ABSTRACT
OBJECTIVE: To evaluate the influence of continent external urinary diversion type Mitrofanoff on male sexuality. MATERIAL AND METHODS: Between 1992 and 2011, 140 patients underwent continent urinary diversion type Mitrofanoff at an academic hospital. Among 76 men, 46 were interviewed about their sexuality after this operation. This study was performed using a set of validated questionnaires (IIEF, DAN PSS and Urolife), grouped by the model of the CTMH. Patients were divided according to their marital status: group 1: patients married before surgery (15 cases), group 2: patients married after surgery (7 cases) and group 3: singles (24 cases). RESULTS: In the first group, the functional dimension of sexuality was positive with an overall score of 81%, the sexual discomfort score was assessed at 26 % and the sexual satisfaction score was 77%. In the second group, sexual function was considered conserved in all cases with a satisfaction score estimated at 98%. These patients reported a feeling of well-being following the disappearance of urinary incontinence with integrity of their body images. In contrast, in the last group, relatively impaired sexual function was noted (65%) with a satisfaction score estimated at 59%. These disorders were multifactorial, mainly related to neurological causal pathology. CONCLUSION: To our knowledge, this is the first study about male sexuality in patients with a continent urinary diversion type Mitrofanoff. Marital status has a major role in the sexuality of these patients. A prospective study with pre- and postoperative evaluation will better clarify the factors affecting sexuality in these patients.
Subject(s)
Sexuality , Urinary Diversion , Urinary Reservoirs, Continent , Adult , Aged , Body Image , Humans , Male , Marital Status , Middle Aged , Sexuality/psychology , Surveys and Questionnaires , Young AdultABSTRACT
Bee stings of the cornea are rarely reported but can potentially cause serious ophthalmologic injuries. Locally, damage occurs through toxic and immunologic reactions and from the stinger retained in the cornea. Early recognition of the possible complications and appropriate treatment may help to prevent permanent loss of vision. Removal of a retained bee stinger remains controversial. We present a case of corneal bee sting with retained stinger apparatus and associated anterior uveitis and discuss the pathologic mechanisms of injury and evaluation of these uncommon presentations.
Subject(s)
Bees , Corneal Injuries , Insect Bites and Stings , Adult , Animals , Humans , Insect Bites and Stings/complications , MaleABSTRACT
PURPOSE: To report the experience of the Tunis Institute of Ophthalmology (Tunisia) in therapeutic penetrating keratoplasty. METHODS: We retrospectively analyzed 35 patients after therapeutic penetrating keratoplasty over a period of 6 years (between September 2002 and September 2008). RESULTS: The mean patient age was 49.3 years. Men outnumbered women by a ratio of 2.5 to 1. The mean follow-up was 13.5 months. Corneal diseases within a therapeutic penetrating keratoplasty were divided into infectious keratitis (21 eyes) and noninfectious diseases (14 eyes). Herpetic keratitis was the most common etiology (11 eyes). The anatomical success rate was 92.4%, with infection eradicated in 80% of cases. The graft clarity at the end of follow-up was 54.2%. Rejection was the leading cause of graft opacification (50%). Final visual acuity was better than 1/10 in 25.7% of patients. Recovery of useful vision was observed in 45.7% of patients. CONCLUSION: Therapeutic penetrating keratoplasty is a surgical technique that has proved its effectiveness in maintaining the integrity of the eyeball. The prognosis for this intervention would probably be better if it could be postponed.
Subject(s)
Keratoplasty, Penetrating , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Tunisia , Young AdultABSTRACT
OBJECTIVES: To study of the association between thyroid carcinoma and Hashimoto's thyroiditis (HT). MATERIAL AND METHODS: [corrected] Retrospective study of 78 patients undergoing surgery between 2001 and 2002, with a pathological diagnosis of Hashimoto's thyroiditis. The clinical data and complementary tests performed before surgery are reported. RESULTS: The mean age was 44.6 years, with 77 females and only one male. There were 12 cases of thyroid cancer associated with HT, mostly with the nodular form, with 11 papillary carcinoma (14.1%) and one non-hodgkin B lymphoma of the thyroid. Tumor size varied from 4 to 60 mm with a mean of 26 mm. There was one microcancer (size<10 mm). CONCLUSIONS: We did not find an increased incidence of thyroid cancer associated with this highly selected population of HT patients.
