[Show abstract][Hide abstract] ABSTRACT: Herein, we report a rare case of metastasis of prostate cancer in the orbit with pertinent literature review. Although, prostate cancer can metastasize in any organ, yet orbital metastasis indicates an aggressive disease course with eminent loss of vision. Very few similar cases have been reported in the literature.
[Show abstract][Hide abstract] ABSTRACT: Purpose
Deep dorsal vein thrombosis of the penis is spontaneously remitting benign thrombophlebitis. We propose to describe clinical assessment, diagnosis and differential diagnosis of deep dorsal vein thrombosis of the penis and to observe its natural course over time.
Patients and methods
Seven patients between ages of 13 and 50 years who self-presented for swelling penile, had diagnosis of deep dorsal vein thrombosis of the penis. Initial history, examination and Doppler ultrasound were undertaken. This was supplemented by blood screening for coagulation defects.
All patients consulted for a painful penis. Priapism were noted in three patients. Doppler ultrasound which realized in all cases, revealed thrombosis of the deep dorsal vein of the penis. The first aetiology of the venous thrombosis was hemopathy (three cases). Early anticoagulants with low molecular weight heparin were instaured. Patients with priapism were treated with aspiration and irrigation of the corpa cavernosa and had good evolution. Specific treatment (chemotherapy, corticosteroid) was used in two patients. However, definitive erectile dysfunction persists in two patients. One among these patients had clinical history of priapism.
Dorsal vein thrombosis of the penis should be considered as a urologic urgency. Its natural course tends to be one of spontaneous resolution. Usually a benign condition, careful etiological search with risk factors is needed to avoid missing exceptional causes. But, follow-up is of utmost importance because risk of erectile dysfunction, which need early diagnosis, effective treatment and psychological support.
[Show abstract][Hide abstract] ABSTRACT: Objectives
To study how the female body is perceived by both sexually active Tunisian women and their partners and how this is related to female sexuality.
Material and methods
Our study was transversal, descriptive and analytic. It involved 100 Tunisian women who have been married for at least one year and consulted in primary care medicine during the month of January 2013. Each one filled in an identification questionnaire 34 items dealing with the way how she perceived its own body, about her partner, her sexual activity and how she perceived it.
The mean age of the participants was 33.2 years (20–51 years). They had been married for 8 years in average (1–25 years). The participants were satisfied with their bodies in 72% of cases. This satisfaction was associated with being unveiled and perceiving the body as physically attractive, erotic, young and positively affecting their self-confidence and self-esteem (P < 0.05). According to participants, most of the husbands (84%) were satisfied with their wives’ bodies. The body satisfaction for women as well as for their husbands was related to satisfying the desire, achieving orgasm, taking the initiative in sexual activity and in preparations to sex (P < 0.05).
A body satisfying both Tunisian women and their spouses seems to be a guarantee of a better self-esteem and a better quality of female sexuality in its various stages and a promotion of the development of women and couples.
[Show abstract][Hide abstract] ABSTRACT: IntroductionLeydig cells tumors of the testis are uncommon, representing between 1 and 3% of the testicular tumors and for which the natural history and therapy are debated between radical orchitectomy and organ-sparing surgery.Subjects and methodsWe report three new cases of Leydig cells tumors, treated in our department and we discuss the clinical, diagnostic and therapeutic aspects of this uncommon tumor.ResultsThe mean patient age was 29 years (23–37 years). Medical referral was for a testicular pain in two and gynecomastia in one case. All patients were treated surgically, through an inguinal incision and the procedure included clamping of the spermatic cord. During surgery, frozen section were analyzed in two cases and the tumor enucleation with organ-sparing surgery was performed. The other patient had an unilateral orchidectomy and controlateral tumorectomy. The mean follow-up was 40 months with no local recurrence.Conclusion
Patients diagnosed with Leydig cells tumors have a good prognosis; this study shows the safety of conservative surgery treatment, provided it is subsequently followed by close surveillance, as it preserves maximum fertility, and these tumors usually have a favorable prognosis.
[Show abstract][Hide abstract] ABSTRACT: Angiosarcoma is a rare malignant tumour occurring in less than 2% of soft tissue sarcomas. Angiosarcoma involving the kidney usually represents metastasis from skin or visceral primary lesions, while angiosarcoma primarily occurring in the kidney is a very rare neoplasm. We report a case of angiosarcoma of the right kidney in a 59-year-old male. The computed tomography scan showed a solid tumour with a low increased density after administration of contrast medium. Histological examination of the piece of nephrectomy confirmed the diagnosis.
