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Papers by Ahmed Umar

Nigerian Journal of Medicine

Review Article IntroductIon Urinary catheters are one of the most commonly used medical devices i... more Review Article IntroductIon Urinary catheters are one of the most commonly used medical devices in clinical practice. [1] They have been used for over 3500 years to drain the urinary bladder when it fails to empty or for other indications. [2] In the United States of America alone, an estimated 30 million indwelling urethral catheters are sold yearly, and about 20% of hospitalized patients have a urethral catheter inserted at any given moment. [3] A urinary catheter is a tube inserted from the external urethral meatus to the bladder to drain urine from the bladder. [4] It can be used for the short term, especially in the perioperative period. Still, it can also be used long term, especially when managing people with urinary incontinence or chronic urine retention. [4] Globally, the commonly used catheter is the Foley catheter invented by an American urologist named Frederic Foley. [5] However, there are several types of urinary catheters, and their use is determined primarily by the indication for urinary catheterization. Under ideal conditions, a urinary catheter that is 100% silicone can remain in situ for up to about 12 weeks. This, however, is often not feasible due to encrustation and bacterial infection that can block the catheter or result in a medical complication. [5] Although urethral catheterization is a standard procedure performed by many cadres of health workers, it may be associated with some complications and thus may be the cause of litigations and medical malpractice consequent on certain complications that may arise such as urethral stricture, urinary tract infection, urethral erosion, sepsis, and urethral injuries. [6] MaterIals and Methods A review of the international literature was conducted using PubMed database and Google Search, using keywords such as "urethral catheter materials and types," "catheterisation techniques and complications," "difficult urethral catheterizations," "retained urethral catheter," "catheter-associated urethral Background: The urethral catheter is an essential medical device that is used in everyday medical practice worldwide. The urethral catheter has evolved over the years with several modifications and improvements to overcome the shortcomings of previous productions. With several indications, it remains one of the most commonly used devices traversing almost all specialties in the field of medicine; however, the process of urethral catheterization is occasionally challenging and may result in injury to the urethra. The attendant complications following its passage far outweigh its cost and the required skills to necessitate appropriate insertion. Knowledge of the type of urethral catheter, training with regard to its insertion, care while in situ, and competency of the attendant caregivers are required for safe catheterization. Aim: This review aims to disseminate knowledge on urethral catheter types, insertion procedures, and its attendant complications so that doctors and other health-care professionals may safely perform this necessary procedure. Materials and Methods: A review of internatinal literature was conducted using PubMed database and goggle search using key words such as urethral catheter materials and types. Result: 105 articles were identified and found suitable for the study.

Journal of West African College of Surgeons

Herein is a case of a 51-year-old farmer who presented to our facility with initial leakage of ur... more Herein is a case of a 51-year-old farmer who presented to our facility with initial leakage of urine but later urine mixed with faeces from the lower abdomen after two previous abdominal surgeries. He had an open transvesical prostatectomy due to benign prostate enlargement complicated by leakage of urine from lower abdominal wall scar. A repeat surgical intervention to correct the urine leakage was followed by recurrence of urine leakage and later by leakage of feculent urine from the lower anterior abdominal wall. At our facility, he had exploratory laparotomy with manual unknotting of ileal loops, fistula tracts excision, resection, and end-to-end ileoileal anastomosis. The bladder wall was repaired with suprapubic cystostomy. Although the finding of asymptomatic multiple small bowel knotting was incidental in the index case, its timely management averted a sitting timed bomb that may lead to a diagnostic dilemma with catastrophic consequences.

African Journal of Urology, 2021

Background Fournier’s gangrene and trauma to the external genitalia are the commonest causes of p... more Background Fournier’s gangrene and trauma to the external genitalia are the commonest causes of peno-scrotal wound defects in our environment. The management of these patients includes initial resuscitation and subsequent wound care with or without wound cover. The aim of this study is to document our experience in the management of peno-scrotal defects in a tertiary hospital of North-Western Nigeria. Methods This is a 20-year retrospective study of patients managed for peno-scrotal wound defects by the Urology Unit in the Department of Surgery of our hospital from January 2001 to December 2019. Data were collected from the patients’ case notes and entered into a proforma. Data were analysed using SPSS version 25.0. Results A total number of 54 patients with peno-scrotal wound defects were managed within the study period with the mean age of 46.27 ± 22.09 years and a range of six weeks to 107 years. The wound defects were sequelae of Fournier’s gangrene in 42 patients (77.8%) and tr...

