[Tumors of the male urethra. A study of 7 cases]

To study the epidemiological, diagnostic and therapeutic features of primary tumors of the male urethra. In this retrospective study we evaluate 7 cases with tumors of the male urethra seen at our department over a period of 16 years [1989 -2005]. The following parameters were studied: the age of the patients, their medial history, clinical signs and symptoms, imaging and treatment modalities used and follow up. The patients' mean age was 56.1 years. Medical history revealed episodes of urethritis in 4 cases and treatment of cervico-urethral strictures in 4 cases. All patients complained of chronic irritating and obstructive symptoms - most patients presented with more than one symptom. Acute urinary retention was found in 5, bleeding per urethram and pyuria in 5 cystourethrography and confirmed by urethrocystoscopy and biopsy. All our patients were found to have squamous cell carcinoma. The tumor was localized in 6 patients. Treatment consisted endoscopic transurethral resection in one patient. Two patients were subjected to surgery. One of them with a stage T3N0M0 tumor of the prostatic urethra underwent urethrectomy in combination with cystoprostatectomy followed by urinary diversion [Coffey], while the other patient with a tumor at the bulbomembranous urethra [stage T4N0M0 with scrotal invasion] was subjected to penectomy and orchidectomy combined with perineal urethrostomy. Both these patients received adjuvant radiotherapy. Excision of a penile phlegmon was carried out in 3 patients. In one of them a urethral stent was left indwelling, while two were subjected to cystostomy. Due to bilateral lymphatic invasion, the remaining patient received preoperative radiotherapy, but he died three months later due to lung metastases. None of our patients received chemotherapy. Mean follow up was 9.5 months. At the end of the follow-up period 3 patients [one treated endoscopically and the two patients that had been subjected to surgery] were disease-free, while one patients had died and the 3 remaining ones were lost to follow up. Despite the availability of a variety of treatment modalities, tumors of the male urethra still have a poor prognosis. Due to their rarity, it is difficult to properly evaluate the treatment options which mainly depend on the tumor stage and whether or not there is lymphatic invasion

[Renal Hydatid cyst: report on 31 cases]

To present recent diagnostic and therapeutic aspects of the renal hydatid cyst. Thirty-one consecutive cases of renal hydatid cyst were seen between January 1989 and June 2006. The patient group consisted of 13 males and 18 females with a mean age of 43 years. The clinical symptoms, biological and radiological investigations as well as the treatment were evaluated. Clinical and radiological examination was diagnostic of renal hydatid cyst in 80.6% of the cases, when combined with serological tests for hydatidosis in 90% of the cases. CT scan confirmed the diagnosis in cases where the radiological examination was not conclusive [4 cases of type IV and 2 cases of type I]. Thirty patients were treated surgically. Percutaneous puncture was done in one case of type I. Twenty-eight patients [90.3%] were subjected to extraperitoneal lombotomy. The anterior approach was chosen in 2 patients due to associated hepatic involvement. The surgical methods consisted of partial cystopericystectomy in 27 [87.1%] patients, pericystectomy in one and nephrectomy in two patients. The immediate postoperative period was uneventful in all but one patient who developed acute pyelonephritis due to the migration of hydatic vesicles into the ureter. The problem resolved after administration of antibiotics and placement of a double-J catheter. Mean follow up was 68 months. During the long-term follow-up based on clinical and radiological examination no recurrence was detected. Radiological and serological examination is the most important step in the diagnosis of renal hydatid cyst. Surgery is the treatment of choice. Percutaneous puncture has recently been used with promising results

[Delayed end-to-end anastomotic repair of post-traumatic posterior urethral rupture]

Objective: To analyse the long-term results of the treatment of post-traumatic posterior urethral rupture by delayed bulboprostatic anastomotic repair and to evaluate the efficacy and advantages of this technique

Patients and Methods: Between February 1989 and February 2004, 15 patients underwent delayed bulboprostatic anastomotic repair of post-traumatic posterior urethral ruptures. The results were evaluated taking into account the quality of micturition, continence and erectile function

Results: After an average follow-up period of 34 months [range: 12 - 72 months], all our 15 patients were continent and voided with a satisfactory flow. To achieve this result, 5 patients [33.3%] had to undergo internal ureterotomy. Only 4 patients [26.7%] reported erectile problems

Conclusion: Delayed bulboprostatic anastomotic repair remains the "gold standard" in the treatment of post-traumatic posterior urethral rupture. Compared to other methods of treatment of post-traumatic stenosis of the ureter, this technique allows for a long-term success with minimal complications