Introduction: Minimally invasive urological interventions have long been practiced blindly in our context. The popularization of ultrasound in urological practice has contributed to changing habits by making the procedures safer and more effective. The objective of this work was to study the technical aspects, indications and results of minimally invasive urological procedures guided by ultrasound. Material and methods: This was a prospective descriptive study lasting 1 year from January to December 2023 at the Médicis clinic in Conakry. Results: We carried out 126 ultrasound-guided urological interventions in one year, including 6 percutaneous nephrostomies (NPC), one renal cyst puncture-aspiration-sclerotherapy, 102 prostate biopsies, 5 drainages by transrectal aspiration of prostatic abscesses, 10 placements of cystostomy probes. Suprapubic, 2 puncture-aspiration-sclerotherapies for vaginal hydroceles. The average age of our patients was 69 years and the predominant age range was 61 - 70. The majority of our patients were male (97.61%) with a sex ratio of 41 men to one woman. Ultrasound-guided urological interventions were for diagnostic purposes (80.95%), for therapeutic purposes (15.77%) and for diagnostic and therapeutic purposes (3.96%). The indications for ultrasound-guided urological interventions were dominated by prostate pathologies (84.91%). The majority of interventions were performed rectally (84.92%) versus (13.43%) abdominally and only 1.58% scrotalally. All procedures were performed in B-ultrasound mode under local anesthesia and on an outpatient basis. For therapeutic interventions, the patients were seen again one month after the procedure, the clinical examination and ultrasound control found the evolution to be favorable. Conclusion: ultrasound is useful in urological practice for guiding minimally invasive interventions. The indications for ultrasound-guided procedures in urology are dominated by prostate pathologies. These procedures are safe and effective with fewer complications. Interventional ultrasound must be further integrated into the habits of urologists.
References
[1]
Passas Martínez, J., Rodríguez Antolín, A. and De La Rosa, S. (2002) Ecografía en urología. Actas Urológicas Españolas, 26, 650-665. https://doi.org/10.1016/s0210-4806(02)72843-x
[2]
Ukimura, O. (2010) Image-Guided Surgery in Minimally Invasive Urology. Current Opinion in Urology, 20, 136-140. https://doi.org/10.1097/mou.0b013e3283362610
[3]
Uppot, R.N., Gervais, D.A. and Mueller, P.R. (2008) Interventional Uroradiology. Radiologic Clinics of North America, 46, 45-64. https://doi.org/10.1016/j.rcl.2008.01.010
[4]
Nascimento, R.G., Coleman, J. and Solomon, S.B. (2008) Current and Future Imaging for Urologic Interventions. Current Opinion in Urology, 18, 116-121. https://doi.org/10.1097/mou.0b013e3282f1c5d3
[5]
Otal, P., Chabbert, V., Millan, M.I., Murat, C., Rousseau, H. and Joffre, F. (2000) Radiologie interventionnelle en urologie et néphrologie. EMC-Néphrologie, 2006, 1-12.
[6]
Diabaté, I., Ouédraogo, B., Sow, I. and Bâ, A. (2015) Cystostomie percutanée à la pince de Kelly: Indications, technique et résultats. Pan African Medical Journal, 22, Article No. 164. https://doi.org/10.11604/pamj.2015.22.164.7280
[7]
Raïssa-Michelle, K.A.B.A.S., N’Dri Simon, D.E.D.E., et al. (2023) Micro-biopsie prostatique transrectale écho-guidée: Notre expérience en milieu tropical sur 317 cas. Journal Africain d’Imagerie Médicale, 15, 215-222. https://doi.org/10.55715/jaim.v15i3.526
[8]
Aguilera, P.A., Choi, T. and Durham, B.A. (2004) Ultrasound-Guided Suprapubic Cystostomy Catheter Placement in the Emergency Department. The Journal of Emergency Medicine, 26, 319-321. https://doi.org/10.1016/j.jemermed.2003.11.016
[9]
Bah, O.R., Barry, M.I.I., Cisse, D., Diallo, A., Bah, I., Guirassy, S., Diallo, A.B., Diallo, T.M.O., Bah, M.D. and Diallo, M.B. (2018) Nephrostomie percutanée échoguidée au service d’urologie du chu de Conakry. Uro’Andro, 1, 415-418.
