BJU InternationalVolume 83, Issue 3 p. 350-350 Colovesical fistula after ingestion of a modelling-knife blade Napier-Hemy, Napier-Hemy Royal Preston Hospital, Preston, UKSearch for more papers by this author Thampuran, Thampuran Royal Preston Hospital, Preston, UKSearch for more papers by this author Elem, Elem Royal Preston Hospital, Preston, UKSearch for more papers by this author Napier-Hemy, Napier-Hemy Royal Preston Hospital, Preston, UKSearch for more papers by this author Thampuran, Thampuran Royal Preston Hospital, Preston, UKSearch for more papers by this author Elem, Elem Royal Preston Hospital, Preston, UKSearch for more papers by this author First published: 25 December 2001 https://doi.org/10.1046/j.1464-410x.1999.00842.xCitations: 2 Mr Elem Royal Preston Hospital, Sharoe Green Lane North, Fulwood, Preston, PR2 9HT, UK. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume83, Issue3February 1999Pages 350-350 RelatedInformation

The results of a prospective study in the University Teaching Hospital, Lusaka, Zambia, on the impact of Human Immunodeficiency Virus on the incidence and prognosis of Fournier's gangrene is presented; Zambia has been in the grip of an HIV epidemic since the early 1980s. A total of 10 patients with an average age of 32 years was observed during a 14-month period (March 1992-April 1993); eight patients had associated HIV infection. A contributory factor to the development of Fournier's gangrene was also present in seven patients, of which six involved the urinary tract. All patients were managed by early surgical débridement under antibiotic cover. Two patients died, only one of whom had associated HIV disease. This study has recorded a significant rise in the prevalence of Fournier's gangrene in Zambia since the advent of the HIV epidemic. It has also been documented that provided aggressive treatment along established lines is initiated without delay, the coexisting HIV infection does not adversely affect the prognosis of Fournier's gangrene.

Acquired immunodeficiency syndrome-associated Kaposi's sarcoma (KS) is well documented in adults. However, very little information is available about KS in the pediatric age group. A retrospectively study was undertaken at the University Teaching Hospital (UTH), Lusaka, Zambia, to define the incidence and clinical profile of KS in Zambian children over the last 13 years and to determine the influence, if any, of the current human immunodeficiency virus (HIV) epidemic on the pattern of pediatric KS. All the histopathological records from 1980 to 1992 were reviewed and all cases of KS along with the total number of malignancies, both in children and adults, were analyzed. Along with this, 17 of 23 case files of pediatric KS patients treated at the UTH since 1984 were retrieved and clinical details recorded. Of a total of 915 cases of KS, 85 (9.25%) were in children < 14 years of age. The age ranged from 7 months to 14 years, with an average of 5.62 years; the male/female ratio was 1.76:1. A significant increase in the incidence of pediatric KS has been recorded since 1987 (p < 0.001). This coincides with the advent of the HIV epidemic in the country. The disease was aggressive and fulminant in pediatric patients. More than 80% HIV seropositivity was detected. Children with blood transfusion-related HIV infection had cutaneous or lymphocutaneous disease, indicating that the mode of acquisition of HIV infection may influence the clinical appearance of KS. Thus, HIV-associated KS in children is becoming a common entity in Zambia. An urgent prospective epidemiologic study is needed to address this problem in HIV-affected regions.

This study analysed histopathological and haematology records of 7836 neoplasms seen during the period 1980-1989 at the University Teaching Hospital, Lusaka, Zambia. The crude incidence rate of each malignancy per 100 000 adults per year was calculated and the patterns of malignancies were compared for the periods 1980-1983 and 1984-1989, the later coinciding with the advent of the human immunodeficiency virus (HN) epidemic. The six most common tumours were carcinoma of the cervix (19.6%), Kaposi's sarcoma (7%), bladder carcinoma (6.3%), hepatoma (5.8%), lymphoma (4.6%) and carcinoma of the breast (4.4%). Significant increases in the crude incidence rates of Kaposi's sarcoma (KS) and carcinoma of the breast were observed during the last 6 years of the study period (P=0.001). Nodal KS showed the most significant rise from a crude incidence rate of 0.25 per 100 000 adults per year in the 1980-1983 period to 1.11 during the 1984-1989 period. In contrast to findings from Europe and the USA, no significant increase in non-Hodgkin's lymphoma was detected in Zambia following the HIV epidemic.