International Surgery Journal, 2019

Background: Urine cytology is an important investigation in the management of urothelial cancer. ... more Background: Urine cytology is an important investigation in the management of urothelial cancer. It is particularly an important test in the management of urinary tract cancers because of its non-invasive nature. Objective of study to review our practice of urine cytology as a diagnostic tool in the management of urinary tract pathology.Methods: A seventeen years retrospective study from 1st January, 2001 to 31st December, 2017 where records of patients who had urine cytology in Usmanu Danfodio University Teaching Hospital (UDUTH), Sokoto, Nigeria were reviewed and data was extracted and analyzed using the SPSS 20.Results: Of the 766 specimens, representing 10.1% of all cytology done in UDUTH (7,554) during the period under review, the highest number of urine cytology was done in 2013 (12%). The age range of the patients was between 2 to 90 years with modal age of 60 years. Majority of the patients were between the ages of 51 to 60 years (24.7%) and male to female ratio was 6.3:1. T...

Savannah Journal of Medical Research and Practice, 2019

Objective: To review the pattern and outcome of ureteroscopy in our institution Materials and Met... more Objective: To review the pattern and outcome of ureteroscopy in our institution Materials and Methods: A retrospective review of ureteroscopies performed at our hospital between January 2013 and December 2018 for patients aged ≥18 years. The following data were extracted from patients' case notes and operation register; patient demographics, symptoms, investigations, diagnosis, definitive treatment, hospital stay, surgical outcome, duration of urethral catheterization and ureteric stenting, complications and duration of follow up visits. SPSS version 20.0 for Windows was used in data analysis. The results are presented in simple frequencies and percentages. Result: Total of 32 ureteroscopies were performed on 32 patients aged between 20 to 65 years with modal age of 32 years (18.8%). The commonest presenting complaint is ureteric colic, 13(40.6%) while the commonest indication for ureteroscopy is ureteric calculi, 14(43.8%) and ureteral obstruction, 12(33.3%). Ureteroscopy, pneumatic lithotripsy and double J (DJ) stenting of the ureter is the definitive treatment in 14(43.8%) patients, making it the most common performed definitive treatment. Following treatment, 63% of the patients were symptom free while 27.2% have residual symptom. The mean hospital stay is 4.6 days, mean duration of DJ stenting of the ureter is 6.3 weeks and that of follow up is 10.4 months. The commonest complications recorded was Urinary tract infection, 12(37.5%) Conclusion: Ureteroscopy is an effective treatment modality for treating ureteric diseases such as calculus and strictures with no mortality recorded during the study period. Keyword: Ureteroscopy, lithotripsy, ureteric calculus, DJ stenting. Savannah Journal of Medical Research and Practice 2018;7(1):17-22

Open Journal of Urology, 2019

Prostate cancer is the second most common cancer in men worldwide and the commonest cause of mort... more Prostate cancer is the second most common cancer in men worldwide and the commonest cause of mortality in men. It is the commonest diagnosed cancer in African men. The earliest and common sites of metastasis are the axial skeleton and regional lymph nodes. Initial presentation of the metastatic disease with cervical or supraclavicular lymphadenopathy is rarely reported. We report 3 cases of metastatic cancer of the prostate presenting initially to physicians with huge cervical and supraclavicular lymph nodes enlargement which on biopsy revealed metastatic adenocarcinoma. On further evaluation, there were non-bothersome storage symptoms, elevated prostate specific antigen and abnormal digital rectal examination. Transrectal ultrasound (TRUS)-guided biopsy of hypoechoic nodules revealed high-grade adenocarcinoma of the prostate on histopathological examination. The cervical and supraclavicular lymphadenopathy resolved after commencement of androgen deprivation therapy. We advocate for prostate cancer screening in African men above 50 years of age presenting with cervical or supraclavicular lymphadenopthy to primary care physicians even in the absence of lower urinary tract symptoms.

