: </strong>Data were analysed using the Statistical Package for Social Sciences (IBM) SPSS version 21. Data were summarised by descriptive statistics. The two arms were compared for similarities in demographic variables. Continuous and categorical variables were compared using the Student's <i>t</i> test and Pearson's chi-square test, respectively. The results of the analysis were presented with the aid of bar charts and tables for clarity. Significant <i>P</i> value was ≤0.05.</p><p><strong>Result: </strong>Sixty patients were recruited into the study and randomised into groups A (rapid urinary decompression) and B (gradual urinary decompression) with 30 patients in each arm of the study. The mean age was 70.92 ± 13.98 years (range 20-96 years). The mean age of the patients recruited into group A was 68.50 ± 14.77 years, whereas that of group B was 73.33 ± 13.19 years. The <i>P</i> value was 0.187. Fifteen patients (50%) developed gross haematuria in group A compared with 7 patients (23.3%) in group B with a statistically significant <i>p</i> value of 0.032. Four (26.7%) of the patients with gross haematuria had blood transfusions in group A, whereas only 1 (16.7%) of the patients with gross haematuria in group B had a blood transfusion. The <i>P</i> value was 0.920.</p><p><strong>Conclusion: </strong>The rate of haematuria is significantly higher in group A with a higher rate of blood transfusion than that of group B. Though gradual urinary decompression is cumbersome, it is recommended to reduce the rate of haematuria and blood transfusion with its associated complications.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}