Subject(s)
Carcinoma, Papillary/complications , Hashimoto Disease/complications , Lymphoma, B-Cell/complications , Thyroid Neoplasms/complications , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Papillary/pathology , Female , Hashimoto Disease/diagnosis , Hashimoto Disease/diagnostic imaging , Hashimoto Disease/pathology , Hashimoto Disease/surgery , Humans , Lymphoma, B-Cell/pathology , Male , Middle Aged , Retrospective Studies , Thyroid Function Tests , Thyroid Gland/pathology , Thyroid Neoplasms/pathology , Thyroidectomy , UltrasonographyABSTRACT
OBJECTIVES: The management of diagnosis, treatment and outcome of malignant neoplasm arising in a lingual thyroid. MATERIAL AND METHODS: We report a case of papillary-follicular carcinoma arising in a lingual thyroid. RESULTS: Lingual carcinoma causes dysphagia and pain due to oropharyngeal obstruction. Surgical pharyngotomy with a trans-hyoid approach provides good access to the lesions. Therefore, the eutopic thyroid was present, in pretracheal position, without neoplastic proliferation. CONCLUSIONS: Carcinoma arising in lingual thyroid is an extreme rare entity. Its diagnosis is histologic. Its treatment is surgical associated with radio-iodine therapy.
Subject(s)
Carcinoma, Papillary, Follicular , Choristoma , Thyroid Gland , Thyroid Neoplasms , Tongue Diseases/complications , Tongue Neoplasms , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Papillary, Follicular/diagnosis , Carcinoma, Papillary, Follicular/pathology , Carcinoma, Papillary, Follicular/surgery , Child , Choristoma/complications , Deglutition Disorders/etiology , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Immunohistochemistry , Laryngoscopy , Magnetic Resonance Imaging , Male , Middle Aged , Thyroid Gland/pathology , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/epidemiology , Thyroid Neoplasms/pathology , Thyroidectomy , Time Factors , Tongue/pathology , Tongue Neoplasms/diagnosis , Tongue Neoplasms/pathology , Tongue Neoplasms/surgeryABSTRACT
PURPOSE: Simultaneous bilateral rhegmatogenous retinal detachments are rare. The purpose of our study was to examine the incidence, predictive factors, surgical results and prognosis of these retinal detachments. PATIENTS AND METHODS: A retrospective analysis of the medical records of 468 consecutive patients, 7-89 years of age (mean, 45.7 years), undergoing surgery for rhegmatogenous retinal detachment between 1993 and 2000. RESULTS: During this period, a total of 497 operations for rhegmatogenous retinal detachment were done. Thirty-two patients had bilateral rhegmatogenous retinal detachment. Simultaneous detachments were observed in seven patients (1.5%). In four cases, the diagnosis of retinal detachment was fortuitous. In fact, most patients presented with unilateral symptoms. The mean age (35 years) of patients suffering from simultaneous bilateral rhegmatogenous retinal detachment was younger than that of patients with unilateral or consecutive bilateral retinal detachments. Five patients were myopic. Multiple round retinal holes were the most frequent lesions responsible for retinal detachment. A preoperative proliferative vitreoretinopathy was found in 57% of cases. The retina was reattached in nine cases (81%). CONCLUSION: Simultaneous bilateral rhegmatogenous retinal detachment is usually found in relatively young myopic patients with atrophic retinal holes. They are rare but severe because of their frequent association with preoperative proliferative vitreoretinopathy.
Subject(s)
Retinal Detachment/etiology , Retinal Perforations/complications , Adolescent , Adult , Age Factors , Female , Humans , Incidence , Male , Middle Aged , Myopia/complications , Prognosis , Retinal Detachment/diagnosis , Retinal Detachment/surgery , Retrospective Studies , Rupture , Vitreoretinopathy, Proliferative/complicationsABSTRACT
INTRODUCTION: Intumescent cataract with ocular hypertony is a medicosurgical emergency. The purpose of our study is to define the clinical and therapeutic particularities of these cataracts. MATERIAL AND METHODS: This retrospective study includes 40 consecutive patients with angle closure secondary to intumescent cataract. All patients were examined between 1st January 1998 and 30 October 2000. RESULTS: The patient population consisted of 28 women (70%) and 12 men ranging in age from 59 to 88 years (mean age: 78 years). Preoperative visual acuity was negative in 17% of cases and limited to light perception in 83% of cases. Ocular pressure varied from 25 to 68 mmHg. Patients underwent surgery one to 23 days after diagnosis. Surgical techniques consisted in extracapsular cataract extraction with (35%) and without (65%) intraocular lens. Preoperative complications were: vitreous loss in 20% of cases and expulsive haemorrhage in 2 cases (5%). Postoperative visual acuity improved in 70% of cases. COMMENT AND CONCLUSION: Intumescent cataract with ocular overpressure gives therapeutic problems, which can be prevented by a preoperative hypotony. Functional results of this study encouraged us to operate the intumescent cataract even if visual acuity is bad.
