A rare case of prostate tuberculosis after holmium laser enucleation of the prostate.

Prostatic tuberculosis is considered to be a rare disease. It is usually associated with nonspecific symptoms and is detected incidentally after prostatic histological analysis. We report the case of a 60-year-old man suffering from acute urinary retention with an estimated 90 g prostate who underwent Holmium laser enucleation of the prostate. The diagnosis of prostate tuberculosis was histological based on the analysis of prostate enucleation chips. The clinical course was favourable under anti-tuberculous drugs.

Persistent Müllerian duct syndrome with torsion of a transverse testicular ectopia: first reported case.

Persistent Müllerian duct syndrome with transverse testicular ectopia is a rare pathologic association. A 7-month-old boy was admitted to the emergency department with a right testicular swelling. Physical examination revealed a tender right testis, the upper limits of which could not be palpated. The left testis was impalpable. An ultrasound revealed a normal right testis with an evident blood flow, overcome by a similar mass but avascular. At surgery, the right hernial sac contained both testes with an infantile uterus and fallopian tubes. The left testis was viable after manipulation. Proximal-salpingectomy with corporeal hysterectomy was performed to allow bilateral scrotal orchiopexy.

A transplant recipient with a mixed germ-cell ovarian tumor.

Immunosuppressed renal transplant recipients seem to be at significantly increased risk of developing neoplasms comparatively to nonimmunosuppressed individuals. A history of malignancy exposes the patient to a high risk for relapse after transplantation. We present a trans-plant recipient with a history of an ovarian mixed germ-cell tumor, with choriocarcinoma component, which was treated seven years prior to transplantation. After three years of follow-up, there was no evidence of tumor relapse. To our knowledge, there is no report of such case in the English literature. Regarding our case report and patients with a history of ovarian germ-cell neoplasm, waiting time before transplantation must take into consideration the stage of the tumor, its prognosis, the proportion of different tumor components, and the overall prognosis of the patient if transplantation is withheld.

[Mitrofanoff continent urinary diversions: The opinion of 57 patients]. / Derivation urinaire continente de type mitrofanoff: point de vue de 57 patients.

OBJECTIVE: To evaluate the psychological repercussions and degree of adaptation in daily living of patients with a Mitrofanoff continent external urinary diversion. PATIENTS AND METHOD: Fifty seven patients were questioned about their Mitrofanoff continent urinary diversions, using a questionnaire translated into their spoken language (Arabic). RESULTS: The mean age was 29 years (range: 10 to 72 years). The indication for the diversion was a neurological cause in 91% of cases. Continence was achieved in every case, but after surgical revision in 3 cases. Self-catheterization was considered to be easy and not especially bothersome in 49 cases (86%). The diversion had occasional and moderate repercussions on activities of daily living, estimated between 3.5 and 17.5%. Sixteen patients (94%) returned to work and another fifteen (79%) successfully resumed their schooling. Nineteen patients (83%) who were sexually active preoperatively reported a satisfactory sex life after the operation. Finally, this operation was highly appreciated by the patients in 96.5% of cases for hygienic and psychological reasons. CONCLUSION: The Mitrofanoff urinary diversion allows satisfactory social, work and family rehabilitation provided the patient adapts to diversion management.

[Oncological results of 117 consecutive radical prostatectomies]. / Résultats carcinologiques de 117 prostatectomies radicales consécutives.

INTRODUCTION: The objective of this study was to evaluate the risk factors of biochemical recurrence in patients with prostate cancer treated by retropubic prostatectomy. MATERIAL AND METHODS: Retrospective analysis of 121 consecutive retropubic radical prostatectomies performed between January 1994 and December 1997. Biochemical recurrence was defined by PSA > or = 0.2 ng/ml. Biochemical recurrence-free survival rates were calculated by the actuarial method. Univariate and multivariate analysis of prognostic factors of biochemical recurrence was performed. RESULTS: The actuarial biochemical recurrence-free survival was 71% at 5 year and 63% at 7.5 years. Kaplan-Meier analysis did not reveal any difference for the risk of biochemical recurrence between patients with doubtful margins and those with positive margins. These two groups were therefore combined. Significant risk factors on univariate analysis were: pathological stage, grade of the predominant cell contingent on the specimen, margins, highest cell grade on biopsies, clinical stage, PSA level, perineural invasion and Gleason score. Significant risk factors for biochemical recurrence on multivariate analysis were: pathological stage, PSA > 10 ng/ml, the highest grade on biopsies, positive margins and perineural invasion. CONCLUSION: Doubtful margins and positive margins appear to be associated with the same risk of biochemical recurrence. The prognostic value of Gleason grade on the specimen is higher than that of the Gleason score. A high Gleason grade on biopsies is associated with a particularly poor prognosis.

[Appendiculoureteroplasty: about 6 cases]. / L'appendiculoureteroplastie: à propos de 6 cas.

OBJECTIVE: Through this work we want to specify the place of ureteroappendiculoplasty as an important technical procedure for ureteral substitution. MATERIAL AND METHODS: Between January 1997 and September 2002, 6 patients had an appendiculoureteroplasty. RESULTS: four women and two men with a mean age of 37 years (range 12 to 55 years) had a lesion of the right ureter. The decision is use the appendix was taken peroperatively in front of the difficulties associated with other procedures. The mean length of ureteral loss was 12 cm (6-15 cm), the pelvic portion of ureter was more damaged than other segments (4 cases). The appendix was suspended between the 2 ureteric extremities in 2 cases and between the ureter and the bladder in 4 cases. After a mean follow-up of 3 years (1-5 years), we noted a recovery of the kidney function in all cases. CONCLUSIONS: autotransplantation of the appendix can be considered a simple procedure that allows sometimes to reestablish the continuity of the ureter with good results.