Browsing by Author "Joseph Epodoi"

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    Clinical, Sonographic and Biochemical Profiles of Patients with a Mainz II Pouch Urine Diversion in Rural Uganda. A Case Series
    (2025-05-24) Ronald Opito; David Aderu; Joseph Epodoi; Denise Apolot; Ritah Kiconco; Richard Mpango; Jacob Eperu; Fred Kirya
    Background: Mainz II pouch urinary diversion is an alternative surgery for patients with an incurable vesicovaginal fistula (VVF). We report six (6) cases of patients who had incurable VVF and were offered Mainz II pouch surgery at Soroti Regional Referral Hospital, between 2009 and 2018 and followed up in 2023. Methods: A retrospective review of charts of 6 patients who were offered Mainz II pouch procedure and a cross-sectional assessment of their biochemical, sonographic and clinical profiles five (5) or more years after the procedure at Soroti Regional Referral Hospital were done. All case notes of patients who underwent the Mainz II procedure between 2009 and 2018 were retrieved from the registry and each patient profiled using a standard data abstraction tool. Results: The ages of the six participants ranged between 16 and 65 years at the time of the procedure. Four of the 6 participants had lived with the fistula for less than 10 years. Four participants had only one delivery and the other 2 had five and six deliveries. All the participants had lived with the Mainz II pouch urine diversion for at least five years (5–14 years). One participant (1/6) had hypertension (BP=161/101). Most participants reported nocturnal incontinence. Sonographic findings revealed one-sided mild vesi coureteral reflux with loss of corticomedullary differentiation in two participants (2/6). One of six (1/6) patients had severe vesicoureteral reflux grade 4. The commonest metabolic disorders were compensated metabolic acidosis (4/6). Conclusion: The Mainz II pouch procedure remains a viable option for managing incurable obstetric fistulas. However, the prevalence of metabolic complications, including acidosis and renal impairment, underscores the need for routine biochemical and sonographic monitoring to ensure optimal long-term patient outcomes. Keywords: Mainz II pouch, vesicovaginal fistula, urinary diversion, acidosi
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    Prostate Cancer Among Patients Presenting with Obstructive Lower Urinary Tract Symptoms at a Tertiary Hospital in South Western Uganda
    (DovePress Taylor and Francis, 2025-09-30) Willy Kyegombe; Okidi Ronald; Anitah Nimusima; Yakobo Nsubuga; Brenda Nakitto; Christine Nannungi; Joseph Epodoi; Ronald Opito; Eddymond Ekuk
    Background: Prostate cancer is currently the second commonest male cancer both globally and in Uganda. Men are often tested after presenting with obstructive lower urinary tract symptoms (LUTS). We evaluated total prostate-specific antigen patterns (tPSA), digital rectal examination (DRE) findings, histological findings and prostate cancer rates among patients presenting to Mbarara regional referral hospital with obstructive LUTS. Methods: This was a cross-sectional study of 140 patients aged ≥50 with obstructive LUTS. Data on demographics and severity of LUTS was collected, plus the results of tPSA testing and DRE. Later, digitally guided transrectal tru-cut prostate biopsy was performed, if necessary. Analysis was done using SPSS (Statistical Package for Social Scientists), version 14. Confidence interval (CI) was set at 95% and P at 0.005. Results: The majority of patients had severe LUTS (n=103, 73.57%), with a median tPSA of 14.4 ng/mL. Ninety-nine patients experienced digitally guided transrectal tru-cut prostate biopsy (70.71%; Fisher’s exact test = 0.001). DRE abnormalities were found in 57.14% (n=80) of participants and these carried a higher risk for prostate cancer diagnosis (risk ratio = 5.895; Fisher’s exact test = 0.04; CI 95%: 1.59–21.822). The tru-cut biopsy positivity rate was high, at 46% (45/99; 95% CI: 30.1–46.3); all had prostate adenocarcinoma and the majority (77.78%, n=35) had a total Gleason score of 8 and above. Of those who had a malignancy, more than a quarter were between 60–80 years of age (37.8%, n = 17). There was no statistically significant relationship between LUTs and prostate cancer diagnosis (Fisher’s exact test 2-sided = 0.84). Conclusion: Although severity of LUTS was not predictive of cancer, there was a high rate of advanced prostate cancer among study participants. DRE remains a valuable tool for identifying potential prostate cancer cases, especially in settings where PSA testing may be limited. Further research is needed to explore effective screening strategies and improve outcomes for men with prostate cancer in Uganda. Keywords: prostate cancer, prostate-specific antigen, lower urinary tract obstruction, digital rectal examinatio