Urologic Emergencies in a Low‑Resource Setting: A 10‑Year Review from South‑Western Nigeria

Abstract

Background: Emergency presentations are quite an important aspect of the urologic practice, and prompt attention is necessary to relieve  symptoms, limit morbidity, and prevent mortality. Adequate knowledge of the pattern of emergency urologic presentations might aid rapid  diagnosis and provide data for hospital and public health planning purposes. We present our experience with urologic emergencies in our hospital.

Objectives: The objective was to describe the pattern of presentation and the peculiar challenges of urologic emergencies in a typical low‑resource setting in South‑Western, Nigeria.

Patients and Methods: A retrospective review of all patients with urologic complaints who presented acutely to the accident and emergency  department (AED) of our hospital, between January 2008 and December 2017, was done. Data were analyzed using the Statistical Package for Social Sciences version 20.

Results: There were 1102 patients seen with urologic complaints, which constitute 3.2% of the total patients presenting to our AED over the 10‑year period reviewed. Urinary retention (28.7%) and gross hematuria (19.5%) were the most common emergency urology presentations, whereas urethral injury was the most common mode of urologic trauma (59%). Over half (53%) of the patients with hematuria had a urologic malignancy. Prostate cancer was the leading urologic malignancy presenting to the AED. Testicular torsion and priapism were predominantly found in young male patients. There were 2.7% mortalities, with complicated prostate cancer, the leading cause (66.7%). Immediate causes of mortality were metastatic disease and urosepsis.

Conclusion: Urologic emergencies are a probable cause of morbidity and mortality in our setting. Adequate knowledge of the pattern of patient
presentation might aid diagnosis, improve outcomes, and provide data for hospital and public health planning purposes.

Keywords: Emergency, urine retention, haematuria, malignancy, mortality, urology