[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Testicular cancer is a rare disease. The incidence of testicular cancer in undescended testicles is of 3 to 48 times greater than in the general population. In the developed countries, the existence of undescended testicles in the adult population is rare, due to systematic practice of elective orchidopexy before the second year of life and orchiectomy in post adolescent males with undescended testicles. Despite these prevention measures, there are still some isolated cases of intra-abdominal testicular tumors in adults. We report a case of testicular cancer in cryptorchid testis revealed by supraclavicular lymphadenopathy. CASE PRESENTATION: We report a case of a 46 year old fertile man with a history of unilateral cryptorchidism who presented with a palpable left supraclavicular mass and absence of the right testicle. On investigations an intrapelvic testis tumor was diagnosed. Laparotomy and complete excision was carried out. The possible association between the undescended testis and cancer transformations is briefly discussed. CONCLUSION: testicular cancer in undescended testicles should not be ignored. Only early diagnosis and lower of testis in scrotumprevent such clinical forms.
[Show abstract][Hide abstract] ABSTRACT: Impalement injuries of the rectum with bladder perforation have been rarely reported. Such lesions have been associated with increased postoperative morbidity. A well-conducted preoperative evaluation of the lesions tends to prevent such complications.
To increase awareness about patients with rectal impalement that involve bladder injuries and to examine the significance of thorough clinical examination and complementary investigation for these patients' management.
Retrospectively, we identified three patients with rectal impalement and bladder perforation treated in University Hospital Hassan II, Fez, Morocco. We recorded the symptoms, subsequent management, and further follow-up for each patient. All available variables of published cases were reviewed and analyzed.
Evident urologic symptoms were present in only one patient. Bladder perforation was suspected in two other patients on the basis of anterior rectal perforation in digital exam. Retrograde uroscanner could definitely confirm the diagnosis of bladder perforation. Fecal and urine diversion was the basis of the treatment. No postoperative complications were noted. We have reviewed 14 previous reports. They are presented mainly with urine drainage through the rectum. Radiologic investigation (retrograde cystography and retrograde uroscanner) confirmed bladder perforation in 10 patients (71.4%). Unnecessary laparotomy was performed in six patients (42.8%). Fecal diversion and urinary bladder decompression using urethral catheter were the most performed procedures in bladder perforation [6/14 patients (42.8%)]. No specific postoperative complications were reported.
A high index of clinical suspicion is required to make the diagnosis of bladder perforation while assessing patients presenting with rectal impalement. Meticulous preoperative assessment is the clue of successful management.
[Show abstract][Hide abstract] ABSTRACT: INTRODUCTION: Male urethral diverticula are rare. Patients with paraplegia may present with acquired diverticula as a result of prolonged catheterization. Diverticula may be asymptomatic or lead to lower urinary tract symptoms. Rarely, the diverticulum may initially present as a scrotal mass. CASE PRESENTATION: We report the case of a male 45-year-old Arab with paraplegia who presented with a mass in the peno-scrotal junction. He had in his medical history iterative prolonged urethral catheterizations associated with urine leakage through the urethral meatus upon applying compression. Diagnosis confirmation of urethral diverticula is obtained by retrograde urethrography. The patient underwent a diverticulectomy with urethroplasty. CONCLUSION: Male acquired urethral diverticula can be found in patients who have a spinal cord injury because of prolonged urethral catheterization. Clinical presentations are different and sometimes can be misleading. Retrograde urethrography is the key to diagnosis and open surgery is the treatment of reference.
Journal of Medical Case Reports 11/2012; 6(1):392.
[Show abstract][Hide abstract] ABSTRACT: Epididymal leiomyosarcoma is very uncommon. Only 16 cases have been reported in the literature. There has never been a reported case of a patient with an African origin with this tumor. We report the medical history of a 70-year-old man who presented an enormous mass located in his epididymis. A tricut biopsy was performed which allowed histological confirmation of epididymal leiomyosarcoma after which the patient underwent excision of the mass. The patient died after the first round of chemotherapy.
[Show abstract][Hide abstract] ABSTRACT: Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. Cases of giant hydronephrosis are rare and usually contain no more than 1-2 litres of fluid in the collecting system. Here, we report a rarely seen case with giant urinary bladder and bilateral giant hydronephrosis due to bladder neck obstruction which contains 4000 mL fluid in the collecting system of the kidney mimicking an ascites in an adult male.