International Journal of Medical Science, 2020

Review Article IntroductIon Urinary catheters are one of the most commonly used medical devices i... more Review Article IntroductIon Urinary catheters are one of the most commonly used medical devices in clinical practice. [1] They have been used for over 3500 years to drain the urinary bladder when it fails to empty or for other indications. [2] In the United States of America alone, an estimated 30 million indwelling urethral catheters are sold yearly, and about 20% of hospitalized patients have a urethral catheter inserted at any given moment. [3] A urinary catheter is a tube inserted from the external urethral meatus to the bladder to drain urine from the bladder. [4] It can be used for the short term, especially in the perioperative period. Still, it can also be used long term, especially when managing people with urinary incontinence or chronic urine retention. [4] Globally, the commonly used catheter is the Foley catheter invented by an American urologist named Frederic Foley. [5] However, there are several types of urinary catheters, and their use is determined primarily by the indication for urinary catheterization. Under ideal conditions, a urinary catheter that is 100% silicone can remain in situ for up to about 12 weeks. This, however, is often not feasible due to encrustation and bacterial infection that can block the catheter or result in a medical complication. [5] Although urethral catheterization is a standard procedure performed by many cadres of health workers, it may be associated with some complications and thus may be the cause of litigations and medical malpractice consequent on certain complications that may arise such as urethral stricture, urinary tract infection, urethral erosion, sepsis, and urethral injuries. [6] MaterIals and Methods A review of the international literature was conducted using PubMed database and Google Search, using keywords such as "urethral catheter materials and types," "catheterisation techniques and complications," "difficult urethral catheterizations," "retained urethral catheter," "catheter-associated urethral Background: The urethral catheter is an essential medical device that is used in everyday medical practice worldwide. The urethral catheter has evolved over the years with several modifications and improvements to overcome the shortcomings of previous productions. With several indications, it remains one of the most commonly used devices traversing almost all specialties in the field of medicine; however, the process of urethral catheterization is occasionally challenging and may result in injury to the urethra. The attendant complications following its passage far outweigh its cost and the required skills to necessitate appropriate insertion. Knowledge of the type of urethral catheter, training with regard to its insertion, care while in situ, and competency of the attendant caregivers are required for safe catheterization. Aim: This review aims to disseminate knowledge on urethral catheter types, insertion procedures, and its attendant complications so that doctors and other health-care professionals may safely perform this necessary procedure. Materials and Methods: A review of internatinal literature was conducted using PubMed database and goggle search using key words such as urethral catheter materials and types. Result: 105 articles were identified and found suitable for the study.

International Surgery Journal, 2020

Background: Urethral stricture is an ancient disease that has plagued men. Management of this dis... more Background: Urethral stricture is an ancient disease that has plagued men. Management of this disease has been evolving due to advances in technology and better understanding of the pathogenesis. Use of oral mucosal grafts for substitution urethroplasty has been gaining world-wide acceptance and application by urologists. This article examines the of application of this urethral substitute among Nigerian urologists.Methods: This was a questionnaire-based study administered to urologists during the annual general meeting and scientific conference.Results: Forty two respondents completed the questionnaire and comprised of 41 (97.6%) males and 1 (2.4%) female. There were 24 (57.1%) consultants, senior registrars and others 4 (9.6%). Thirty three (78.6%) of the respondents had practised for less than 10 years. Region of practice in Nigeria were 13 (31%) in South-west, 5 (11.9%) in South-East, 3 (7.1%) in South -South, 9 (21.4%) in North-West, 10 (23.8%) in North-central and 2 (4.8%) in ...

International Surgery Journal

Background: Urine cytology is a simple, safe, non-invasive and cheap investigation that is used a... more Background: Urine cytology is a simple, safe, non-invasive and cheap investigation that is used as adjunct to cystoscopy in the diagnosis of bladder cancer. Its low sensitivity is a major limitation against its use as a sole diagnostic test for bladder cancer. The objective of this study was to determine the pattern of urine cytology seen in patients with clinical diagnosis of bladder tumour in our practice.Methods: This is a retrospective study of patients with clinical diagnosis of bladder tumour that had urine cytology in our centre. The age and gender of the patients, number of urine cytology per patient per year and cytologic diagnosis were analysed using the SPSS 20.Results: During the period under review, a total of 512 urine cytology was done for patients with clinical diagnosis of bladder tumour. The age range of the patients was 6 to 90 years with modal age of 60 years. 457 (89.3%) were males while 54 (10.5%) were females and 1 (0.2%) was unspecified. Male to female ratio ...

