Anus Diseases in Proctology Consultation in the Yaounde University Teaching Hospital (Cameroon): Male Predominance, Taboo and Neglected Diseases

Background/Aims: In Cameroon, there are several taboos around anus diseases: male homosexuality, traditional medical problem, and humiliation. The aim of this retrospective study was to describe the demographic, clinical presentation, and pathological features of anus diseases in Yaounde. Methods: Records of 820 outpatients with anorectal complaints seen in proctology consultation with endo-anal examination, from January 2008 to June 2014 were reviewed. Information collected included age, gender, complaints, and anus diseases. Result: There were 589 men (71.8%) and 231 women (28.2%). Patients with anus diseases were older than those without (40.6 years vs. 37.1 years, p=0.005). Dominant presenting symptoms included bleeding in 56.7%, and anal pain in 44.1% of patients. Hemorrhoids were the most common etiology for these complaints (70.7%); followed by anal fissures (20.1%), anusitis (8.3%), and suppurative pathologies (6.6%), typically in male adults. Anal fistula was the most frequent suppuration 61.1%, followed by abscess 38.9%. Anorectal tumors were rare. In multivariate analysis, hemorrhoids (OR = 2.56; 95%CI: 1.86-3.51; p = 0.01) and anal fissure (OR = 3.9; 95%CI: 2.4-6.3; p <10-5) were associated with bleeding. Thrombosed hemorrhoids (OR = 11.9; 95%CI: 6.4- 22.3; p = 0.01), anal fissure (OR = 3.9; 95%CI: 2.4-6.3; p <10-5), and anorectal abscess (OR = 2.6; 95%CI: 1.2-5.8; p <10-5) were associated with pain. Conclusion: Bleeding, anal pain and rectal prolapse are common presenting symptoms. Hemorrhoids are the most common etiology for these complaints. Data from this study could serve as guidance to gastroenterologists and other practitioners to recognize, assess, and manage anus diseases in our midst.