[Vaginal flap urethroplasty in the treatment of urethral destruction of obstetric origin]

Objective: Urethral destruction of obstetric origin is frequent in North Africa. The objective of this study was to evaluate the results of urethral repair by vaginal flap in women affected by urethrovaginal fistulae

Patients and Methods: From January 1998 to December 2001, five patients were subjected to urethroplasty by vaginal flap mobilized from the anterior vaginal wall. The patients' age ranged from 30 to 45 years; all were primiparous with obstetric urethrovaginal fistulae revealed by permanent urinary leakage. The closures were realized in two continuous sutures of PDS 4/0 on a urethral catheter of 16 Fr. The ablation of the catheter was practised on the 10th postoperative day

Results: Urinary continence was achieved in four patients. The remaining patient had stress urinary leakage corrected by colposuspension. Recovery with good results was noted in 80% of the cases

Conclusion: This technique allowed us to achieve an improvement of the quality of urethral repair. Being an easily performed technique, it allows at the same time to achieve elegant, effective and reliable results

[Fracture of the corpus cavernosum: report on 123 cases]

Objective: To analyze the diagnostic and therapeutic aspects of fracture of the corpus cavernosum and compare our results with those in the literature

Patients and Methods: Between January 1976 and June 2002, 123 cases of fracture of the corpus cavernosum were treated at our department. The mean age of the patients was 25 years. In the majority of cases [71.5%], fracture of the penis occurred by forced manipulation of the erected penis. The diagnosis was based on clinical examination. The patients were treated surgically by repair of the tunica albuginea, mostly [74 cases] after degloving of the penile skin. One case of ureteral rupture was encountered after fracture of both corpora cavernosa

Results: In 95 patients, the postoperative outcome was satisfactory. However, 8 cases of fibrous plaques and 4 cases of penile curvature were encountered. None of our patients experienced postoperative erectile dysfunction

Conclusion: Fracture of the corpus cavernosum is a pathology which remains quite rare. The diagnosis is based on clinical examination and treatment is surgical in the majority of cases. The outcome of the treatment of such fractures is usually satisfactory provided the patients present at an early stage

[Approach of diagnosis and treatment of female urinary stress incontinence]

This work concerns twenty eight cases of urinary stress incontinence treated between 1977 and 1987. The high incidence of previous perineal operations and multiparity is noted. The diagnosis has been established clinically in all cases.Different types of surgery for urinary stress incontinence have been used: endoscopic bladder neck suspension in 17 cases, and retropubic colpopexy in 9 cases. The results are good in respectively 88% and 78%. Correct diagnosis and operative indication are the main elements of treatment of urinary stress incontinence. Each procedure permiting reposition of the bladder neck and proximal urethra in abdominal manometric enclosure amends the urinary stress incontinence. This endoscopic bladder neck suspension procedure is indicated. Otherwise, this procedure is quick, simple, allowing an easy access eventhough for multi-operated and fat patients. The failure's factors are analysed