Nigerian Journal of Medicine

Review Article IntroductIon Urinary catheters are one of the most commonly used medical devices i... more Review Article IntroductIon Urinary catheters are one of the most commonly used medical devices in clinical practice. [1] They have been used for over 3500 years to drain the urinary bladder when it fails to empty or for other indications. [2] In the United States of America alone, an estimated 30 million indwelling urethral catheters are sold yearly, and about 20% of hospitalized patients have a urethral catheter inserted at any given moment. [3] A urinary catheter is a tube inserted from the external urethral meatus to the bladder to drain urine from the bladder. [4] It can be used for the short term, especially in the perioperative period. Still, it can also be used long term, especially when managing people with urinary incontinence or chronic urine retention. [4] Globally, the commonly used catheter is the Foley catheter invented by an American urologist named Frederic Foley. [5] However, there are several types of urinary catheters, and their use is determined primarily by the indication for urinary catheterization. Under ideal conditions, a urinary catheter that is 100% silicone can remain in situ for up to about 12 weeks. This, however, is often not feasible due to encrustation and bacterial infection that can block the catheter or result in a medical complication. [5] Although urethral catheterization is a standard procedure performed by many cadres of health workers, it may be associated with some complications and thus may be the cause of litigations and medical malpractice consequent on certain complications that may arise such as urethral stricture, urinary tract infection, urethral erosion, sepsis, and urethral injuries. [6] MaterIals and Methods A review of the international literature was conducted using PubMed database and Google Search, using keywords such as "urethral catheter materials and types," "catheterisation techniques and complications," "difficult urethral catheterizations," "retained urethral catheter," "catheter-associated urethral Background: The urethral catheter is an essential medical device that is used in everyday medical practice worldwide. The urethral catheter has evolved over the years with several modifications and improvements to overcome the shortcomings of previous productions. With several indications, it remains one of the most commonly used devices traversing almost all specialties in the field of medicine; however, the process of urethral catheterization is occasionally challenging and may result in injury to the urethra. The attendant complications following its passage far outweigh its cost and the required skills to necessitate appropriate insertion. Knowledge of the type of urethral catheter, training with regard to its insertion, care while in situ, and competency of the attendant caregivers are required for safe catheterization. Aim: This review aims to disseminate knowledge on urethral catheter types, insertion procedures, and its attendant complications so that doctors and other health-care professionals may safely perform this necessary procedure. Materials and Methods: A review of internatinal literature was conducted using PubMed database and goggle search using key words such as urethral catheter materials and types. Result: 105 articles were identified and found suitable for the study.

Journal of West African College of Surgeons

Herein is a case of a 51-year-old farmer who presented to our facility with initial leakage of ur... more Herein is a case of a 51-year-old farmer who presented to our facility with initial leakage of urine but later urine mixed with faeces from the lower abdomen after two previous abdominal surgeries. He had an open transvesical prostatectomy due to benign prostate enlargement complicated by leakage of urine from lower abdominal wall scar. A repeat surgical intervention to correct the urine leakage was followed by recurrence of urine leakage and later by leakage of feculent urine from the lower anterior abdominal wall. At our facility, he had exploratory laparotomy with manual unknotting of ileal loops, fistula tracts excision, resection, and end-to-end ileoileal anastomosis. The bladder wall was repaired with suprapubic cystostomy. Although the finding of asymptomatic multiple small bowel knotting was incidental in the index case, its timely management averted a sitting timed bomb that may lead to a diagnostic dilemma with catastrophic consequences.

African Journal of Urology, 2021

Background Fournier’s gangrene and trauma to the external genitalia are the commonest causes of p... more Background Fournier’s gangrene and trauma to the external genitalia are the commonest causes of peno-scrotal wound defects in our environment. The management of these patients includes initial resuscitation and subsequent wound care with or without wound cover. The aim of this study is to document our experience in the management of peno-scrotal defects in a tertiary hospital of North-Western Nigeria. Methods This is a 20-year retrospective study of patients managed for peno-scrotal wound defects by the Urology Unit in the Department of Surgery of our hospital from January 2001 to December 2019. Data were collected from the patients’ case notes and entered into a proforma. Data were analysed using SPSS version 25.0. Results A total number of 54 patients with peno-scrotal wound defects were managed within the study period with the mean age of 46.27 ± 22.09 years and a range of six weeks to 107 years. The wound defects were sequelae of Fournier’s gangrene in 42 patients (77.8%) and tr...