Canadian Urological Association journal = Journal de l'Association des urologues du Canada 05/2013; 7(5-6):E430-2. · 1.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective
To identify the clinical features of unconsummated marriage amongst couples, the etiological factors, the therapeutic approaches and to clarify the different evolutive aspects.
Patients and methods
In this retrospective study, the files of 80 consecutive couples followed for unconsummated marriage between 2000 and 2010 at our andrology consultation were reviewed.
The mean age of the husbands was 36 years (22–82 years), that of the brides was 28 years (17–57 years). The average length of marriage was 14 months (range 3 months–7 years). Couples had little knowledge of sexology. The sexual dysfunctions noted were: erectile dysfunction in 40% of cases, premature ejaculation in 5%, a combination of premature ejaculation with erectile dysfunction and decreased libido in 15%, vaginismus in 12.5% and the associated causes (erectile dysfunction with vaginismus) in 27.5%. The first-line treatment was based on a sexological approach consisting of sex education and sex therapy, associated in some cases with oral drugs and as second-line treatment, sometimes intracavernous injections. After a mean follow-up of 5 months (range 1–15 months), the outcomes of treatment were: good prognosis with consummation of marriage in 57 cases (71.25%), failure with unconsummated marriage in 18 cases (22.25%) and not known in five cases (6.25%).
Unconsummated marriage is quite frequent in the Arab-Islamic world. The best treatment is prevention based on sexual education of youngsters and treatment of sexual dysfunctions for people who consult before marriage.
[Show abstract][Hide abstract] ABSTRACT: Objective
To identify the clinical features of unconsummated marriage (UCM) amongst couples, the etiological factors, the therapeutic approaches and to clarify the different evolutive aspects.
Patients and methods
In this retrospective study, the files of 80 consecutive couples followed for UCM between 2000 and 2010 at our andrology consultation were reviewed.
The mean age of the husbands was 36 years (22–82 years), that of the brides was 28 years (17–57 years). The average length of marriage was 14 months (range 3 months–7 years). Couples had little knowledge of sexology. The sexual dysfunctions noted were: erectile dysfunction in 40% of cases, premature ejaculation in 5%, a combination of premature ejaculation with erectile dysfunction and decreased libido in 15%, vaginismus in 12.5% and the associated causes (erectile dysfunction with vaginismus) in 27.5%. The first-line treatment was based on a sexological approach consisting of sex education and sex therapy, associated in some cases with oral drugs and as second-line treatment, sometimes intracavernous injections. After a mean follow-up of 5 months (range 1–15 months), the outcomes of treatment were: good prognosis with consummation of marriage in 57 cases (71.25%), failure with UCM in 18 cases (22.25%) and not known in five cases (6.25%).
UCM is quite frequent in the Arab Islamic world. The best treatment is prevention based on sexual education of youngsters and treatment of sexual dysfunctions for people who consult before marriage.
[Show abstract][Hide abstract] ABSTRACT: In the Maghreb, organ failure constitutes a major public health problem, especially given the increasing number of patients with chronic renal failure and the high cost of care. In this study, we attempted to seek the recommendations, through a questionnaire, of various officials related to organ transplantation as well as leaders of ethics committees and religious groups in different countries of the Maghreb. The objective was to improve the rate of organ donation and transplantation. We received 36 replies (62%) within the prescribed time limit. In our survey, 83% of the respondents felt that living donor transplantation should be promoted initially, followed gradually by measures to increase cadaver donor transplantation to achieve a target of about 30 transplants with cadaver kidney donors per million inhabitants. To expand the donor pool, 83% of the respondents proposed to expand the family circle to include the spouse and inlaws. To improve the cadaver donation activity, one should improve the organizational aspects to ensure at least 50 renal transplantations per year (100%) and provide material motivation to the treatment team proportional to the activity of organ donation and transplantation. Finally, 93% of the respondents suggested suitable moral motivation of the donors.
Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 01/2013; 24(1):150-6.
[Show abstract][Hide abstract] ABSTRACT: Ganglioneuroma is a rare, benign, neurogenic tumor originating from the neural sheath and frequently located in the retroperitoneum. We report five cases of retroperitoneal ganglioneuroma. Complete resection of this tumor was performed with a good outcome. Our diagnosis was confirmed by histology. The frequency, diagnosis, imaging and treatment of this rare tumor are discussed.
