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ABSTRACT: The incidence of iatrogenic pneumothorax (IPx) will increase with invasive procedures particularly at training hospitals, that is why we have made a retrospective study of the common diagnostic or therapeutic causes of IPx and its impact on morbidity. From January 2011 to December 2011, 36 patients developed IPx as emergencies, after an invasive procedure. Their mean age was 38 years (range: 19-69 years). Of the patients, 21 (58%) were male and 15 (42%) were female. The purpose was diagnostic in 6 cases and therapeutic in 30 cases. In 8 patients (22%) the procedure was performed due to underlying lung diseases and in 28 patients (78%) for other diseases. The procedure most frequently causing IPnx was central venous catheterization, with 20 patients (55%), other frequent causes were mechanical ventilation in 8 cases (22%) (of whom we reported 3 cases of bilateral pneumothorax), 6 cases of thoracentesis (16%) and 2 patients had life-saving percutaneous tracheotomy. The majority of our patients were managed by a small chest tube placement (unilateral n=30, bilateral n=3). The average duration of drainage was 3 days (range: 1-15 days), sadly one of our patients died of ischemic brain damage 15 days after tracheotomy. At training hospitals the incidence of IPnx will increase with the increase in invasive procedures, which should only be performed by experienced personnel or under their supervision.
Revista portuguesa de pneumologia 11/2012; · 0.27 Impact Factor
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ABSTRACT: Primary non-Hodgkin's lymphoma of the adrenal gland is rare. We report the case of a 31-years-old patient hospitalized with asthenia and adrenal insufficiency. The CT scan showed a bilateral adrenal mass. A scano-guided biopsy suspected an endocrinoid tumor. The surgical exploration demonstrated a huge mass invading the retroperitoneal space, and the biopsy concluded to a central follicular phenotype B rmalignant lymphoma with a high rank of malignity. The thoracic CT scan did not show any lymph node. The medullar biopsy eliminated a secondary lymphoma. The patient was treated by chemotherapy and radiotherapy with a good result during 16 months.
Annales de Chirurgie 11/2003; 128(8):557-60. · 0.35 Impact Factor
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ABSTRACT: The authors report a retrospective serial of 225 patients presenting an infiltrating bladder tumor. The infiltrating tumors represent 29.2% of bladder tumors. The middle age of our patients is 59 years with a sex-ratio of 7.3. In the histology, 80% of the tumors are a cell transitional carcinoma and 65% of the patients are classified stage T3T4. The surgical treatment has could be achieved at 73.3% of the cases and 66.7% of the patients had a radical cystectomy. The urinary diversion was essentially an continent urostomy using Benchekroun's hydraulic valve. At 28 months mean follow-up, a locoregional recurrence has been noted from 18% of the Tur achieved alone and 4% of the radical cystectomy. A metastasis has been noted from 18% of the patients and this in a mean delay of 12 months.
Annales d Urologie 11/2003; 37(5):279-83. · 0.36 Impact Factor
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ABSTRACT: The authors report their experience of neurogenic bladder about 73 cases during 16 years. The analysis of the data permits to affirm that the neurogenic bladder remained a rare pathology, that their aetiologies is acquired in 87.6% of the cases with a predominance of spinal cord traumatisms, which explains the predominance of the pathology among the young subject of masculine sex (middle age of 32 years, sex-ratio is 2.5). The clinical signs are represented by urinary incontinence that constitutes the main motive of consultation, followed by obstructive signs and frequent miction associated to urge miction. The explorations put in evidence an important rate of complications because of the diagnostic delay. The therapeutic management aims to assure a most complete draining of the bladder to low pressure, to assure the continence or at least to manage the incontinence while assuring the comfort and the patient's autonomy.
Annales d Urologie 11/2003; 37(5):284-7. · 0.36 Impact Factor
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ABSTRACT: We report our experience with treating the vaginal aplasia by vaginoplasty used sigmoid graft in about three cases. Two patients presented with the Rokitansky-Kuster-Hauser syndrome and one a gender reassignment for intersex. Anatomic and functional results were satisfactory with no vagina stenosis. All three are sexually active. The sigmoid colon is the best choice for interposition vaginoplasty.
Annales d Urologie 11/2003; 37(5):296-8. · 0.36 Impact Factor
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ABSTRACT: The authors report one case of vesical paraganglioma, not suspected in a 50-years-old female patient who presented gross hematuria as only symptom. The patient was not hypertensive. Radiologic and endoscopic investigations revealed a trigonal submucosal tumour. Complete transurethral resection of the tumor was performed with no intraoperative complications. The histopathological diagnosis indicated pheochromocytoma. Blood pressure was stable. There has been no recurrence for 18 months after transurethral resection.
