Browsing by Author "Glover-Addy, H."
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Item Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country(African Journal of Paediatric Surgery, 2015-10) Appeadu-Mensah, W.; Hesse, A.A.J.; Glover-Addy, H.; Osei-Nketiah, S.; Etwire, V.; Sarpong, P.Background: Over 300 different operations have been described for the management of hypospadias. In recent times, the numbers of operations used in various centres have gradually reduced as the principles necessary to ensure adequate cosmetic and functional results with minimum complications are better understood. The aim of this article was to review the different types of operations used for managing hypospadias in a tertiary hospital in a developing country, to analyse the complications of surgery and discuss the factors that contribute to complications. Materials and Methods: Patient folders, theatre, and ward records were used to obtain the required information. The age at surgery, types of hypospadias at presentation, types of operations done and complications were analysed. Results and Conclusion: With three main types of operations, tubularised incised plate urethroplasty and meatal advancement and glanuloplasty incorporated for anterior hypospadias (glanular, coronal, subcoronal, distal, midpenile), and lateral based flap urethroplasty for posterior hypospadias (proximal penile, penoscrotal, scrotal, perineal), most hypospadias were corrected with acceptable complication rates. Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country | Request PDF. Available from: https://www.researchgate.net/publication/304269798_Complications_of_hypospadias_surgery_Experience_in_a_tertiary_hospital_of_a_developing_country [accessed Sep 14 2018].Item Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country(African Journal of Paediatric Surgery, 2015-10) Appeadu-Mensah, W.; Hesse, A.A.J.; Glover-Addy, H.; Osei-Nketiah, S.; Etwire, V.; Sarpong, P.Background: Over 300 different operations have been described for the management of hypospadias. In recent times, the numbers of operations used in various centres have gradually reduced as the principles necessary to ensure adequate cosmetic and functional results with minimum complications are better understood. The aim of this article was to review the different types of operations used for managing hypospadias in a tertiary hospital in a developing country, to analyse the complications of surgery and discuss the factors that contribute to complications. Go to: Materials and Methods: Patient folders, theatre, and ward records were used to obtain the required information. The age at surgery, types of hypospadias at presentation, types of operations done and complications were analysed. Go to: Results and Conclusion: With three main types of operations, tubularised incised plate urethroplasty and meatal advancement and glanuloplasty incorporated for anterior hypospadias (glanular, coronal, subcoronal, distal, midpenile), and lateral based flap urethroplasty for posterior hypospadias (proximal penile, penoscrotal, scrotal, perineal), most hypospadias were corrected with acceptable complication rates.Item Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country.(Afr J Paediatr Surg., 2015-12) Appeadu-Mensah, W.; Hesse, A.A.J.; Glover-Addy, H.; Osei-Nketiah, S.; Etwire, V.; Sarpong, P.Background: Over 300 different operations have been described for the management of hypospadias. In recent times, the numbers of operations used in various centres have gradually reduced as the principles necessary to ensure adequate cosmetic and functional results with minimum complications are better understood. The aim of this article was to review the different types of operations used for managing hypospadias in a tertiary hospital in a developing country, to analyse the complications of surgery and discuss the factors that contribute to complications. Materials and Methods: Patient folders, theatre, and ward records were used to obtain the required information. The age at surgery, types of hypospadias at presentation, types of operations done and complications were analysed. Results and Conclusion: With three main types of operations, tubularised incised plate urethroplasty and meatal advancement and glanuloplasty incorporated for anterior hypospadias (glanular, coronal, subcoronal, distal, midpenile), and lateral based flap urethroplasty for posterior hypospadias (proximal penile, penoscrotal, scrotal, perineal), most hypospadias were corrected with acceptable complication rates.Item Continent cutaneous diversion for bladder exstrophy in adults(African Journal of Urology, 2013-06) Mensah, J.E.; Asante, E.K.; Mensah, W.A.; Glover-Addy, H.Objectives: Bladder exstrophy is a rare and devastating congenital anomaly. These patients are usually seen immediately after birth where correction can be attempted. Presentation in adulthood where bony fusion has occurred and bladder capacity is very low presents a major surgical challenge. Such patients require urinary diversion. This is a review of our initial experience with continent cutaneous urinary diversion in patient with classic bladder exstrophy who presented in adulthood. Patients and methods: We reviewed the social and clinical characteristics, operative reports, and postoperative course of two female and five male patients who have been living with bladder exstrophy since birth. They underwent augmentation cystoplasty or simple cystectomy, bladder neck transection, repair of epispadias followed by a continent cutaneous diversion. The continent catheterizable outlet was constructed using the serous lined extramural tunnel technique as a continence mechanism. Postoperative continence, renal function, and changes in social life were documented. Results: Follow-up has ranged from 17 months to 5 years in these initial patients. Thus far, all these patients have achieved complete daytime and night time continence, Complications consisted of pouch cutaneous fistula which was successfully