Primary testicular non-Hodgkin lymphoma. A 10-year Tunisian single-institute experience

Primary testicular non-Hodgkin lymphoma [NHL] is an uncommon extra nodal presentation, accounting for 1% of all NHL and 1 to 9% of testicular neoplasms. Median age at time of presentation is 60 years old. Anthracycline based chemotherapies are most frequently used. To analyze baseline characteristics, treatment modalities and survival of six cases of primary testicular non-Hodgkin lymphoma. We screened 46 testicular neoplasm cases registered from January 1999 to January 2009 and found six primary testicular lymphoma patients. These six cases were analyzed for baseline clinical features, investigations, treatment and outcome variables. Median age was 50 years old and median duration of symptoms was 4 months. All patients had testicular swelling. Four patients had abdominal lymphadenopathy. Most patients had diffuse large B-cell histology. All patients underwent high inguinal orchidectomy and five were treated with anthracycline based chemotherapy. Four patients completed therapy and one of them relapsed two years later. Primary testicular NHL is an uncommon entity and with current combined modality treatment, the outcome may be as good as nodal NHL

[Emphysematous pyelonephritis. Epidemiological, clinical, biological, bacteriological, radiological, therapeutic and prognostic features. Retrospective study of 30 cases]

Emphysematous pyelonephritis is an uncommon, necrotizing bacterial infection of the kidney. It is a severe, lifethreatening affection. To study the epidemiological, clinical, biological, bacteriological and radiological features of this affection, and to describe its therapeutic management and prognostic characteristics. We conducted a retrospective study including 30 patients who were treated for an emphysematous pyelonephritis, in Charles Nicolle hospital department of urology, from 1987 to 2009. Emphysematous pyelonephritis generally affects adults. It is especially favored by diabetes and urinary tract obstruction. Escherichia coli is the main causative agent. Uroscan is the key of diagnosis. It is both medical and surgical emergency; the treatment combines intensive care with appropriate antibiotics and often drainage. Nephrectomy may be necessary from the outset, or after drainage failure. Prognosis is poor, with a high mortality rate [23%], in our series. Management of emphysematous pyelonephritis poses real problems. This affection is still threatening, despite of advances in intensive care

[Place of percutaneous nephrolithotomy in the treatment of staghorn stones. about 83 cases]

Staghorn stone is considered as a dreadful type of renal stones. The choice of the best treatment is always difficult. To evaluate the results of percutaneous nephrolithotomy in the treatment of staghorn stones. We report 83 cases of staghorn stones that were treated by percutaneous nephrolithotomy during a period of 10 years from 1994 to 2004. The mean age was 44 years and sex-ratio was 2.2. The right kidney was treated alone in 42% of cases, the left one in 56% of cases and both kidneys in only two cases. The mean area of stones was 6,6 cm[2]. One renal puncture was necessary in 97% of cases. The rate of stone free after percutaneous nephrolithotomy only was about 54% and when combined with lithotripsy the rate was 64%. Combined treatment using percutaneous nephrolithotomy and lithotripsy is considered as the best procedure for staghorn stones treatment

[Lumboscopic treatment of ureteral stones. About 31 cases]

The aim of our study is to state the efficiency and the place of lumboscopy in the treatment of ureteral stones. We report 31 cases of patients operated by lumboscopy for ureteral stones from January 2001 to December 2005. In most of cases, the indication is stone which size is higher than 15 mm. The mean operating time is 91 min and the rate of conversion to open surgery is 9, 7%. 9 [29%] postoperative complication is noted. The mean hospital stay is 5 days. No ureteral stricture or kidney destruction is noted with a mean follow-up of 34 months. Lumboscopy is a safe and effective technique in the treatment of the ureteral stones with a low rate of complications. It can replace open surgery in most of cases

[Lumboscopic treatment of simple renal cysts]

To assess feasibility and efficiency of lomboscopy in the treatment of simple renal cysts. We report 12 cases of patients presenting symptomatic simple renal cysts treated by lumboscopy from January 2000 to December 2004. The mean age was 57 years [43-72]. They were 11 women and one man. The main revealing sign was pain in each case. A mass was found in 2 cases [16%]. Ultrasonography was realized in all cases. Computed Tomography was realized in 4 cases [33%]. It was a unique cyst in 9 cases [75%], a double cysts in 2 cases [17%] and 4 cysts in 1 case [8%]. The mean size of the cysts was 7.7 cm [5-16]. A parapyelic cyst was found in one case. All the patients were operated through a retroperitoneal approach. Excision of cyst dome was made. The mean operating time was 80 mm [50-160]. No intraoperative complication was noted. The mean hospital stay was 3 days [1-4]. All the cysts were found to be benign histologically. No recurrence is noted with a mean follow-up of 21 months [5-31]. Lumboscopy is a safe and effective technique in the treatment of the symptomatic simple renal cysts with a low rate of complications and recurrence

[Morgagni hernia in elderly patients: a study about two cases]

Two cases of retrocostoxiphoid hernia are reported. Both patients were adults. The hernia was strangled in one case and symptomatic in the second case. The diagnosis was confirmed by radiology. Reduction of the visceral hernia and closure of the orifice was carried out after laparotomy. A review of literature and of clinicopathological features are given in the present article. Histogensis and differential diagnosis are also discussed