[Show abstract][Hide abstract] ABSTRACT: Although the management of either isolated rectal or bladder injury is no more controversial, their combined effect and their optimal management has been seldom reported in the English literature. From a case report of a 45-year-old male who was found to have a combined bladder and rectal injury secondary to a stab wound of the perianal area, the authors develop a diagnostic and therapeutic algorithm for the management of this uncommon trauma.
[Show abstract][Hide abstract] ABSTRACT: Buschke-Lowenstein tumour (BLT) is a giant condyloma acumina, which is rare entity and represents only 1% of all populace. It is a rare viral disease, essentially transmitted by sexual intercourse, characterized by a potential for malignant transformation, invasion and recurrence after treatment. We report a case of BLT associated with perinea-scrotal melanoma. This association was never described in the literature. The purpose of our case report is to discuss the clinical and pathological appearances of these two entities and to outline the recent studies of molecular biology, which can explain this association.
Progrès en Urologie 01/2012; 22(1):70-2. · 0.80 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Inflammatory pseudotumors, also known as inflammatory myofibroblastic tumors, are uncommon benign tumors of unknown etiology which may develop at several anatomical sites. In the urogenital tract, inflammatory pseudotumor usually affects the urinary bladder or the prostate. Inflammatory pseudotumor of the kidney is very rare. It is considered as a reactive inflammatory lesion that features very good prognosis.
We present the case of a 57-year-old Moroccan man who presented with a two-month history of gross hematuria and left lumbar pain. Imaging investigations revealed a left kidney mass and pathological examination of the nephrectomy specimen showed an inflammatory pseudotumor.
As the preoperative definitive diagnosis of such a tumor is not possible, surgery is advised because only pathological examination of the nephrectomy specimen can establish the diagnosis with certainty. From one case report and literature review, the authors suggest a diagnostic and therapeutic strategy for the management of this rare tumor.
[Show abstract][Hide abstract] ABSTRACT: Seminal vesicle cyst is an extremely rare disease. Its association with ipsilateral renal agenesis is even more exceptional. We present herein one case of a 16-year-old male who presented with a four-month history of lower urinary tract symptoms (LUTSs) and micturition pain. The digital rectal examination revealed a small mass arising from the prostate. The urine culture showed that E. coli is sensitive to all antibiotics tested. Transrectal ultrasound (TRUS) revealed a cystic mass in the outer prostate. Seminal vesicle cyst and left renal agenesis were confirmed by magnetic resonance imaging (MRI). Maximum flow (Q(max)) at uroflow was greater than 15 mL/sec. We therefore decided to manage this disease conservatively with alpha blockers and antibiotics. After 6-month' followup the patient did not report any complain and the uroflow test was similar to a normal urination. From one case report and literature review, the authors suggest a diagnostic and therapeutic strategy for the management of this rare condition.
[Show abstract][Hide abstract] ABSTRACT: Introduction. Primary melanoma of the urinary bladder is very rare. As far as we know, 19 cases have been reported worldwide, usually as case reports. Case Presentation. We present a 71-year-old male patient presented with a 2-month history of hematuria. Ultrasonography revealed a 5-cm-size mass located in the bladder trigone. A transurethral resection of the bladder tumor (TURBT) revealed a malignant melanoma. Evaluation for metastatic disease was negative. The patient deceased five months later before radical treatment could be performed. Conclusion. This is one more reported case of primary melanoma of the urinary bladder. The previously reported cases of bladder melanoma are reviewed. Therapy and prognosis are discussed.
[Show abstract][Hide abstract] ABSTRACT: Urachal affections are rare. Their variable ways of presentation may represent a diagnostic challenge. Urachal sinuses are a rare type of these abnormalities. They are usually incidental findings and remain asymptomatic unless a complication (most commonly the infection) occurs. Infection of the urachal sinus would clinically present as purulent umbilical discharge, abdominal pain, and periumbilical mass. We report herein a case of infected urachal sinus in male adult. The diagnosis was suspected clinically and confirmed with ultrasonography and computed tomography scan. A preoperative cysto-fibroscopy showed normal aspect of the bladder and excluded sinus communication. An initial broad spectrum antibiotic therapy followed by complete excision of the sinus and fibrous tract without cuff of bladder has been therefore performed. The postoperative course was uneventful. No recurrence was observed after 18 months of followup. Histological examination did not reveal any sign of malignancy.