African Journal of Urology 01/2013; 19(4):215–218.
[Show abstract][Hide abstract] ABSTRACT: This study assessed the human epidermal growth factor receptor-2 (HER2) protein expression in urothelial bladder carcinoma and its relationship with p53 and p63 expression. In 151 patients, paraffin-embedded tissues of transurethral resection or cystectomy were evaluated by immunohistochemistry (IHC), using antibodies against HER2, p53 and p63. HER2 overexpression (score 3+), p53 overexpression and decreased expression of p63 were detected in 14 (9.3%), 48 (31.8%) and 58 (38.4%) tumors, respectively. HER2 overexpression, p53 overexpression and decreased expression of p63 were associated with high tumor grade (p = 0.0002, p = 0.0002 and p = 0.046, respectively) and advanced TNM stage (p = 0.017, p = 0.012 and p = 0.001, respectively) of urothelial bladder carcinoma. In univariate analysis HER2 overexpression was significantly associated with decreased expression of p63 (p = 0.037). In multivariate analysis, only tumor grade was correlated with HER2 overexpression (p = 0.006). In this study, HER2 is overexpressed in 9.3% of urothelial bladder carcinomas. HER2 overexpression was strongly correlated with tumor grade but not with TNM stage, p53 and p63. The development of target therapies using anti-HER2 and the identification of patients which who benefit from those therapies need further studies.
Journal of Microscopy and Ultrastructure. 01/2013; 1(s 1–2):17–21.
[Show abstract][Hide abstract] ABSTRACT: INTRODUCTION: Cystic lymphangioma is a rare benign vascular tumor that may arise in various sites, revealed at any age. Abdominal locations represent less than 10% of the cases preferentially involving the mesentery. We report a case of primary lymphangioma arising from the kidney. PRESENTATION OF CASE: A 50-year-old woman was admitted for severe left lumbar pain. Abdominal ultrasonography and computed tomography revealed a 6×10 cm multiloculated cystic mass with hydronephrosis, extending along the left renal hilum. Surgical exploration revealed a retroperitoneal cystic tumor. Anatomopathologic examination concluded it to be a cystic lymphangioma. DISCUSSION: The cystic lymphangioma is a benign malformative tumor of the lymphatic system. Surgery is the best curative treatment with complete excision, the prognosis is excellent. CONCLUSION: Primary renal lymphangioma is exceedingly rare. Medical imaging has certain limits for the diagnosis which required histological confirmation. The treatment of choice is surgical.
International journal of surgery case reports. 03/2012; 3(12):587-589.
[Show abstract][Hide abstract] ABSTRACT: We compared short- and long-term outcomes of renal transplants with single versus multiple arteries.
We retrospectively analyzed data from kidney transplants from 208 living donors performed between 1994 and 2010. Renal grafts were divided into two groups: single renal artery (n = 164) versus multiple renal arteries (n = 44). The groups were compared regarding early and late vascular and urological complications. Patient and graft survivals were compared using Kaplan-Meier survivorship curves with comparisons using the log-rank test.
Both groups were comparable regarding acute rejection episodes, posttransplant hypertension, postsurgery renal artery stenosis, and urologic complications. Only hemorrhagic complications and renal artery thrombosis were significantly higher in the multiple renal arteries group (P = .027 and .03, respectively). Warm ischemia time was significantly longer in the multiple renal arteries group without any influence on the incidence of acute tubular necrosis (P = .2). Mean creatinine clearance at 1 year was 65 versus 50 mL/min/1.73 m(2) (P = .5) and at 5 years, 60 versus 55 mL/min/1.73 m(2) (P = .1) for the single versus multiple renal arteries groups, respectively. Return to hemodialysis was necessary for 18.8% of the single and 16.1% of the multiple renal arteries group.
The use of an allograft with multiple renal arteries is a safe, successful surgical procedure, that does not influence patient or graft survivals or increase surgical complication rates provided the surgical team is evolved with technical skill.
[Show abstract][Hide abstract] ABSTRACT: RéSUMé: Nous rapportons ici un nouveau cas de cette entité afin de souligner les caractéristiques anatomocliniques utiles à son identification et ceci, en vue de la distinguer des corticosurrénalomes, qui sont de pronostic nettement plus sombre.
