Spectrum and Management of Urological Emergencies at Tertiary Hospital in Northwestern Nigeria

Abstract

Background: Urological emergencies are urological conditions that require immediate interventions in order to avoid morbidity and or mortality. The commonest urological emergency worldwide is acute urinary retention. The objective of this study is to review the spectrum and management of urologic emergencies in our environment. Methods: This is a retrospective study of patients managed for urological emergencies in our hospital from January to December, 2017. Data were collected from the case notes via a proforma, and analyzed using IBM SPSS version 20.0 for Windows. The results were reported in percentages, mean ± standard deviation. Results: A total number of 173 patients were managed for urological emergencies within the study period with mean age of 45.88 ± 12.03 years and a range of 1 to 80 years. The male to female ratio was 9:1. The commonest urological emergency was acute urinary retention (40.5%) from benign prostatic hyperplasia (17.9%), urethral stricture (12.7%) and prostate cancer (5.2%). Other emergencies were acute epididymo-orchitis (13.9%), schistosomal ureteric obstruction (9.8%), gross haematuria (8.1%), urological trauma (7.5%), renal stone colic (5.7%), Fournier's gangrene (5.2%), priapism (2.3%), testicular torsion (1.7%) and others (5.3%). The interventions offered were urinary diversion ± saline bladder irrigation (57.8%), prostatectomy (18.0%), ureteroscopy ± double J stenting (5.2%), wound debridement (5.2%), corporal aspiration (2.3%), and orchidopexy (1.7%). Most of the patients (92.5%) were successfully managed and discharged but there was associated mortality in 2.9%. Conclusion: Urinary retention, acute scrotum, schistosomal ureteric obstruction, gross hematuria and urological trauma are the most common urological emergencies in our practice. Urinary diversion ± bladder irrigation, Antibiotics therapy and prostatectomy were the commonest interventions offered.