[Show abstract][Hide abstract] ABSTRACT: Penile amputation is a rare condition for which immediate surgical replantation is warranted. We present herein one case of a 27-year-old male who presented to the Emergency Department after his wife cut his penis. The penis was replanted microsurgically. The deep dorsal penile veins and superficial veins were anastomosed. Although we could not reanastomose the arteries, wound healing occurred without any problem one week postoperatively and the patient regained erectile function 4 weeks after surgery. At 1-year follow-up examinations he reported on restored erectile function and a normal urinary function.
[Show abstract][Hide abstract] ABSTRACT: A rare intratubular gonadal stromal tumor was present in the testis of a 45-year-old man who was admitted to our hospital with the chief complaint of gradual enlargement of the left testis. Tumoral markers were negative and no extension was observed. The tumor comprised an intratubular mixture of two types of tumor cells with intercellular junctions: the predominant tumor cells were consistent with a Sertoli cell origin and cells comprising the minor population consistent with a Leydig cell origin. The patient is disease free after 6-month follow-up. The case is considered to be a testicular mixed tubular Sertoli-Leydig cell tumor. It highlights a rare type of primary tumor of the testis that features a good prognosis.
[Show abstract][Hide abstract] ABSTRACT: Partial ureteropelvic junction disruption as a result of blunt trauma is rare and frequently missed by the initial trauma evaluation. Delays in diagnosis have also been associated with significant morbidity. A high index of suspicion should lead to appropriate investigations, and the management will be determined by the severity of the disruption. We present herein a 24-year-old man who was admitted to the Emergency Room with multiple organ injuries caused by a severe blunt trauma. Emergency celiotomy was performed for massive hemoperitoneum and shattered spleen which led to splenectomy. The diagnosis of partial UPJ disruption was missed preoperatively and suspected in CT scan after appearance of flank tender mass. Confirmation was obtained in retrograde ureteropyelography and treated conservatively with indwelling ureteral stent. We present herein an extensive review of the literature to examine the current status of this entity and to determine if improvements could be made in the diagnosis and treatment.
[Show abstract][Hide abstract] ABSTRACT: IntroductionIl existe une association entre les troubles mictionnels de l’hypertrophie bénigne de la prostate (HBP) et la dysfonction
érectile (DE) dont la physiopathologie n’est pas complètement élucidée. De nombreuses publications ont mis l’accent sur le
rôle de la sévérité des symptômes urinaires dans cette association et sur les résultats des différentes thérapeutiques utilisées.
Aucune publication n’a jamais évoqué l’effet du stade évolutif des symptômes urinaires avec apparition de complications sur
ObjectifsÉvaluer la corrélation entre la DE et le stade évolutif des troubles urinaires chez des patients présentant une HBP, et étudier
l’évolution de cette DE sous différentes thérapeutiques.
Matériel et méthodesIl s’agit d’une étude prospective menée sur une période de 12 mois, au CHU de Fès au Maroc, pendant laquelle ont été vus en
consultation d’urologie 100 patients souffrant de troubles urinaires du bas appareil (TUBA) secondaires à une HBP. Leur fonction
érectile avait été évaluée à l’aide du questionnaire IIEF-5 (Index international de la fonction érectile). Dans notre population,
il n’était pas possible d’utiliser de façon fiable l’IPSS (International Prostatic Symptoms Score) ni d’avoir une idée exacte
sur le début de la symptomatologie mictionnelle. Ainsi, nous avions étudié chez nos patients l’âge, le stade évolutif de l’HBP
(HBP compliquée ou non) et la réponse de la DE aux différents traitements utilisés.
RésultatsL’âge moyen de nos patients était de 64,3 ans. Quarante patients (40 %) avaient une HBP compliquée et 60 patients une HBP
non compliquée. La fonction érectile était fortement altérée chez 30 patients (75 %) ayant une HBP compliquée et chez 20 patients
(33 %) ayant une HBP symptomatique non compliquée nécessitant un traitement médical. Le traitement médical par un alphabloquant
(tamsulosine) avait contribué à améliorer la fonction érectile chez 12 patients de ce groupe (20 %). Les patients ayant une
HBP compliquée avaient bénéficié d’un traitement chirurgical (résection transurétrale de prostate, RTUP, ou chirurgie ouverte),
et la fonction érectile n’a pas été statistiquement améliorée dans ce groupe de patients.
ConclusionLe risque de DE chez les patients présentant une HBP est lié au stade évolutif de l’HBP. En effet, ce risque est beaucoup
plus important chez les patients ayant une HBP compliquée. Le traitement médical par un alphabloquant améliore la fonction
érectile. Par contre, statistiquement parlant, la chirurgie n’améliore pas celle-ci.