Review of reports of thyroid tissue sent for histopathology to the Department of Pathology at the University Teaching Hospital, Lusaka (UTH) by one of the five general surgical units at the institution during the period January 1981-December 1990 shows a 20pc decrease in the incidence of colloid goitre and doubling of the incidence of the adenoma and carcinoma when compared to the study done at the Central Hospital, Kitwe in the late sixties. In our study for the general pathology of the thyroid gland female to male ratio is 7.4:1; 1.25:1 when only thyroid cancers are considered. The incidence of papillary carcinoma is substantially lower than in the west. Recently, there has been an increased incidence of thyroid abscesses associated with HIV infection. Knowledge of the local pattern of surgical pathology of an organ is important for planning the operative management more effectively but in many developing countries, such as ours, this information is not readily available. Goitre is common in Zambia and to our knowledge to date there is only one comprehensive report done during the period January 1966, to March 1971. This deals with the Northern and Western regions of the country. This study was undertaken to look into the surgical pathology of the thyroid gland seen at the University Teaching Hospital, Lusaka, which is in the central part of the country.

The pattern of malignancies among indigenous Zambian children is described. The study, based upon an analysis of histopathology, autopsy and haematology records for a 10-year period (1980-1989), reveals a total of 525 neoplasms with a peak prevalence in the 5-9 year age group. Non-Hodgkin's lymphoma (17.5%) was the most common disorder followed by Burkitt's lymphoma (13.9%), retinoblastoma (11.4%), Kaposi's sarcoma (8.8%), Hodgkin's disease (5.9%), Wilms' tumour (5.9%), acute lymphocytic leukaemia (4%), rhabdomyosarcoma (3.4%), nasopharyngeal carcinoma (2.7%) and osteogenic sarcoma (2.1%). Kaposi's sarcoma and Hodgkin's disease revealed a significant male dominance; the former presented mainly in nodal form. Compared to an earlier report from Zambia (1968-1972), a significant increase in the incidence of Kaposi's sarcoma and nasopharyngeal carcinoma was noted in the present series.

Observations are presented on 9 patients recently treated in the University Teaching Hospital, Lusaka, Zambia, for painful urinary frequency, suprapubic pain and microscopic and/or macroscopic haematuria without any demonstrable urinary tract infection. At cystoscopy the bladder mucosa of all patients depicted a highly characteristic, uniformly congested appearance with no demonstrable ulcers; there was no significant reduction in bladder capacity. The histological appearance was essentially non-specific in type with an apparent resemblance to that of interstitial cystitis; mast cells were, however, absent in all specimens. An important feature common to all patients was an associated HIV infection; cytochemistry of the bladder tissue did not reveal an associated cytomegalovirus cystitis. No such case was observed in Zambia prior to the advent of HIV infection and the phenomenon was observed only in seropositive patients. It has been suggested that the virus is likely to be associated with the genesis of the bladder symptoms. The natural history of the disorder, its incidence among the seropositive individuals and its pathogenesis remain unclear.

The pattern of urological malignancy among the indigenous population of Zambia (determined on the basis of histopathological reports from a major national hospital during an 8-year period) is presented. A total of 6514 malignancies were observed, of which 784 (12%) were of urological origin. Bladder carcinoma, predominantly squamous type, was the commonest urological tumour (51%), followed by carcinoma of the prostate (26%), carcinoma of the penis (18%), renal tumours (4.3%) and testicular malignancy (0.7%). In nearly 32% of the bladder tumours, bilharzial ova were demonstrated histopathologically. Nephroblastoma accounted for 70% of the renal tumours and from a total of 7 cases of testicular tumours 5 were embryonal carcinoma and 2 seminoma. A brief reference is made to the pattern and aetiology of urological malignancies in some neighbouring countries.