Annales d Urologie 11/2003; 37(5):264-6. · 0.36 Impact Factor
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ABSTRACT: The authors describe a case of enterovesical fistulas in a patient with Crohn's disease that presented exclusively as urinary symptoms manifesting as bladder tumor. Ultrasound examination showed a normal upper urinary tract and a bladder tumor. Cystoscopy examination revealed a bladder tumor at the retrotrigonal region without showing the fistula orifice. Transurethral resection of the tumor revealed an inflammatory pseudotumor of the urinary bladder at the results of histological studies. Magnetic resonance imaging showed a normal upper urinary tract but a bladder tumor and a sigmoidovesical fistula. The results of barium contrast studies established the presence of numerous enterovesical fistulas. Partial resection of the ileum, ileostomy, colostomy and suture of the bladder fistulas was performed. Histological diagnosis of the affected ileum was Crohn's disease. The clinical features, natural history and treatment of enterovesical fistula secondary of Crohn's disease were discussed.
Annales d Urologie 09/2003; 37(4):180-3. · 0.36 Impact Factor
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ABSTRACT: The authors reports their experience of a large series of 1050 cases of vesico-vaginal fistulas recorded during 30 years and analyse their epidemiological, anatomo-clinical, and therapeutic aspects. Patients could be classified as a function of site of fistula into 3 types, according to the Benchekroun's classification: type I ureto-vaginal fistula (30%); type II cervico-vaginal fistula (22%); type III vesico-vaginal fistula (48%). Etiology was mainly obstetrical (93%). An associated lesion was detected in 10.4% of cases (uterine, ureteral and rectal). Treatment was only performed after a minimal period of three months with the following results in obstetrical vesico-vaginal fistulas. Type I fistula, using a low approach and requiring urethral refection in 100 cases, showed good results in only 60% of cases. Type II fistulae, usually treated through a low approach (80%), were treated with 80% good results. Type III fistula, were nearly always corrected (98%) after two procedures. The overall results are good in 80% of cases. The failures concerned in majority the complex vesico-vaginal fistulas type I, are treated by urinary diversion (51 Coffey, 5 Bricker) and since 1975, 73 continent ileocecal or ileal bladders using Benchekrouns' technique.
Annales d Urologie 09/2003; 37(4):194-8. · 0.36 Impact Factor
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ABSTRACT: The authors report 24 patients presenting a transitional tumor of bladder pT1G3 collected between January 1996 and December 2000. They represent 19% of the superficial tumors of bladder. Two patients had of straightaway a cystectomy after resection for an unverifiable tumor by endoscopy and another after a second resection discovering a real pT2. Only 5 patients received a BCG therapy is 24% of the cases. A recurrence without progression has been noted in 38% of the cases and a progression in 19% of the patients. These last patients had a cystectomy and with a follow-up to 28 months, no recurrence has been noted.
Annales d Urologie 09/2003; 37(4):199-202. · 0.36 Impact Factor
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ABSTRACT: The authors report a series of 36 cases of perinephric phlegmon during 15 years. The patients are 27 men and 9 women. Mean age was 37 years (ranging between 25 and 70). The promoting factors of PPN are diabetes (27.8%), and kidney calculi (22.3%). Delay diagnosis is more than 3 weeks in 80% of the patients. The clinical symptomatology was dominated by pain, fever and flank mass. Diagnosis is carried out by ultrasonography in 84% and by CT scan whenever it is done. The common germs are negative Gram bacilli and staphylococcus. The treatment consists in antibiotherapy associated to a percutaneous drainage of the collection in 6 patients (16.7%) and a surgical drainage in 30 patients (83.7%). The follow-up are favorable in all cases.
Annales d Urologie 09/2003; 37(4):160-3. · 0.36 Impact Factor
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A Benchekroun,
A Iken,
A Qarro,
H Aelalj,
Y Nouini,
L Benslimane,
Z Belahnech,
H Jira,
H Kasmaoui,
M Marzouk,
M Faik
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ABSTRACT: The authors report 2 cases of prostatic tuberculosis. The patients are 59 and 62-years-old respectively. They presented obstructive and irritative symptoms of the lower urinary tract. The prostatic finding and PSA were abnormals. The prostatic biopsy was negative. The diagnosis of prostatic tuberculosis was made by histologic analysis after transuretral resection of prostate. The treatment is based on chemotherapy anti-tuberculosis.
Annales d Urologie 07/2003; 37(3):120-2. · 0.36 Impact Factor
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ABSTRACT: Adenocarcinoma of urethra is a rare tumour, which occurs more often in female than in male. The localizations on bulbomenbranous urethra, most frequent, have worse prognostic than those of penile urethra. Because of scarcity of these tumours there is not therapeutic consensus. The treatment is based on the tripod surgery, more or less mutilating, chemotherapy and radiotherapy associated or managed in a separate way. We report the case of a young patient with adenocarcinoma of the posterior urethra treated by a protocol of radio-chemotherapy.
