[Show abstract][Hide abstract] ABSTRACT: Objective:
To analyse the effects of baseline body mass index (BMI) on the postoperative and remote consequences of nephrectomy in living kidney donors, as body weight is conventionally used as an exclusion criterion for kidney donation and a BMI of <35 kg/m(2) is often required.
Patients and methods:
We retrospectively studied 189 living-related kidney donors who had their nephrectomy between 1986 and 2009 in our urology department. We recorded the BMI at the time of donation, and analysed variables after surgery, and clinico-biological factors remotely. The effect of the initial BMI after surgery and much later after nephrectomy was assessed.
The mean follow-up was 9.28 years. The mean (range) BMI at the time of donation was 26.5 (18.5-41.1) kg/m(2); 33% of donors were overweight (BMI 25-30) and 21% were obese (⩾30), with 10.5% having a BMI of >35 kg/m(2). The duration of hospitalisation was not related to the BMI. There was no significant difference between the mean BMI of donors with a simple postoperative history and donors who had complications after surgery. Among obese donors, only 7.7% had a complication, which was a surgical-site infection in all cases. The baseline BMI was higher among donors who maintained normal renal function and no proteinuria than in donors with impaired renal function and/or proteinuria; the difference was not significant. The occurrence of hypertension or diabetes was independent of baseline BMI. Donors with dyslipidaemia had no significantly greater baseline BMI than those with no dyslipidaemia.
The BMI at the time of kidney donation does not seem to influence the short- or long-term consequences of nephrectomy in living donors.
Arab Journal of Urology 09/2015; 13(3):221-4. DOI:10.1016/j.aju.2015.06.002
[Show abstract][Hide abstract] ABSTRACT: Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethro-rectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption due to a gunshot wound and complicated by urethro-rectal fistula.
African Journal of Urology 05/2015; 101(2). DOI:10.1016/j.afju.2015.03.004
[Show abstract][Hide abstract] ABSTRACT: A better understanding of the anatomy of the renal vein and its relationship with the arterial and excretory systems can prevent intra operative complications.
Three-dimensional endocasts of intrarenal vessels and renal collecting systems were obtained from fresh cadavers, by injecting a polyester resin coloured with different pigments. A total of 71 endocasts were studied: 37 right kidneys and 34 left kidneys.
Renal vein was unique in 88% of cases and double in 11% of cases. It was formed in 52% of cases by 3 trunks. Intrarenal veins anastomosed together to form 2 levels of arcades in 28% of cases and 3 levels in 71% of cases. The venous drainage of the upper pole was provided by two anterior and posterior plexus in 38% of cases, and by a single anterior plexus in 61% of cases. In 22% of cases, the venous drainage of the lower pole was provided by both an anterior and a posterior plexus, and in 77% of cases, there was only an anterior plexus. Renal artery was posterior to the vein in 66% of cases. It was anterior to the vein in 29% of cases, and located directly above it in 4% of cases. In 60% of cases, we noted a close relationship between the anterior surface of the ureteropelvic junction and the lower branch of the renal vein.
Venous vascularisation of the kidney appears to be variable and its relationship with the arterial and the excretory systems may be complex.
[Show abstract][Hide abstract] ABSTRACT: The hydatid cyst is a real public health problem in Tunisia. The retrovesical localization is rare. It is considered an aberrant or ectopic location defined by the development of the parasite in the subvesical and retrovesical fat.
From 2004 to 2013, 4 patients with retrovesical hydatid cyst were hospitalized and operated in the Department of Urology at the Charles Nicolle hospital of Tunis in Tunisia. The average patient age was 40.75 years (range: 23-76). Signs of bladder irritation were the most frequent presenting complaint. No cases of hydaturia were noted. The diagnosis was made on the ultrasound and the computed tomographic urography. Hydatid serology was positive for 3 patients. In 3 cases, a hydatid cyst of the liver was associated. A total cysto-pericystectomy was performed for 1 patient, for others it was partial.
The postoperative course was uneventful. No urinary fistula or infection of the residual cavity was observed. One patient had a retroperitoneal cyst recurrence requiring reoperation.
Retrovesical location of hydatid cyst is rare and treatment is primarily surgical.
