Advertisement

World Journal of Surgery

, Volume 37, Issue 2, pp 344–348 | Cite as

Urologic Disease in a Resource-poor Country

  • Marc ManganielloEmail author
  • Christopher D. Hughes
  • Lars Hagander
  • David Bayne
  • Jean Hamiltong Pierre
  • Jill C. Buckley
  • John G. Meara
Article

Abstract

Background

Understanding the role that urologic disease plays within central Haiti could lead to the development of sustainable and regionally appropriate urologic care. We aim to document the prevalence of urologic surgical disease presenting for treatment in central Haiti.

Methods

The present study is based on a retrospective review of surgical case logs at five Partners in Health and Zanmi Lasante hospitals in central Haiti. Data were collected from June 30, 2009, through July 29, 2010, and included patient demographics, disease processes, interventions required, surgeon name, and surgeon training (urologic trained versus non-urologic trained).

Results

Urologic surgical disease comprised 498/5,539 (9.0 %) of all surgical cases in central Haiti from July 2009–July 2010. A total of 492 diagnoses and 498 urologic procedures on 469 patients were recorded. Most common diagnoses included hydrocele (33.3 %), phimosis (23.0 %), benign prostatic hyperplasia (10.8 %), and cryptorchidism (7.3 %). Hydrocelectomy was the most commonly performed procedure (160/498, 32.1 %), followed by circumcision (117/498, 23.4 %) and open prostatectomy (38/498, 7.6 %). Surgeon training (urologic versus non-urologic) was determined for 360/498 (72.3 %) of surgical cases. Urologic trained surgeons performed 55/360 (15.3 %) of all surgical procedures. Among patients who underwent prostatectomy, urology surgeons performed 14/31 (45.2 %) of open prostatectomies, and non-urology surgeons performed 17/31 (54.8 %). Urologists performed all transurethral resections of the prostate (9 vs. 0; p = 0.0051).

Conclusions

Urologic surgical diseases comprise a substantial source of morbidity for patients in central Haiti. Understanding the scale and scope of urologic disease is important in developing health systems to adequately address the regional burden of surgical disease in limited-resource settings.