Annales d Urologie 07/2003; 37(3):131-4. · 0.36 Impact Factor
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ABSTRACT: Inflammatory pseudotumor is a reactive benign lesion which can be very difficult to distinguish from some malignant bladder tumors like sarcomas or sarcomatoid carcinoma. Inflammatory pseudotumour (IPT) of the urinary bladder is a benign proliferate lesion which can simulate clinically and histologically a sarcoma. A case of an inflammatory pseudotumor of the urinary bladder in a 18-years-old man is presented. This patient presented with sudden onset of gross painless hematurial related to large polypoid and ulcerated bladder masses found on endoscopy. Initial pathological analysis was interpreted as rhabdomyosarcoma but subsequent reviews were consistent with a benign process resembling nodular fasciitis. This rare, benign and presumed non-neoplastic, reactive lesion must be differentiated from sarcomas of the urinary bladder. Immunohistochemistry seems to be the method of election in differentiating inflammatory pseudo-tumor from other spindle cell proliferations of the bladder. When diagnosis is certain, complete transurethral resection is the treatment of choice. However, if there is no total pathologic confirmation, if it is a very wide lesion or if it is recurring after endoscopic resection, a partial cystectomy is suggested.
Annales d Urologie 07/2003; 37(3):105-7. · 0.36 Impact Factor
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ABSTRACT: The author reports a serie of 4 cases of male urethral diverticulum. All cases were acquired origin. They are complication of urethroplasty. Diagnosis is clinical, based on the development of a perineal mass or phlegmon. This diagnosis is confirmed by cystourethrography. Treatment is by open surgery and consists on diverticulectomy and repair urethra in one stage. Two steps are necessary as the reported cases, where they are urethral stenosis or a inflammatory involvement of the peridiverticulum tissues. This treatment achieves good results.
Annales d Urologie 07/2003; 37(3):127-30. · 0.36 Impact Factor
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ABSTRACT: Giant hydronephrosis is uncommon. Ureteropelvic obstruction represent the more frequent cause. In 1939, Stirling defined it as the presence of more than 1000 ml of fluid in the collecting system. The Authors report two cases with ureteropelvic obstruction causing giant hydronephrosis. The treatment includes pyeloplasty in the first case and nephrectomy in the second case.
Annales d Urologie 05/2003; 37(2):61-4. · 0.36 Impact Factor
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ABSTRACT: This case report describes a 53-year old man with Cushing's syndrome due to Adrenocorticotropic Hormone (ACTH) independent bilateral adrenocortical macronodular hyperplasia (AIMAH). His plasma cortisol showed no diurnal rhythm and was unsuppressable by high-dose dexamethasone. Plasma ACTH was undetectable and did not respond to corticotrophin-releasing hormone. The aetiology of this rare disease remains uncertain. The treatment is based on bilateral adrenalectomy.
Annales d Urologie 05/2003; 37(2):65-7. · 0.36 Impact Factor
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ABSTRACT: Although sildenafil citrate (Viagra) has demonstrated effectiveness in the treatment of erectile dysfunction (ED), the dosing regimens often used in clinical trials may not always match those employed in clinical practice. This study was undertaken to further assess the efficacy and safety of sildenafil taken as required in male outpatients 18 years of age and older with ED (n=71). It was conducted as a placebo-baseline-controlled, open-label, flexible dose-escalation study, with sildenafil (25,50, or 100 mg) administered for 8 weeks following a 4-week placebo run-in. Efficacy variables included questions 3 and 4 of the International Index of Erectile Function (IIEF), other IIEF domains, patient event logs, and quality-of-life (QOL) assessments. Treatment with sildenafil resulted in improvements from baseline in all IIEF domains analyzed (all P<0.0001), as well as overall QOL and amelioration of specific sexual and social relationships (all P&<0.0001). Sildenafil was well tolerated. One participant discontinued treatment because of adverse events. Results suggest that flexible dosing with oral sildenafil is safe and has beneficial effects on all indices of erectile function and QOL.
International Journal of Impotence Research 04/2003; 15 Suppl 1:S19-24. · 1.71 Impact Factor
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ABSTRACT: The authors report a case of pseudosarcomatous fibromyxoid tumor of the prostate. It is always a benign lesion, whose mains differentials diagnoses are sarcomas of the prostate. Diagnosis is based on histological examination. Treatment is surgical.
Annales d Urologie 03/2003; 37(1):40-2. · 0.36 Impact Factor
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ABSTRACT: Sarcomatoid carcinoma of the kidney is an uncommon tumor associated with a very poor prognosis. Because this tumor can be occasionally difficult to distinguish from renal sarcoma, immunohistochemistry and electronmicroscopy are sometimes necessary for diagnosis. Therapy is actually essentially surgical because if adjuvant therapies should follow radical nephrectomy, no standardized regimen has been at present defined.
Annales d Urologie 03/2003; 37(1):5-7. · 0.36 Impact Factor
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ABSTRACT: Cystic tumors of the adrenal gland are uncommon, but are being increasingly more frequently diagnosed during routine radiological evaluation. The management of these "incidentalomas" remains to be defined. Adrenal cysts have been traditionally managed by excision or aspiration to rule out malignancy. Actually, for some authors, in the cases of incidentally found cysts, if the suspicion of malignancy is low, and the lesion is non-functional, observation of the patients with regular follow-up may be an alternative. We report a case of a non-aspirated incidental adrenal cyst with a follow-up of four years.
Annales d Urologie 01/2003; 36(6):365-7. · 0.36 Impact Factor