[10]
Dagli, M. and Ramchandani, P. (2011) Percutaneous Nephrostomy: Technical Aspects and Indications. Seminars in Interventional Radiology, 28, 424-437. https://doi.org/10.1055/s-0031-1296085
[11]
Brandt, M.P., Lehnert, T., Czilwik, T., Borgmann, H., Gruber-Rouh, T., Thalhammer, A., et al. (2019) CT-Guided Nephrostomy—An Expedient Tool for Complex Clinical Scenarios. European Journal of Radiology, 110, 142-147. https://doi.org/10.1016/j.ejrad.2018.11.028
[12]
Hausegger, K.A. and Portugaller, H.R. (2006) Percutaneous Nephrostomy and Antegrade Ureteral Stenting: Technique—Indications—Complications. European Radiology, 16, 2016-2030. https://doi.org/10.1007/s00330-005-0136-7
[13]
Young, M. And Leslie, S.W. (2023) Percutaneous Nephrostomy. StatPearls Publishing.
[14]
Weltings, S., Schout, B.M.A., Roshani, H., Kamphuis, G.M. and Pelger, R.C.M. (2019) Lessons from Literature: Nephrostomy versus Double J Ureteral Catheterization in Patients with Obstructive Urolithiasis—Which Method Is Superior? Journal of Endourology, 33, 777-786. https://doi.org/10.1089/end.2019.0309
[15]
Manikandan, R., Kumar, S., Dutt, U., Singh, S., Dorairajan, L., Sreerag, K., et al. (2020) Prospective Audit of Complications after Ultrasonography-Guided Percutaneous Nephrostomy for Upper Urinary Tract Obstruction Using Modified Clavien Classification System. Urology Annals, 12, 31-36. https://doi.org/10.4103/ua.ua_18_19
[16]
Skolarikos, A., Alivizatos, G., Papatsoris, A., Constantinides, K., Zerbas, A. and Deliveliotis, C. (2006) Ultrasound-Guided Percutaneous Nephrostomy Performed by Urologists: 10-Year Experience. Urology, 68, 495-499. https://doi.org/10.1016/j.urology.2006.03.072
[17]
Kocoglu, H., Alan, C., Malkoc, E., Eşkin, M.B., Kurt, H.A. and Ersay, A.R. (2012) Un abordaje diferente a la nefrostomía percutánea por urólogos. Actas Urológicas Españolas, 36, 613-619. https://doi.org/10.1016/j.acuro.2012.02.008
[18]
Monville, H., Wagner, L., Dibo, D., Soustelle, L., Muyshondt, C., Droupy, S., et al. (2014) Sclérothérapie percutanée à l’éthanol des kystes rénaux symptomatiques: Résultats à 4 ans. Progrès en Urologie, 24, 353-358. https://doi.org/10.1016/j.purol.2013.11.003
[19]
Lanchon, C., Fiard, G. and Long, J.-A. (2015) Prise en charge des lésions kystiques du rein: Revue de la littérature. Progrès en Urologie, 25, 675-682. https://doi.org/10.1016/j.purol.2015.05.013
[20]
Baysal, T. and Soylu, A. (2009) Percutaneous Treatment of Simple Renal Cysts with N-Butyl Cyanoacrylate and Iodized Oil. Diagnostic and Interventional Radiology, 15, 148-152.
