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Urologic disease in a resource-poor country

Manganiello, Marc; Hughes, Christopher D.; Hagander, Lars LU ; Bayne, David; Pierre, Jean H.; Buckley, Jill C. and Meara, John G. (2013) In World Journal of Surgery 37(2). p.8-344
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... (More)
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. (Less)
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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Prevalence, Retrospective Studies, Urinary Bladder Calculi/epidemiology/surgery, Nephrolithiasis/epidemiology/surgery, Middle Aged, Male, Newborn, Infant, Humans, Haiti/epidemiology, Male/*epidemiology/surgery, Genital Diseases, Female, Developing Countries, Cost of Illness, Preschool, Child, 80 and over, Adolescent, Aged, Adult, Urologic Diseases/*epidemiology/surgery, Urologic Surgical Procedures/*statistics & numerical data, Young Adult
in
World Journal of Surgery
volume
37
issue
2
pages
8 - 344
publisher
Springer
external identifiers
  • scopus:84874115203
ISSN
1432-2323
DOI
10.1007/s00268-012-1818-3
language
English
LU publication?
no
id
fd46730f-78a2-471e-ac08-dd38dd47309f (old id 4281610)
date added to LUP
2014-04-14 11:48:16
date last changed
2019-02-20 06:07:40
@article{fd46730f-78a2-471e-ac08-dd38dd47309f,
  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.},
  author       = {Manganiello, Marc and Hughes, Christopher D. and Hagander, Lars and Bayne, David and Pierre, Jean H. and Buckley, Jill C. and Meara, John G.},
  issn         = {1432-2323},
  keyword      = {Prevalence,Retrospective Studies,Urinary Bladder Calculi/epidemiology/surgery,Nephrolithiasis/epidemiology/surgery,Middle Aged,Male,Newborn,Infant,Humans,Haiti/epidemiology,Male/*epidemiology/surgery,Genital Diseases,Female,Developing Countries,Cost of Illness,Preschool,Child,80 and over,Adolescent,Aged,Adult,Urologic Diseases/*epidemiology/surgery,Urologic Surgical Procedures/*statistics & numerical data,Young Adult},
  language     = {eng},
  number       = {2},
  pages        = {8--344},
  publisher    = {Springer},
  series       = {World Journal of Surgery},
  title        = {Urologic disease in a resource-poor country},
  url          = {http://dx.doi.org/10.1007/s00268-012-1818-3},
  volume       = {37},
  year         = {2013},
}