Keywords

Benign Prostatic Hyperplasia Lymphatic Filariasis Male Circumcision Urethral Stricture Hydrocele 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Jamison DT, Breman JG, Measham AR et al (2006) World Bank and disease control priorities project. In: Jamison DT et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York, p 1401Google Scholar
  2. 2.
    World Health Organization (2008) Report of WHO meeting on global initiative for emergency and essential surgical care (GIEESC) http://www.who.int/surgery/education_training/GIEESC_TanzaniaReportApril08. Accessed 2 Oct 2012
  3. 3.
    Thompson MJ, Huntington MK, Hunt DD et al (2003) Educational effects of international health electives on US and Canadian medical students and residents: a literature review. Acad Med 78:342–347PubMedCrossRefGoogle Scholar
  4. 4.
    Ozgediz D, Roayaie K, Debas H et al (2005) Surgery in developing countries: essential training in residency. Arch Surg 140:795–800PubMedCrossRefGoogle Scholar
  5. 5.
    Silverberg D, Wellner R, Arora S et al (2007) Establishing an international training program for surgical residents. J Surg Educ 64:143–149PubMedCrossRefGoogle Scholar
  6. 6.
    Jarman BT, Cogbill TH, Kitowski NJ (2009) Development of an international elective in a general surgery residency. J Surg Educ 66:222–224PubMedCrossRefGoogle Scholar
  7. 7.
    Qureshi JS, Samuel J, Lee C et al (2011) Surgery and global public health: the UNC-Malawi surgical initiative as a model for sustainable collaboration. World J Surg 35:17–21. doi: 10.1007/s00268-010-0836-2 PubMedCrossRefGoogle Scholar
  8. 8.
    Kalilani-Phiri LV, Umar E, Lazaro D et al (2010) Prevalence of obstetric fistula in Malawi. Int J Gynaecol Obstet 109:204–208PubMedCrossRefGoogle Scholar
  9. 9.
    Kirschner CV, Yost KJ, Du H et al (2010) Obstetric fistula: the ECWA Evangel VVF Center surgical experience from Jos, Nigeria. Int Urogynecol J Pelvic Floor Dysfunct 21:1525–1533CrossRefGoogle Scholar
  10. 10.
    DeRidder D (2011) An update on surgery for vesicovaginal and urethrovaginal fistulae. Curr Opin Urol 21:297–300CrossRefGoogle Scholar
  11. 11.
    Raassen TJIP, Verdaasdonk EGG, Vierhout ME (2008) Prospective results after first-time surgery for obstetric fistulas in East African women. Int Urogynecol J 19:73–79CrossRefGoogle Scholar
  12. 12.
    Robertson WG (2003) Renal stones in the tropics. Semin Nephrol 23:77–87PubMedCrossRefGoogle Scholar
  13. 13.
    Goel MC, Ahlawat R, Bhandari M (1999) Management of staghorn calculus: analysis of combination therapy and open surgery. Urol Int 63:228–233PubMedCrossRefGoogle Scholar
  14. 14.
    Debas HT, Gosselin R, McCord C et al (2006) Surgery. In: Jamison DT et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York, pp 1245–1260Google Scholar
  15. 15.
    Mackenzie CD, Lazarus WM, Mwakitalu ME et al (2009) Lymphatic filariasis: patients and the global elimination programme. Ann Trop Med Parasitol 103(Suppl 1):S41–S51PubMedCrossRefGoogle Scholar
  16. 16.
    Beau de Rochars MVE, Milford MD et al (2004) Geographic distribution of lymphatic filariasis in Haiti. Am J Trop Med Hyg 71:598–601PubMedGoogle Scholar
  17. 17.
    Eberhard ML, Walker EM, Addiss DG et al (1996) A survey of knowledge, attitudes, and perceptions (KAPs) of lymphatic filariasis, elephantiasis, and hydroceles among residents in an endemic area in Haiti. Am J Trop Med Hyg 54:299–303PubMedGoogle Scholar
  18. 18.
    Global Programme for the Elimination of Lymphatic Filariasis (2002) Report of an informal consultation on surgical approaches to the urogenital manifestations of lymphatic filariasis. World Health Organization, Geneva, pp 15–16Google Scholar
  19. 19.
    Mante SD, Gueye SM (2011) Capacity building for the modified filarial hydrocelectomy technique in West Africa. Acta Trop 120(Suppl 1):S76–S80PubMedCrossRefGoogle Scholar
  20. 20.
    Morris BJ (2007) Why circumcision is a biomedical imperative for the 21st century. BioEssays 29:1147–1158PubMedCrossRefGoogle Scholar
  21. 21.
    Moses S, Bailey RC, Ronald AR (1998) Male circumcision: assessment of health benefits and risks. Sex Transm Infect 74:368–373PubMedCrossRefGoogle Scholar
  22. 22.
    Gray RH, Kigozi G, Serwadda D et al (2007) Male circumcision for HIV prevention in men in Rakai, Uganda: a randomized trial. Lancet 369:657–666PubMedCrossRefGoogle Scholar
  23. 23.
    Szabo R, Short RV (2000) How does male circumcision protect against HIV infection? BMJ 320:1592–1594PubMedCrossRefGoogle Scholar
  24. 24.
    Yu X, Elliott SP, Wilt TJ et al (2008) Practice patterns in benign prostatic hyperplasia surgical therapy: the dramatic increase in minimally invasive technologies. J Urol 180:241–245PubMedCrossRefGoogle Scholar
  25. 25.
    McVary KT, Roehrborn CG, Avins AL et al (2010) Guideline on the management of benign prostatic hyperplasia. American Urological Association Education and Research, Inc. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm. Accessed 2 Oct 2012
  26. 26.
    Gratzke C, Schlenker B, Seitz M et al (2007) Complications and early postoperative outcome after open prostatectomy in patients with benign prostatic enlargement: results of a prospective multicenter study. J Urol 177:1419PubMedCrossRefGoogle Scholar
  27. 27.
    Litwin MS, Saigal CS, Yano EM et al (2005) Urologic diseases in America project: analytical methods and principal findings. J Urol 173:933–937PubMedCrossRefGoogle Scholar
  28. 28.
    McIntyre T, Hughes CD, Pauyo T et al (2011) Emergency surgical care delivery in post-earthquake Haiti: partners in health and Zanmi Lasante experience. World J Surg 35:745–750. doi: 10.1007/s00268-011-0961-6 PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Marc Manganiello
    • 1
    Email author
  • Christopher D. Hughes
    • 3
    • 4
  • Lars Hagander
    • 3
    • 4
  • David Bayne
    • 2
  • Jean Hamiltong Pierre
    • 5
  • Jill C. Buckley
    • 1
  • John G. Meara
    • 3
    • 4
  1. 1.Institute of UrologyBurlingtonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Department of Plastic and Oral SurgeryChildren’s Hospital BostonBostonUSA
  4. 4.Program in Global Surgery and Social ChangeHarvard Medical SchoolBostonUSA
  5. 5.Zanmi LasanteCangeHaiti

Personalised recommendations