RESUMO
Background: Atypical renal cysts are suspicious for malignancy. It is hard in some cases to give a sharp radiological diagnosis and propose an appropriate management
Aim: To give the histological results of the operated atypical renal cysts and to establish a correlation between the radiological findings and histological features
Methods: Between January 2001 and December 2012, 22 patients have been operated in our department for atypical renal cysts. There were 10 type III and 12 type IV Bosniak lesions. We have reported clinical, epidemiological and radiological findings. We have analyzed the histological results taking into consideration the radiological findings
Results: According to histological findings, 7 among the 10 type III lesions were benign [70%]. However, only one case of benign tumor was noted in type IV lesions [8.3%]. There was no evident correlation between tumors size and histology. With a median follow up of 48 months, three patients died because of locally advanced tumors
Conclusion: Management of atypical renal cysts remains difficult. A careful computed tomography staging is essential before treatment. Type III and type IV Bosniak cysts were malign in 30% and 91% of cases, respectively. There was no correlation between tumor size and malignancy. A nephron sparing surgery should be proposed whenever possible
RESUMO
Post traumatic posterior urethral disruption is a common condition, its treatment is controversial. To assess the long term results of endoscopic realignment compared with delayed urethroplasty, in the management of post traumatic urethral disruption. Between February 2002 and March 2009, 30 patients have been operated for post traumatic posterior urethral disruption. 20 have had a primary endoscopic realignment and 10 have had delayed urethroplasty. Analysis of the results took into consideration, the quality of micturition, the continence and the erectile function. Median follow-up was 21 months, good results were recorded in 13 patients among the group of realignment [65%]. 0f the failure cases [7], 3 underwent urethroplasty and 4 were managed by endoscopic treatment. Endoscopic realignment could avoid open surgery in 17 patients [85%]. Among the 10 patients that underwent urethroplasty, 7 patients had good results [70%]. No patient had urinary incontinence. A post operative erectile dysfunction was noted in one patient from the realignment group and two other patients from the urethroplasty group. The endoscopic urethral realignment could be used as a primary therapeutic management of post traumatic urethral disruption. It could be recommended for recent trauma, between one and two weeks, and for patients that can support exaggerated lithotomy position. Endoscopic realignment is an effective safe therapeutic mean that does not contraindicate a second-line urethroplasty