Subject(s)
Cataract/complications , Cataract/therapy , Ocular Hypertension/complications , Aged , Aged, 80 and over , Cataract Extraction , Female , Humans , Intraocular Pressure , Lenses, Intraocular , Male , Middle Aged , Ocular Hypertension/prevention & control , Preoperative Care , Retrospective Studies , Visual AcuityABSTRACT
Malignant glaucoma is a rare and dramatic complication that occurs more frequently after glaucoma filtration surgery for angle closure glaucoma and rarely for open angle glaucoma. We report a case of a highly myopic monocular 38-year-old woman, with a primary open angle glaucoma who developed malignant glaucoma in the first postoperative days of a trabeculectomy. Treatment consisted of extracapsular cataract extraction and vitrectomy, with the removal of the anterior hyaloid and preventive circular buckling. Late postoperative events have been marked by the occurrence of anterior synechiae and residual hypertension. We discuss the pathogenesis of malignant glaucoma, its management and the results of the different therapeutic procedures.
Subject(s)
Glaucoma/etiology , Myopia/complications , Trabeculectomy/adverse effects , Adult , Female , Glaucoma/complications , Humans , Severity of Illness IndexABSTRACT
PURPOSE: We present preliminary research on penetrating keratoplasty in corneal dystrophy secondary to congenital glaucoma. The aim was to analyse the functional and anatomic results of this morbid condition where visual prognosis is usually poor. PATIENTS AND METHODS: Six cases of congenital glaucoma in which the ocular pressure is controlled were studied. Age varied from 10 months to 11 years, the medium age was 47.7 months (SD: 42.8). These patients underwent penetrating keratoplasty. Recession varied from 3 months to 29 months, with a medium recession of 18.4 months (SD: 11.54). RESULTS: Anatomic results: the graft remained transparent in 5 eyes. Some postoperative complications were noticed: ocular hypertonia medically treated in one case, minor uveitis in one case, total cataract operated by phacophagy with a final outcome of ophthalmomalacia, buphtalmia (31.5 of diameter and ocular tonus at 7 mmHg). Functional results: an amelioration of visual acuity was obtained in 5 of 6 cases. CONCLUSION: The anatomic and functional results were satisfactory. Ocular pressure must be normalised before keratoplasty. Important buphtalmia constitutes one contra-indication to this intervention. Hypotonia would appear to be a factor of poor prognosis.
Subject(s)
Glaucoma/genetics , Keratoplasty, Penetrating , Child , Child, Preschool , Consanguinity , Corneal Dystrophies, Hereditary/genetics , Corneal Dystrophies, Hereditary/surgery , Female , Follow-Up Studies , Glaucoma/surgery , Humans , Infant , Male , Postoperative Complications/etiology , Reoperation , Treatment Outcome , TunisiaSubject(s)
Rabies/epidemiology , Adolescent , Adult , Animals , Animals, Wild , Artiodactyla , Cat Diseases/epidemiology , Cats , Child , Child, Preschool , Disease Reservoirs/veterinary , Dog Diseases/epidemiology , Dogs , Female , Humans , Infant , Male , Middle Aged , Rabies/therapy , Rabies/veterinary , Rodent Diseases/epidemiology , Rodentia , TunisiaABSTRACT
The partition of the delta 5 leads to 4 3-oxosteroid isomerase of Pseudomonas testosteroni in aqueous two-phase systems containing both the macroligand, polyoxyethylene glycol-bound estradiol, and charged (cationic or anionic) dextrans has been studied. If the enzyme is well retained in the upper phase by an adequate amount of macroligand, it is possible to improve the removal of the contaminating proteins by extracting them into a lower phase containing positively or negatively charged dextran. Some mult-step extraction experiments were carried out to purify isomerase, by washing the upper phase successively with cationic and anionic dextran-rich phases.
