Browsing by Author "Toboh, B."
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Item Contemporary Evaluation and Treatment of Male Urethral Stricture Disease in West Africa(Current Bladder Dysfunction Reports, 2013-06) Mensah, J.E.; Asante, E.K.; Kyei, M.Y.; Toboh, B.Urethral stricture is a common cause of morbidity and sometime mortality in West Africa. A variety of investigative tool and techniques are currently available to evaluate and manage this condition. Major urological societies have issued evidence based guidelines for the evaluation and management of this disease. In Ghana and West Africa the resources available in the developed world may not be available. The patient population is different with most patients presenting with complications like acute urinary retention. Therefore evidence based guidelines may not be strictly adhered to. We performed a retrospective audit of the evaluation and management of urethral stricture at Korle Bu Teaching hospital in Accra Ghana between November 2011 and November 2012 and compared our findings with published studies from the sub region. Post inflammatory strictures predominate but the percentage is decreasing due to the rapid increase in the incidence of pelvic fracture urethral injury. To reduce the cost of investigation a thorough history and physical examination is essential, imaging tests performed are those that will influence management plan. Although urethrotomy and dilatation are not curative, patients who otherwise would have benefited from urethroplasty are still offered repeated urethrotomy because of lack of theatre space and trained surgeons to perform urethroplasty. For the same reason many patients in the sub region spend many months to years with a suprapubic catheter. © 2013 Springer Science+Business Media New York.Item Penile Strangulation by Self Placement of Metallic Nut: Corporal Cavernosa Tissue Showed Resilience to Thermal Burns Sustained at Removal(Ghana Medical Journal, 2015-03) Kyei, M.Y.; Asante, E.K.; Mensah, J.E.; Klufio, G.O.; Paintsil, A.; Gepi-atee, S.; Morton, B.; Ampadu, K.; Toboh, B.We report a case of a 37-year-old male who presented with a 12-hour history of a strangulating 2cm wide by 0.8 cm thick metallic nut on the penile shaft at the peno- scrotal junction. Unlike instances where these metallic objects are placed to enhance sexual stimulation this nut was rather placed to prevent intercourse. A Bosch electric circular grinder was successfully used for removal but a thermal burn to the penile tissues was sustained in the process as the hardness of the nut required a high energy to cut and its thickness did not allow for effective cooling during the process of removal. This resulted in a circumferential denudation of penile skin, a urethro-cutaneous fistula at the penoscrotal junction and a mid-bulbar urethral stricture. The penile wound was subsequently covered with a split skin graft with a delayed closure of the urethrocutaneous fistula and a buccal mucosa patch urethroplasty for the mid bulbar stricture. Despite the degree of thermal burns sustained the patient has maintained good erectile function with grade four rigidity. The tunica albuginea and the underlying corpora cavernosa have shown a significant degree of resilience to thermal burns compared to the corpora spongiosum where the thermal burns led to a urethrocutaneous fistula.Item Penile Strangulation by self-Placement of Metallic Nut(Ghana medical journal, 2015-03) Kyei, M.Y.; Asante, E.K.; Mensah, J.E.; Klufio, G.O.; Paintsil, A.; Gepi-Atee, S.; Morton, B.; Ampadu, K.; Toboh, B.We report a case of a 37-year-old male who presented with a 12-hour history of a strangulating 2cm wide by 0.8 cm thick metallic nut on the penile shaft at the peno-scrotal junction. Unlike instances where these metallic objects are placed to enhance sexual stimulation this nut was rather placed to prevent intercourse. A Bosch electric circular grinder was successfully used for removal but a thermal burn to the penile tissues was sustained in the process as the hardness of the nut required a high energy to cut and its thickness did not allow for effective cooling during the process of removal. This resulted in a circumferential denudation of penile skin, a urethro-cutaneous fistula at the peno-scrotal junction and a mid-bulbar urethral stricture. The penile wound was subsequently covered with a split skin graft with a delayed closure of the urethrocutaneous fistula and a buccal mucosa patch urethroplasty for the mid bulbar stricture. Despite the degree of thermal burns sustained the patient has maintained good erectile function with grade four rigidity. The tunica albuginea and the underlying corpora cavernosa have shown a significant degree of resilience to thermal burns compared to the corpora spongiosum where the thermal burns led to a urethrocutaneous fistula.