Urologic disease in a resource-poor country.
BACKGROUND
Understanding the role that urologic disease plays within central Haiti could lead to the development of sustainable and regionally appropriate urologic care. We aim to document the prevalence of urologic surgical disease presenting for treatment in central Haiti.


METHODS
The present study is based on a retrospective review of surgical case logs at five Partners in Health and Zanmi Lasante hospitals in central Haiti. Data were collected from June 30, 2009, through July 29, 2010, and included patient demographics, disease processes, interventions required, surgeon name, and surgeon training (urologic trained versus non-urologic trained).


RESULTS
Urologic surgical disease comprised 498/5,539 (9.0 %) of all surgical cases in central Haiti from July 2009-July 2010. A total of 492 diagnoses and 498 urologic procedures on 469 patients were recorded. Most common diagnoses included hydrocele (33.3 %), phimosis (23.0 %), benign prostatic hyperplasia (10.8 %), and cryptorchidism (7.3 %). Hydrocelectomy was the most commonly performed procedure (160/498, 32.1 %), followed by circumcision (117/498, 23.4 %) and open prostatectomy (38/498, 7.6 %). Surgeon training (urologic versus non-urologic) was determined for 360/498 (72.3 %) of surgical cases. Urologic trained surgeons performed 55/360 (15.3 %) of all surgical procedures. Among patients who underwent prostatectomy, urology surgeons performed 14/31 (45.2 %) of open prostatectomies, and non-urology surgeons performed 17/31 (54.8 %). Urologists performed all transurethral resections of the prostate (9 vs. 0; p = 0.0051).


CONCLUSIONS
Urologic surgical diseases comprise a substantial source of morbidity for patients in central Haiti. Understanding the scale and scope of urologic disease is important in developing health systems to adequately address the regional burden of surgical disease in limited-resource settings.
Institute of Urology, Lahey Clinic, 41 Mall Road, Burlington, MA 01805, USA. Marc.d.manganiello@lahey.org
Marc
M
Manganiello
Christopher D
CD
Hughes
Lars
L
Hagander
David
D
Bayne
Jean Hamiltong
JH
Pierre
Jill C
JC
Buckley
John G
JG
Meara
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003906:Developing Countries; D005260:Female; D005832:Genital Diseases, Male / Q000453:epidemiology* / Q000601:surgery; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000453:epidemiology / Q000601:surgery; D015995:Prevalence; D012189:Retrospective Studies; D001744:Urinary Bladder Calculi / Q000453:epidemiology / Q000601:surgery; D014570:Urologic Diseases / Q000453:epidemiology* / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000706:statistics & numerical data*; D055815:Young Adult