The distribution of patients depending of nosology entities is given in Table 2.

・ Malformative uropathies

○ High malformative uropathies

High uropathies in 30 cases were dominated by pyelo-ureteral junction anomalies and the kidney multi-cystic dysplasia with respectively 16 and 6 cases. The other high uropathies were represented by polycystic kidney (n = 2), the kidney agenesis (n = 2), the kidney ectopia (n = 2), the horseshoe-shaped kidney (n = 1) and the bifid ureter (n = 1).

○ Low malformative uropathies

Low uropathies were essentially formed by posterior urethra’s valves (n = 23) and hypospadias (n = 24). The other diagnoses were the bladder exstrophy (n = 8), the congenital reflux from urethra to bladder (n = 1), and the congenital urethral stenosis (n = 1). Other low malformative uropathies were represented by urachus cyst (n = 4), the peritoneovaginal canal pathology (n = 254), the testicular ectopia (n = 69), the spermatic cord torsion (n = 15), paraphimosis (n = 3), phimosis (n = 2), and varicocele (n = 2).

・ Urolithiasis

Urolithiasis concerned boys principally (89.5%). The age bracket from 5 to 10 years was the more concerned with 39.5%. These lithiasis were happened on pre-existing uropathy in 7 cases (4.3%); it’s PUJA (n = 3), PUV (n = 2), kidney ectopia (n = 1) and bifid ureter (n = 1).

・ Kidney and urinary tract tumours

The tumoural pathology was dominated by Wilms’ tumour with 35 cases (83.3% of tumours). The other tumours diagnosed were bladder tumour and testicular with 9.5% and 7.1% of tumours, respectively.

・ Traumatic pathology

Four (4) cases of kidney contusion, 4 cases of urethral stenosis, 1 case of glans amputation after posthectomia and 1 case of urethral section have been registered.

・ Infectious pathology

Fourty two (42) cases of urinary tractus infection with banal germ have been registered and 2 cases among them were urinary schistosomiasis. Infectious complications like pyonephrosis (n = 4) and kidney abscess (n = 1) have been observed. Other type of infections were acute orchiepipidymitis (n = 3), infected urinoma (n = 1) and scrotal abscess (n = 1).

・ Other uropathy

The other uropathies types were the priapism (n = 10), mucous prolapsed of urethra (n = 4), iatrogenic urethral fistula (n = 4) and the secondary ureterovesical reflux (n = 3).

In our study, per year 88.8 cases for hospital frequency of uropathy have been found. It represented 7.4% of the whole hospitalisation. This proportion is superior to the reports of Agossou-Voyeme and Dao who respectively found 4.8% and 2.8% in their series [2] [4] . This difference is relative to the context of the study. The average age of our patients was 4 years. This result is near to those of Agossou-Voyeme and Dao who found 4.4 years and 4 years 11 months respectively [2] [4] . Urologic pathologies predominated on boys with 7.3 as sex-ratio. The predominance of urologic disease at boys has been reported in developed countries’ literature, and this in a similar way as developing countries’ one [1] [4] [5] . It concerned the definition of the paediatric urology which dealt with urinary apparatus pathologies for both sexes (male and female), and particularly male genital organs [6] .

Considering nosologic entities, the uro-genital malformation was the most frequent pathology in our series with a proportion of 62.7%. This predominance had been observed in developed countries’ literature which is similar to developing countries’ literature [1] [4] [5] . In our context, this frequency of the malformative pathologies would increase with the development of antenatal diagnosis.

Among these MU, the PUJA was more frequent in terms of high uropathy. His frequency of 2 cases per year (15 cases in 8 years), which is close to the frequency found by Kahloul et al. [7] (15 cases in 8.5 years, namely 1.7 cases/year) is very inferior to those reported by Diarra et al. [8] (13 cases in 1.5 years namely 8.7 cases/ year).

Among low MU, PUV were the most frequent and the most serious. The increasing of creatininemia (average of 133 umol/L) was present at 45% of patients who had PUV. This kidney’s function deterioration in this MU has been also reported by other African authors: Khemakhem and al. (18/38 or 47.4%) and Dami (33.33%) [9] [10] . This kidney function deterioration would be function of the late in diagnosis and the seriousness of the pathology. PUV formed the first aetiology of chronic obstructive renal failure to the boy [5] . Another frequent complication in PUV is the urinary infection: about 2/3 of patients in our series (64.5%) and 75% in Dami’s serie [10] . This frequency of urinary tract infections reported by many authors [3] [11] [12] confirms the seriousness of this pathology with the risk of septicaemia in pyelonephritis. These complications are able to strike a blow at patients’ vital prognosis underlining the necessity of early diagnosis and adequate treatment.

The total nephrectomy has been indicated for a muted kidney in 5 cases on 16 PUJA; it forms a high rate. In PJUA, the waited nephrectomy rate was about 10% for primary nephrectomy and inferior to 1% for secondary nephrectomy in the western series at the end of years 1980 [13] -[15] . These series were composed of a majority of postnatal diagnosis, with which the primary nephrectomy decreased and secondary nephrectomy become very rare [16] [17] . It’s important in our context to promote the antenatal diagnosis, with obstetrical echography and at default, act to early screening of MU in order to reduce nephrectomy rate.

This screening will have to concern also PUV in particular because of their seriousness. An early and adequate treatment, in particular the endoscopic resection, will contribute to the reduction of this pathology’s lethality.

Postoperatives complications have been observed in 15 patients with a morbidity rate of 2.1%. It was about parietal suppuration in 6 cases and fistula in 7 cases after bladder lithotomy or after surgery of hypospadias and bladder exstrophy.

The global mortality of uropathies in our series was 2.3%. This high rate is similar to rate found by Agossou-Voyeme et al. (2.8%) [2] . The principal cause of death was the Wilms’ tumour with 58.8%. This high rate of lethality is explained by difficulties met in the care of cancer in developing countries, mainly the problems of accessibility to treatment and delay on diagnosis. It calls out to an early screening of cases by complete and systematic clinic exam for any child who is consulted or made medical visit, and who has a best accessibility for chemotherapy. Posterior urethra valves provided two cases of death due to renal failure after elevation of urea. The endoscopic treatment of such disease is not accessible in our context. The other causes of death were represented by bladder exstrophy, strangled inguinal hernia, kidney abscess, bladder tumour, and urolithiasis. The main problems were the inadequacy of our health system which cannot provide good quality of care and the cultural considerations that urge certain parents to use traditional medicines before their admission to hospital. That situation explained the delay on diagnosis and care thus leading to drawbacks.