International Surgery Journal, 2019

Background: Urine cytology is an important investigation in the management of urothelial cancer. ... more Background: Urine cytology is an important investigation in the management of urothelial cancer. It is particularly an important test in the management of urinary tract cancers because of its non-invasive nature. Objective of study to review our practice of urine cytology as a diagnostic tool in the management of urinary tract pathology.Methods: A seventeen years retrospective study from 1st January, 2001 to 31st December, 2017 where records of patients who had urine cytology in Usmanu Danfodio University Teaching Hospital (UDUTH), Sokoto, Nigeria were reviewed and data was extracted and analyzed using the SPSS 20.Results: Of the 766 specimens, representing 10.1% of all cytology done in UDUTH (7,554) during the period under review, the highest number of urine cytology was done in 2013 (12%). The age range of the patients was between 2 to 90 years with modal age of 60 years. Majority of the patients were between the ages of 51 to 60 years (24.7%) and male to female ratio was 6.3:1. T...

Savannah Journal of Medical Research and Practice, 2019

Objective: To review the pattern and outcome of ureteroscopy in our institution Materials and Met... more Objective: To review the pattern and outcome of ureteroscopy in our institution Materials and Methods: A retrospective review of ureteroscopies performed at our hospital between January 2013 and December 2018 for patients aged ≥18 years. The following data were extracted from patients' case notes and operation register; patient demographics, symptoms, investigations, diagnosis, definitive treatment, hospital stay, surgical outcome, duration of urethral catheterization and ureteric stenting, complications and duration of follow up visits. SPSS version 20.0 for Windows was used in data analysis. The results are presented in simple frequencies and percentages. Result: Total of 32 ureteroscopies were performed on 32 patients aged between 20 to 65 years with modal age of 32 years (18.8%). The commonest presenting complaint is ureteric colic, 13(40.6%) while the commonest indication for ureteroscopy is ureteric calculi, 14(43.8%) and ureteral obstruction, 12(33.3%). Ureteroscopy, pneumatic lithotripsy and double J (DJ) stenting of the ureter is the definitive treatment in 14(43.8%) patients, making it the most common performed definitive treatment. Following treatment, 63% of the patients were symptom free while 27.2% have residual symptom. The mean hospital stay is 4.6 days, mean duration of DJ stenting of the ureter is 6.3 weeks and that of follow up is 10.4 months. The commonest complications recorded was Urinary tract infection, 12(37.5%) Conclusion: Ureteroscopy is an effective treatment modality for treating ureteric diseases such as calculus and strictures with no mortality recorded during the study period. Keyword: Ureteroscopy, lithotripsy, ureteric calculus, DJ stenting. Savannah Journal of Medical Research and Practice 2018;7(1):17-22

Open Journal of Urology, 2019

Prostate cancer is the second most common cancer in men worldwide and the commonest cause of mort... more Prostate cancer is the second most common cancer in men worldwide and the commonest cause of mortality in men. It is the commonest diagnosed cancer in African men. The earliest and common sites of metastasis are the axial skeleton and regional lymph nodes. Initial presentation of the metastatic disease with cervical or supraclavicular lymphadenopathy is rarely reported. We report 3 cases of metastatic cancer of the prostate presenting initially to physicians with huge cervical and supraclavicular lymph nodes enlargement which on biopsy revealed metastatic adenocarcinoma. On further evaluation, there were non-bothersome storage symptoms, elevated prostate specific antigen and abnormal digital rectal examination. Transrectal ultrasound (TRUS)-guided biopsy of hypoechoic nodules revealed high-grade adenocarcinoma of the prostate on histopathological examination. The cervical and supraclavicular lymphadenopathy resolved after commencement of androgen deprivation therapy. We advocate for prostate cancer screening in African men above 50 years of age presenting with cervical or supraclavicular lymphadenopthy to primary care physicians even in the absence of lower urinary tract symptoms.