Canadian Urological Association journal = Journal de l'Association des urologues du Canada 05/2015; 9(5-6):E374-8. DOI:10.5489/cuaj.2782 · 1.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The association of renal cancer and renal tuberculosis is uncommon. While the incidental discovery of renal cell carcinoma in a tuberculous kidney is a classical finding, the discovery of tuberculous lesions after nephrectomy for cancer is exceptional. We report the case of a female patient aged 60 who had a partial nephrectomy for a 5 cm exophytic kidney tumor. Pathological examination concluded that renal clear cell carcinoma associated with follicular caseo tuberculosis.
Urology Case Reports 03/2015; 12(3). DOI:10.1016/j.eucr.2015.01.009
[Show abstract][Hide abstract] ABSTRACT: Eosinophilic cystitis is a rare inflammatory disease of the bladder which origin and pathogenesis are unknown. Since the first description in 1960, hundreds of cases have been reported, 20 Pseudotumor forms. We report a case of cystitis eosinophils in tumor-form, a patient of 72 years without urological or allergic history. The patient was treated with endoscopic resection alone. The outcome was favorable with disappearance symptoms and no recurrence at 1, 3 and 6 months controls. We carry a literature review of cystitis eosinophils on the different clinical manifestations, the means diagnostic and therapeutic modalities.
Urology Case Reports 02/2015; 9(3). DOI:10.1016/j.eucr.2015.01.006
[Show abstract][Hide abstract] ABSTRACT: Évaluer les données récentes de la littérature concernant les indications thérapeutiques dans les cancers du rein localement avancés et/ou métastatiques et analyser le bénéfice des thérapies ciblées depuis leur adjonction dans l’arsenal de traitement.
La Presse Médicale 12/2014; 44(2). DOI:10.1016/j.lpm.2014.07.020 · 1.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Introduction:
Our aim was to study the demographic and social characteristics of 189 living related kidney donors in Tunisia, and explore some of the social consequences of kidney donation.
This is a descriptive retrospective study of 189 living related kidney donors who had their nephrectomy in Charles Nicolle Hospital between 1986 and 2009. The demographic and social characteristics at the time of donation were studied and changes in the social and occupational status after donation were assessed.
The average age at the time of donation was 41.8 ± 12.1 years (range: 20-67 years). Female predominance (59.2% of cases) was noted. Donors were siblings in 46% of cases, parents in 42% of cases and spouses in only 9% of cases. There were more mothers than fathers, more wives than husbands, but fewer sisters than brothers. Twenty-six percent of donors were illiterate and 40% were unemployed at the time of donation. After donation, the social status remained stable for 70% of donors. No divorces were reported. The occupational status was unchanged in 94% of cases. Sixteen percent of female donors had at least one pregnancy after nephrectomy. Nearly 90% of surveyed donors whose recipients were alive at the time of the survey were still in favor of kidney donation.
Women play an important role in living related kidney donation in Tunisia. Family situation and occupational status did not seem to be compromised after nephrectomy, and most donors were willing to donate if the decision was to be repeated. Key words: Kidney Transplantation; Living Donors; Social Conditions.
[Show abstract][Hide abstract] ABSTRACT: Seminal vesicle malformations are a rare cause of obstructive azoospermia, often associated with other internal genitalia and upper urinary tract birth defects. We report 5 new cases of seminal vesicle agenesis in men presenting with hypospermia and azoospermia. Imaging showed seminal vesicle unilateral agenesis in all patients. The remaining seminal vesicle was hypoplastic in 3 cases, dilated in 1 case and with abnormally thick content in another case. Vas deferens agenesis was observed unilaterally in 2 patients and bilaterally in 2 other patients. No renal malformations were detected. Genetic study showed in all cases a 46 XY karyotype without any microdeletions. A single heterozygous cystic fibrosis transmembrane regulator gene mutation was diagnosed in 1 man, but not found in his partner. Intracytoplasmic sperm injection using sperm from a testicular biopsy was performed in 3 couples, without success.
[Show abstract][Hide abstract] ABSTRACT: Epidemiological studies link obesity, as measured by increased body mass index (BMI) to the incidence of renal cell carcinoma (RCC) as well as to the cancer-related mortality of RCC patients. RCC is the third cancer most robustly associated with increased BMI. Understanding the role of the adipose tissue in renal carcinogenesis is therefore of major importance for the development of novel paradigms of RCC prevention and treatment. Here, we discuss the current knowledge on the impact of obesity on the development and progression of RCC as well as the role of adipose tissue-derived hormones (adipokines) in the conflict between growing tumors and the immune system.