[21]
Brown, D., Nalagatla, S., Stonier, T., Tsampoukas, G., Al-Ansari, A., Amer, T., et al. (2021) Radiologically Guided Percutaneous Aspiration and Sclerotherapy of Symptomatic Simple Renal Cysts: A Systematic Review of Outcomes. Abdominal Radiology, 46, 2875-2890. https://doi.org/10.1007/s00261-021-02953-9
[22]
Dietrich, C., Chiorean, L., Potthoff, A., Ignee, A., Cui, X. and Sparchez, Z. (2016) Percutaneous Sclerotherapy of Liver and Renal Cysts, Comments on the EFSUMB Guidelines. Zeitschrift für Gastroenterologie, 54, 155-166. https://doi.org/10.1055/s-0041-106594
[23]
El Harrech, Y., Sossa, J., Chafiki, J., Janane, A., Ameur, A. and Abbar, M. (2009) Place de la ponction-sclérothérapie à la polyvidone-iodine dans le traitement des kystes rénaux simples symptomatiques. Journal de Radiologie, 90, 1075-1078. https://doi.org/10.1016/s0221-0363(09)73247-0
[24]
Sudrial, J., Casalonga, A., Predour, S. and Combes, X. (2012) Cathétérisme sus-pubien. Annales françaises de médecine d'urgence, 3, 28-30. https://doi.org/10.1007/s13341-012-0270-1
[25]
Ahluwalia, R., Johal, N., Kouriefs, C., Kooiman, G., Montgomery, B.S. and Plail, R. (2006) The Surgical Risk of Suprapubic Catheter Insertion and Long-Term Sequelae. The Annals of The Royal College of Surgeons of England, 88, 210-213. https://doi.org/10.1308/003588406x95101
[26]
Harrison, S.C.W., Lawrence, W.T., Morley, R., Pearce, I. and Taylor, J. (2010) British Association of Urological Surgeons’ Suprapubic Catheter Practice Guidelines. BJU International, 107, 77-85. https://doi.org/10.1111/j.1464-410x.2010.09762.x
[27]
Jacob, P., Rai, B.P. and Todd, A.W. (2012) Suprapubic Catheter Insertion Using an Ultrasound-Guided Technique and Literature Review. BJU International, 110, 779-784. https://doi.org/10.1111/j.1464-410x.2011.10882.x
[28]
Day, N. (2013) Improving Documentation and Use of Ultrasound for Suprapubic Catheter Insertions. BMJ Quality Improvement Reports, 2, u741.w214. https://doi.org/10.1136/bmjquality.u741.w214
[29]
Cho, K.H., Doo, S.W., Yang, W.J., Song, Y.S. and Lee, K.H. (2010) Suprapubic Cystostomy: Risk Analysis of Possible Bowel Interposition through the Percutaneous Tract by Computed Tomography. Korean Journal of Urology, 51, 709-712. https://doi.org/10.4111/kju.2010.51.10.709
[30]
Cronin, C.G., Prakash, P., Gervais, D.A., Hahn, P.F., Arellano, R., Guimares, A., et al. (2011) Imaging-Guided Suprapubic Bladder Tube Insertion: Experience in the Care of 549 Patients. American Journal of Roentgenology, 196, 182-188. https://doi.org/10.2214/ajr.10.4520
[31]
Ouzzane, A., Coloby, P., et al. (2011) Recommandations pour la bonne pratique des biopsies prostatiques. Progrès en Urologie, 21, 18-28. https://doi.org/10.1016/j.purol.2010.07.001
Streicher, J., Meyerson, B.L., Karivedu, V. and Sidana, A. (2019) A Review of Optimal Prostate Biopsy: Indications and Techniques. Therapeutic Advances in Urology, 11, Article 1756287219870074. https://doi.org/10.1177/1756287219870074
[34]
Moudouni, S.M., Zahraoui, M.R., Adarmouch, L., Lakmichi, M.A., Bentani, N., Jarir, R., et al. (2014) L’anesthésie locale pour les biopsies prostatiques écho-guidées: Etude prospective randomisée comparant deux méthodes. Progrès en Urologie, 24, 108-113. https://doi.org/10.1016/j.purol.2013.07.011
[35]
Lee, M.S., Moon, M.H., Kim, C.K., Park, S.Y., Choi, M.H. and Jung, S.I. (2020) Guidelines for Transrectal Ultrasonography-Guided Prostate Biopsy: Korean Society of Urogenital Radiology Consensus Statement for Patient Preparation, Standard Technique, and Biopsy-Related Pain Management. Korean Journal of Radiology, 21, 422-430. https://doi.org/10.3348/kjr.2019.0576
[36]
Ploussard, G., Fiard, G., Barret, E., Brureau, L., Créhange, G., Dariane, C., et al. (2022) French AFU Cancer Committee Guidelines—Update 2022-2024: Prostate Cancer-Diagnosis and Management of Localised Disease. Progrès en Urologie, 32, 1275-1372. https://doi.org/10.1016/j.purol.2022.07.148
[37]