IntroductionAlthough the relationship between the lower urinary tract symptoms (LUTS) and the erectile dysfunction (ED) is no more debated,
its underlying mechanism remains obscure so far. Several studies emphasized the correlation between the severity of LUTS and
the sexual function, and the impact of the different medications used. This study is the first to highlight the association
between the stage of evolution of BPH (complicated and noncomplicated BPH) and the severity of the ED.
ObjectivesTo assess the correlation between ED and the stage of evolution of BPH, and to evaluate the impact of different medications
Patients and methodsThis is a prospective trial relating of 100 patients admitted for urologic consultation, in the Universitary Hospital Center
of Fez in Morocco, in a period of 12 months. To evaluate the severity of ED, we used International Index of Erectile Function
(IIEF). In our patients, it was not possible to use the International Prostate Symptom Score (IPSS) to assess the severity
of urinary symptoms, and it was not possible to date exactly the beginning of LUTS. Hence, we studied patients’ age, the stage
of evolution of BPH (complicated or noncomplicated BPH) and the response of the ED to different treatments.
ResultsThe average man age was 64.3 years. Forty patients had complicated BPH and 60 patients had noncomplicated BPH. Thirty patients
(75%) among 40 with complicated BPH had severe ED, whereas an ED rate of 33% (20 patients) was noticed in patients presenting
with noncomplicated BPH. Alpha-blockers (tamsulosin) improved erectile function in 12 patients (20%) among those with noncomplicated
BPH. Patients presenting with complicated BPH underwent surgical procedure (either transurethral resection of the prostate
or open prostatectomy). Erectile function was not statistically improved in this group of patients.
ConclusionED showed a correlation with the stage of evolution of symptomatic BPH. Indeed, the risk of ED is higher in patients with
complicated BPH. The alphablockers improved the erectile function in the group of noncomplicated BPH, contrary to the surgical
Mots clésTrouble du bas appareil urinaire–Hypertrophie bénigne de la prostate–Dysfonction érectile
KeywordsLow urinary tract symptoms–Benign prostatic hyperplasia–Erectile dysfunction
[Show abstract][Hide abstract] ABSTRACT: Double-J ureteral stents are commonly used to manage urinary obstructions. Pain, bladder irritative symptoms, and fever are usually signs of early complications related to double-J stents; late complications are more troublesome. We review 4 cases that highlight a variety of late complications with double-J stents (encrustation, migration, and fragmentation). Following a review of the literature, guidelines are established for monitoring potential risk factors as well as management strategies for prevention of possible complications when using double-J stents.
[Show abstract][Hide abstract] ABSTRACT: Urinary bladder pheochromocytoma is rare. From a case report of unsuspected pheochromocytoma and literature review, the authors develop a diagnostic and therapeutic algorithm for the management of this ectopic pheochromocytoma localization.
[Show abstract][Hide abstract] ABSTRACT: Paraganglioma is a rare tumor arising from undifferentiated cells of the primitive neural crest. These tumors are most commonly found in the adrenal gland, other localisations are also possible. A 58-year-old woman who presented with history of left lumbar pain, headache, hypertension, palpitation and sweating was found to have a secreting left renal hilar pheochromocytoma. Radical excision of the tumor was therefore undertaken and her hypertension was controlled. From the case report and literature review, the authors suggest a diagnostic and therapeutic strategy for the management of ectopic localization of pheochromocytoma.
[Show abstract][Hide abstract] ABSTRACT: Cancers of the male urethra constitute less than 1% of all malignant urological tumours, and the occurrence of sarcomas in the urethra is even less frequent. To our knowledge, only one case has been previously described in the English literature.
We report the clinical features, histology, imaging and treatment of urethral leiomyosarcoma in a male patient.
The occurrence of sarcoma in the urethra is most unusual, and its appearance as a primary growth in the male urethra is not recorded in the English literature. In conclusion, this case highlights a rare type of primary male urethral malignancy that features a poor prognosis.
[Show abstract][Hide abstract] ABSTRACT: Renal cysts are common in old patients, and usually remain untreated. Giant renal cysts measuring more than 15 cm in greatest diameter are uncommon and the association with hypertension is very rare. We present a case of a 25-year-old woman with a giant right renal cyst associated with hypertension that was treated by laparoscopic excision, followed by resolution hypertension.