British Journal of UrologyVolume 66, Issue 5 p. 555-556 Introduction of a Foley Catheter by Puncture Suprapubic Cystostomy B. ELEM, Corresponding Author B. ELEM Department of Surgery, University of Zambia, Lusaka, ZambiaDepartment of Surgery, University of Zambia School of Medicine, P.O. Box 50110, Lusaka, ZambiaSearch for more papers by this author B. ELEM, Corresponding Author B. ELEM Department of Surgery, University of Zambia, Lusaka, ZambiaDepartment of Surgery, University of Zambia School of Medicine, P.O. Box 50110, Lusaka, ZambiaSearch for more papers by this author First published: November 1990 https://doi.org/10.1111/j.1464-410X.1990.tb15016.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume66, Issue5November 1990Pages 555-556 RelatedInformation

Total substitution of both ureters in 5 patients with advanced obstructive uropathy due to extensive ureteric bilharziasis is described. It is recommended that ureteric replacement in the presence of marked obstructive uropathy should not be undertaken without preliminary renal drainage. An open through-and-through nephrostomy is recommended for this purpose. It is suggested that this approach will help to minimise the incidence of nephrectomy in areas of endemic urinary bilharziasis.

A giant fibrous pseudotumor of the right testicular tunics in a 27-year-old Zambian is presented. It has been suggested that associated Schistosoma haematobium infection could have contributed to the giant size and rapid growth of the lesion.

The pattern of schistosomiasis of the prostate and seminal vesicles in Zambia is presented. The results were based on histological examination and digestion of tissue obtained from 50 cadavers. Compared to the bladder (62%) and seminal vesicles (58%), the infestation was least common (50%) in the prostate. The infection was due to Schistosoma haematobium alone in all organs. The most significant finding was the histological inactivity secondary to this parasitic infection. It is suggested that schistosomiasis of these organs is unlikely to be causally related to male infertility in Zambia.

Observations are presented on 11 cases of haemospermia in the University Teaching Hospital, Zambia, a country where bilharziasis is endemic. Seven patients were severely hypertensive but only two had urinary bilharziasis. The incidence of Schistosoma haematobium infection of the prostate and seminal vesicles is discussed and it is concluded that there is no significant association between the parasitic infection and haemospermia.

Experience in the use of a ureteric nipple in ten patients with bilharzial strictures of 15 ureters is presented. It is recommended that this method should be the procedure of choice in the surgical management of selected cases of bilharzial ureteropathy. The need for further experience in its use in calcified ureters is stressed.

British Journal of UrologyVolume 56, Issue 3 p. 331-333 Total Intestinal Metaplasia with Focal Adenocarcinoma in a Schistosoma-infested Defunctioned Urinary Bladder B. ELEM, Corresponding Author B. ELEM Department of Urology, Ndola Central Hospital. Ndola, ZambiaUrology Unit, Department of Surgery, University Teaching Hospital, Private Bag RW IX, Lusaka. Zambia.Search for more papers by this authorS. Z. ALAM, S. Z. ALAM Department of Urology, Ndola Central Hospital. Ndola, ZambiaSearch for more papers by this author B. ELEM, Corresponding Author B. ELEM Department of Urology, Ndola Central Hospital. Ndola, ZambiaUrology Unit, Department of Surgery, University Teaching Hospital, Private Bag RW IX, Lusaka. Zambia.Search for more papers by this authorS. Z. ALAM, S. Z. ALAM Department of Urology, Ndola Central Hospital. Ndola, ZambiaSearch for more papers by this author First published: June 1984 https://doi.org/10.1111/j.1464-410X.1984.tb05401.xCitations: 6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References Kickham, C. J. E. and Keegan, J. J. (1963) The bladder left behind. Journal of Urology, 89, 689. Sibler, S. J. (1973). Carcinoma in bladder left behind. Journal of Urology, 110, 675–677. Zaharan, M. M., Kamel, F., Mooro, H. and Issa, A. (1976). Bilharziasis of urinary bladder and ureter. Urology, 8, 73–79. Citing Literature Volume56, Issue3June 1984Pages 331-333 ReferencesRelatedInformation

The findings of a retrospective study of 900 consecutive autopsies in the University Teaching Hospital, Lusaka undertaken in order to determine the incidence of renal tuberculosis among indigenous Zambians have been stated. In all. a diagnosis of tuberculosis renal or otherwise was made in 70 (7.7%} cases; renal involvement was present in 18 {25.7%}. There was not a single case of classical ulcerocavernous type of renal lesions. It has been suggested that renal tuberculosis in Zambians mainly occurs secondary to extensive miliary Spread in advanced pulmonary tuberculosis: the affected person usually succumbs to the disease prior to the occurence of any renal symptoms.