Canadian Urological Association journal = Journal de l'Association des urologues du Canada 10/2011; 5(5):E87-9. · 1.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Nutcracker syndrome is a rare cause of hematuria in children. Clinical signs relate to compression of the left renal vein between the aorta and the superior mesenteric artery. The diagnosis is suggested on cystoscopy, which reveals unilateral hematuria, and confirmed by imaging. We report the case of a 4-year-old child who presented nutcracker syndrome confirmed by CT angiography of the abdomen after excluding the other causes of hematuria. Through this observation, we emphasize the reality of this syndrome in children and the value of imaging in the evaluation of this rare affection.
Archives de Pédiatrie 09/2011; 18(11):1188-90. · 0.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To study the evolution of impaired renal function after external continent urinary diversion (Mitrofanoff principle) (ECUD-M) associated with ileocystoplasty.
Over 18 years from 1992 to 2009, ECUD-M with ileocystoplasty was performed in 120 patients with mean age of 25.5 years. Renal impairment was evident in 43 patients (17 children and 26 adults).
Ninety percent of patients demonstrated a neurologic bladder and mild to moderate renal failure. Initially, all patients underwent continuous bladder drainage for a mean of 3 weeks. Renal function improved in 35 patients, although with persistent mild renal insufficiency. The other patients demonstrated moderate persistent residual renal insufficiency. During a mean follow-up of 10 years (range, 1-18 years), renal function returned to normal in 13 patients, stabilized at lower values in 15, and remained moderate in 5. After a mean follow-up of 8 years (range, 6-12 years), renal failure gradually worsened, increasing to higher values in 6 patients and leading to hemodialysis in 4. One patient underwent living-donor kidney transplantation, with good evolution.
ECUD-M with ileocystoplasty can lead to normalization unless stabilizationof impaired residual renal function by eliminating the obstructive factor provides self-adequate management of the diversion. The procedure delays for the need forhemodialysis therapy, and enables patients to prepare for kidney transplantation into a previously reconstructed lower urinary tract.
[Show abstract][Hide abstract] ABSTRACT: Mucinous tubular and spindle cell carcinomas (MTSCC) are low-grade renal epi-thelial neoplasms with approximately 100 documented cases reported in the literature. We report a case of MTSCC in a 79-year-old patient in association with a renal tuberculosis infection that has never been reported. Further investigations are needed to determine the frequency and true prognosis of these tumors.
Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 03/2011; 22(2):335-8.
[Show abstract][Hide abstract] ABSTRACT: De novo tumors are common complications after solid organ transplantation. Lymphoma and skin cancers are the most frequently observed malignancies. However, graft carcinomas can be observed to be five times more frequent after kidney transplantation compared to their incidence in the general population. We report a case of a 49-year-old female who developed an early adenocarcinoma of the graft as revealed by acute renal failure. She underwent transplantectomy and chemotherapy with hemodialysis therapy. Carcinoma of the graft is a rare but serious complication usually occurring late after transplantation. Close monitoring of a kidney recipient using abdominal ultrasound may detect this complication at early stages, which may improve the prognosis. Similarly, good screening of donors may prevent tumor transmission.
[Show abstract][Hide abstract] ABSTRACT: To assess the changing profile of children's nephrectomy indications in the south of Tunisia during the last two decades.
There were 94 children who underwent nephrectomy between 1982 and 2007. They were classified into two groups. The first group included 55 out of 511 hospitalized children between 1982 and 1994, the second included 39 out of 382 hospitalized children between 1995 and 2007. K2 (Chi-squared) test was used for this statistical analysis. A P value of < 0.05 was considered statistically significant.
The average was 7. Pathologies leading to nephrectomies were dominated in both groups by 3 main aetiologies: urolithiasis (42.5%), Wilm's tumors (21.3%) and pelvi-ureteric junction (13.8%). While in the first group, urolithiasis was found to be the major indication of nephrectomy (54.5%, p<0.05), in the second group, kidney tumors had become the major indication (33%, p<0.05) followed by urolithiasis (25.6%). So, the rate of nephrectomies performed due to urolithiasis had clearly decrease (P = 0.005), but there were no statistical differences observed between the rates of nephrectomies performed due to tumors or upper urinary tract malformations in the two groups.
The profile of children's nephrectomy indications in Tunisia stretches currently to be similar to the one of the industrialized countries, with regression of evolved kidney lithiasis leaving place to the tumorous pathologies, because of early detection, improvement and appropriate treatment of urinary lithiasis.