Ndiaye, M., Jalloh, M., Ndoye, M., Faye, S.T., Kouka, S.C.N., Ndour, N.S., et al. (2021) Ultrasound-Guided Prostate Biopsy: Indication, Morbidity and Outcome at Hopital General Idrissa Pouye. African Journal of Urology, 27, Article No. 54. https://doi.org/10.1186/s12301-021-00155-9
[38]
Shen, P., Zhu, Y., Wei, W., Li, Y., Yang, J., Li, Y., et al. (2011) The Results of Transperineal versus Transrectal Prostate Biopsy: A Systematic Review and Meta-Analysis. Asian Journal of Andrology, 14, 310-315. https://doi.org/10.1038/aja.2011.130
[39]
Xue, J., Qin, Z., Cai, H., Zhang, C., Li, X., Xu, W., et al. (2017) Comparison between Transrectal and Transperineal Prostate Biopsy for Detection of Prostate Cancer: A Meta-Analysis and Trial Sequential Analysis. Oncotarget, 8, 23322-23336. https://doi.org/10.18632/oncotarget.15056
[40]
Abdelmoteleb, H., Rashed, F. and Hawary, A. (2017) Management of Prostate Abscess in the Absence of Guidelines. International Brazilian Journal of Urology, 43, 835-840. https://doi.org/10.1590/s1677-5538.ibju.2016.0472
[41]
Ackerman, A.L., Parameshwar, P.S. and Anger, J.T. (2017) Diagnosis and Treatment of Patients with Prostatic Abscess in the Post-Antibiotic Era. International Journal of Urology, 25, 103-110. https://doi.org/10.1111/iju.13451
[42]
Alnadhari, I., Sampige, V.R.P., Abdeljaleel, O., El Ansari, W., Ali, O., Salah, M., et al. (2020) Presentation, Diagnosis, Management, and Outcomes of Prostatic Abscess: Comparison of Three Treatment Modalities. Therapeutic Advances in Urology, 12, Article 175628722093062. https://doi.org/10.1177/1756287220930627
[43]
Khudhur, H., Brunckhorst, O., Muir, G., Jalil, R., Khan, A. and Ahmed, K. (2020) Prostatic Abscess: A Systematic Review of Current Diagnostic Methods, Treatment Modalities and Outcomes. Turkish Journal of Urology, 46, 262-273. https://doi.org/10.5152/tud.2020.19273
[44]
Chang, Y., Pan, S., Lin, C., Huang, C., Chung, C., Chen, Y., et al. (2023) Factors Deciding Conservative or Intervention Treatment for Prostate Abscess: A Retrospective Case-Control Study. Journal of Personalized Medicine, 13, Article 484. https://doi.org/10.3390/jpm13030484
[45]
Liang, F., Cao, J., Qin, L. and Zhang, X. (2023) Giant Prostate Abscess: A Case Report and Literature Review. American Journal of Men’s Health, 17, Article 15579883231219570. https://doi.org/10.1177/15579883231219570
[46]
Wooster, M.E., Huang, G., Sanders, J.W. and Peacock, J.E. (2021) Prostatic Abscess: Clinical Features, Management, and Outcomes of a “Stealth” Infection: Retrospective Case Series and Review of the Literature. Diagnostic Microbiology and Infectious Disease, 99, Article 115285. https://doi.org/10.1016/j.diagmicrobio.2020.115285
[47]
Tariel, E. and Mongiat-Artus, P. (2004) Traitement des hydrocèles de l’adulte. Annales d’Urologie, 38, 180-185. https://doi.org/10.1016/j.anuro.2004.05.002
[48]
Forss, M., Bolsunovskyi, K., Lee, Y., Kilpeläinen, T.P., Aoki, Y., Gudjonsson, S., et al. (2023) Practice Variation in the Management of Adult Hydroceles: A Multinational Survey. European Urology Open Science, 58, 1-7. https://doi.org/10.1016/j.euros.2023.09.005
[49]
Shakiba, B., Heidari, K., Afshar, K., Faegh, A. and Salehi-Pourmehr, H. (2023) Aspiration and Sclerotherapy versus Hydrocelectomy for Treating Hydroceles: A Systematic Review and Meta-Analyses. Surgical Endoscopy, 37, 5045-5051. https://doi.org/10.1007/s00464-023-10143-5
[50]
Khaniya, S., Agrawal, C.S., Koirala, R., Regmi, R. and Adhikary, S. (2009) Comparison of Aspiration-Sclerotherapy with Hydrocelectomy in the Management of Hydrocele: A Prospective Randomized Study. International Journal of Surgery, 7, 392-395. https://doi.org/10.1016/j.ijsu.2009.07.002
[51]
Francis, J.J. and Levine, L.A. (2013) Aspiration and Sclerotherapy: A Nonsurgical Treatment Option for Hydroceles. Journal of Urology, 189, 1725-1729. https://doi.org/10.1016/j.juro.2012.11.008
[52]
Beiko, D.T., Kim, D. and Morales, A. (2003) Aspiration and Sclerotherapy versus Hydrocelectomy for Treatment of Hydroceles. Urology, 61, 708-712. https://doi.org/10.1016/s0090-4295(02)02430-5