repaired with interposition of a rectus abdominis flap and one case of urosepsis. All upper urinary tract imaging studies have shown stable function. All the patients are doing well with improved social interaction. Conclusion: Bladder neck closure in conjunction with continent cutaneous diversion is a reliable and safe method for achieving continence in adults presenting with bladder exstrophy. Total continence can be achieved without resorting to multiple complex and expensive surgeries. © 2013 Pan African Urological Surgeons' Association.Item Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: An initial experience(African Journal of Paediatric Surgery, 2011-05) Mensah, Y.; Glover-Addy, H.; Etwire, V.; Twum, M.; Asiamah, S.; Appeadu-Mensah, W.; Hesse, A.Background: Intussusception is a common abdominal emergency in children which necessitates prompt diagnosis and management. Nonsurgical methods of managing this condition are rapidly gaining popularity with fluoroscopic-guided pneumatic reduction being one of such methods that has been used with great success in many countries. We present our initial experience with fluoroscopic-guided pneumatic reduction of intussusception at Korle Bu Teaching Hospital which is also the first time the technique has been used in Ghana. Materials and Methods: A total of 18 children were enrolled in the study between August 2007 and February 2008 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were given air enema under fluoroscopic-guidance using locally assembled equipment. The intraluminal pressure was monitored with a pressure gauge and was not permitted to go above 120 mmHg. A total of three attempts of 3 min each were allowed. Results: There were 12 males and 6 females. The average age of the patients was 8.3 months (SD= 3 months). Twelve (67%) of the cases were reduced successfully while 6 (33%) failed to reduce. A majority of those that did not reduced had symptoms for at least 2 days. Bowel perforation occurred in three (16.7%) cases. Conclusion: Pneumatic reduction of intussusception is a cost-effective and rapid method of management of intussusception. It however has limitations like high reported rate of bowel perforation and limited ability to identify lead points. The benefits however seem to outweigh these challenges, such as fluoroscopic-guided pneumatic reduction has a very high success rate. Fluoroscopic guided pneumatic reduction should be considered as one of the primary modes of reduction in Ghana and other neighbouring countries that are yet to practice it.Item Pneumatic reduction of intussuseception in children at the Korle-Bu Teaching Hospital- an initial experience(African Journal of Paediatric Surgery, 2011) Mensah, Y.B.; Glover-Addy, H.; Etwire, V.; Twum, M.B.; Asiamah, S.; Appeadu-Mensah, W.; Hesse, A.A.J.Item Prevalence of severe acute rotavirus gastroenteritis and intussusceptions in Ghanaian children under 5 years of age(Journal of Infection in Developing Countries, 2012-02) Enweronu-Laryea, C.C.; Sagoe, K.W.C.; Glover-Addy, H.; Asmah, R.H.; Mingle, J.A.; Armah, G.E.Introduction: Vaccination is the most effective preventive strategy against rotavirus disease. Regional differences in prevalent rotavirus genotypes may affect vaccine efficacy. Pre-vaccine surveillance for burden of rotavirus disease, prevalent rotavirus genotypes, and association between rotavirus disease and intussusceptions helps in monitoring the impact of vaccination. Methodology: A prospective study was conducted from January 2008 to December 2009 in children younger than five years hospitalized for longer than 24 hours with acute gastroenteritis. Data on confirmed cases of intussusception were collected retrospectively. Stools were tested by enzyme immunoassay, reverse-transcriptase polymerase chain reaction and nucleotide sequencing. Results: Acute gastroenteritis (AGE) caused 13.1% (2,147/16,348) of hospitalizations among children under five years. Stools were tested for 50.2% (1077/2147) of AGE cases. Of these, 49% (528/1077) were rotavirus positive. Rotavirus gastroenteritis, non-rotavirus gastroenteritis, and intussusceptions were most prevalent in children under 15 months [80.3%, 74% and 91% respectively]. Rotavirus was detected from more than 60% of acute gastroenteritis cases during peak months. The prevalence of intussusception showed no seasonal pattern. The peak ages of six to twelve months for acute gastroenteritis and five to eight months for intussusception overlapped. G1, G2 and mixed G/P genotypes were common in the isolated rotaviruses. Conclusion: Rotavirus gastroenteritis causes significant morbidity in children younger than five years of age in Ghana. Although the peak age of rotavirus gastroenteritis and intussusceptions overlapped, there was no seasonal correlation between them. The high prevalence of mixed G/P genotypes in Ghanaian children may affect the effectiveness of vaccination. © 2012 Enweronu-Laryea et al.Item Ultrasound Guided Hydrostatic Reduction of Intussusception in Children at Korle Bu Teaching Hospital: An Initial Experience(Ghana Medical Journal,, 2005) Mensah, Y.; Glover-Addy, H.; Twum, M.Intussusceptions is the telescoping or invagination of a portion of intestine (intussusceptum) into an adjacent segment (intussuscipiens). It is one of the common causes of bowel obstruction in infants and toddlers. Sonography has now been accepted as a method for guiding hydrostatic reduction of intussusception with tap water, normal saline or Ringer's lactate solution. This method is currently being used at Korle Bu Teaching Hospital. It is a very simple, efficient, economical and quick method of managing intussusception. The duration of the procedure ranges between two minutes and thirty minutes, with the majority being under ten minutes. A total of twenty intussusceptions were managed in eighteen patients over a nine month period. In fifteen patients (75%) the intussusception was reduced successfully. In five patients (25%), the procedure failed to reduce the intussusceptions.