International Journal of Medical Science, 2020

Review Article IntroductIon Urinary catheters are one of the most commonly used medical devices i... more Review Article IntroductIon Urinary catheters are one of the most commonly used medical devices in clinical practice. [1] They have been used for over 3500 years to drain the urinary bladder when it fails to empty or for other indications. [2] In the United States of America alone, an estimated 30 million indwelling urethral catheters are sold yearly, and about 20% of hospitalized patients have a urethral catheter inserted at any given moment. [3] A urinary catheter is a tube inserted from the external urethral meatus to the bladder to drain urine from the bladder. [4] It can be used for the short term, especially in the perioperative period. Still, it can also be used long term, especially when managing people with urinary incontinence or chronic urine retention. [4] Globally, the commonly used catheter is the Foley catheter invented by an American urologist named Frederic Foley. [5] However, there are several types of urinary catheters, and their use is determined primarily by the indication for urinary catheterization. Under ideal conditions, a urinary catheter that is 100% silicone can remain in situ for up to about 12 weeks. This, however, is often not feasible due to encrustation and bacterial infection that can block the catheter or result in a medical complication. [5] Although urethral catheterization is a standard procedure performed by many cadres of health workers, it may be associated with some complications and thus may be the cause of litigations and medical malpractice consequent on certain complications that may arise such as urethral stricture, urinary tract infection, urethral erosion, sepsis, and urethral injuries. [6] MaterIals and Methods A review of the international literature was conducted using PubMed database and Google Search, using keywords such as "urethral catheter materials and types," "catheterisation techniques and complications," "difficult urethral catheterizations," "retained urethral catheter," "catheter-associated urethral Background: The urethral catheter is an essential medical device that is used in everyday medical practice worldwide. The urethral catheter has evolved over the years with several modifications and improvements to overcome the shortcomings of previous productions. With several indications, it remains one of the most commonly used devices traversing almost all specialties in the field of medicine; however, the process of urethral catheterization is occasionally challenging and may result in injury to the urethra. The attendant complications following its passage far outweigh its cost and the required skills to necessitate appropriate insertion. Knowledge of the type of urethral catheter, training with regard to its insertion, care while in situ, and competency of the attendant caregivers are required for safe catheterization. Aim: This review aims to disseminate knowledge on urethral catheter types, insertion procedures, and its attendant complications so that doctors and other health-care professionals may safely perform this necessary procedure. Materials and Methods: A review of internatinal literature was conducted using PubMed database and goggle search using key words such as urethral catheter materials and types. Result: 105 articles were identified and found suitable for the study.

International Surgery Journal, 2020

Background: Urethral stricture is an ancient disease that has plagued men. Management of this dis... more Background: Urethral stricture is an ancient disease that has plagued men. Management of this disease has been evolving due to advances in technology and better understanding of the pathogenesis. Use of oral mucosal grafts for substitution urethroplasty has been gaining world-wide acceptance and application by urologists. This article examines the of application of this urethral substitute among Nigerian urologists.Methods: This was a questionnaire-based study administered to urologists during the annual general meeting and scientific conference.Results: Forty two respondents completed the questionnaire and comprised of 41 (97.6%) males and 1 (2.4%) female. There were 24 (57.1%) consultants, senior registrars and others 4 (9.6%). Thirty three (78.6%) of the respondents had practised for less than 10 years. Region of practice in Nigeria were 13 (31%) in South-west, 5 (11.9%) in South-East, 3 (7.1%) in South -South, 9 (21.4%) in North-West, 10 (23.8%) in North-central and 2 (4.8%) in ...

International Surgery Journal

Background: Urine cytology is a simple, safe, non-invasive and cheap investigation that is used a... more Background: Urine cytology is a simple, safe, non-invasive and cheap investigation that is used as adjunct to cystoscopy in the diagnosis of bladder cancer. Its low sensitivity is a major limitation against its use as a sole diagnostic test for bladder cancer. The objective of this study was to determine the pattern of urine cytology seen in patients with clinical diagnosis of bladder tumour in our practice.Methods: This is a retrospective study of patients with clinical diagnosis of bladder tumour that had urine cytology in our centre. The age and gender of the patients, number of urine cytology per patient per year and cytologic diagnosis were analysed using the SPSS 20.Results: During the period under review, a total of 512 urine cytology was done for patients with clinical diagnosis of bladder tumour. The age range of the patients was 6 to 90 years with modal age of 60 years. 457 (89.3%) were males while 54 (10.5%) were females and 1 (0.2%) was unspecified. Male to female ratio ...