[To analyse diagnosis, management and prognosis of florid cystitis glandularis (pseudoneoplastic entity)]. / La cystite glandulaire pseudo tumorale.

PURPOSE: To analyse diagnosis, management and prognosis of florid cystitis glandularis (pseudoneplastic entity). PATIENTS AND METHODS: A retrospective study of 6 consecutive patients with florid cystitis glandularis seen at the department of Urology of Monastir (Tunisia) from January 1996 to July 2006. All patients underwent ultrasonography, and cystoscopy. Computed tomography (CT) was performed in four patients and magnetic resonance imaging (MRI) in one patient. RESULTS: The six patients, all of whom were male, ranged from 22 to 68 (average 42) years of age. The most common complaints was haematuria. Radiological examination and cystoscopy suggested a bladder tumor in all patients. Histopathology revealed features of cystitis glandularis of intestinal type. Features of the pelvic CT and MRI were consistent with the diagnosis of pelvic lipomatosis in one patient. The endoscopic resection was performed in 5 patients. Recurrence occurred in one of these 5 patients within one and 7 years of follow-up. The other patient had developed a low compliance small-capacity bladder and bilateral ureteral obstruction. A total cystoprostatectomy and ileal neobladder construction was considered, but it was declined by the patient. The patient was treated with anti-inflammatory drug (Indometacine 100 mg/day). CONCLUSION: Cystitis glandularis may be mistaken for bladder tumor The diagnosis is histological. Treatment is based on eradication of the irritative factors and endoscopic resection of the tumoral masses. The clinical course is unclear, requiring long-term fellow-up.

[Prostate cancer: comparative study of stage T1a and stage T1b]. / Cancer de prostate: étude comparative stade T1a et stade T1b.

OBJECTIVE: To compare the epidemiological profiles and histoprognostic factors of two groups of prostate cancer: T1a versus T1b. MATERIALS AND METHODS: Between January 1996 and December 2005, 1359 patients were operated for benign prostatic hyperplasia (BPH) in our urology department. All patients had a PSA less than 4 ng/ml, an adenomatous prostate on digital rectal examination with a homogeneous appearance on prostatic ultrasonography. The population of patients with prostate cancer was classified into group 1 (stage T1a) and group 2 (stage T1b). The following parameters were studied: age at diagnosis, PSA, volume of prostatic tissue removed (by resection or enucleation), histological findings. RESULTS: In this series of 1359 operated patients (762 by endoscopic resection and 597 by transvesicalprostatectomy), 44 (3.23%) had prostate cancer Group 1 comprised 18 patients (40.9%) and group 2 comprised of 26 patients (59.1%). Group 1 had a mean age of 74.7 years, a mean PSA of 2.36 ng/ml and a mean prostatic volume of 37.16 ml. Corresponding values for group 2 were 74.4 years, 3.11 ng/ml and 26.3 ml, respectively The Gleason score was low (2-4 and 5-6) and no grade 4 was observed for any of the patients of group 1, while 50% of patients of group 2 had a high Gleason score (7-10). CONCLUSION: The incidence of stage T1a and T1b prostate cancer is low due to the increasingly systematic use of PSA. The volume of the prostate and transitional zone does not influence the stage T1a and T1b prostate cancer detection rate. T1b cancer has a poorer prognosis than stage T1a cancer.

[Uroflowmetry in children: Prospective study of normal parameters]. / Débitmétrie de l'enfant: étude prospective des paramètres normaux.

INTRODUCTION: Uroflowmetry is the simplest urodynamic test to study the lower urinary tract. Uroflowmetry parameters, especially maximum flow rate, are important, but are difficult to interpret due to the lack of normal uroflowmetry data in children. OBJECTIVE: The objective of this prospective clinical study was to evaluate normal uroflowmetry parameters in a prospective series of 202 children between the ages of 5 and 15 years. MATERIALS AND METHODS: We prospectively studied uroflowmetry in a series of 202 children between the ages of 5 and 15 years. Children with voiding disorders, or a psychiatric or neurological illness were excluded. The following variables were determined: age, body surface area (BSA (m2)), maximum flow rate (Qmax (ml/s)), voided volume (V (ml)) and maximum flow time (TQmax (s)). RESULTS: Qmax increased with age, V and BSA in both sexes and was greater in girls. In girls between the ages of 5 and 6 years, mean Qmax was 15.8 for a mean V of 173 and BSA less than 1.06 and, in girls between the ages of 13 and 15 years, mean Qmax was 26.2 for a mean V of 327 and BSA greater than 1.06. TQmax also increased with age, V and BSA and was greater in boys. In boys between the ages of 5 and 6 years, mean TQmax was 6.5 for a mean V of 174 and BSA less than 1.6 and, in boys between the ages of 13 and 15 years, mean TQmax was 7.4 for a mean V of 332 and BSA greater than 1.6. A positive correlation was demonstrated between age and uroflowmetry parameters and the most significant correlation was observed between age and Qmax in both sexes. CONCLUSION: This study on normal uroflowmetry parameters in children not presenting any voiding disorders demonstrated a significant difference, in both sexes, between Qmax and TQmax in relation to age, V and BSA. Uroflowmetry could therefore be useful in the diagnosis of infravesical obstruction.

[An unusual testicular tumour: splenogonadal fusion]. / Une tumeur testiculaire inhabituelle: fusion splénogonadique.

Splenogonadal fusion is a rare congenital anomaly that is often discovered at operation or autopsy. The diagnosis is difficult, but could be based on preoperative scintigraphy and frozen section histological examination to avoid useless orchidectomy. It is a benign lesion, which must be distinguished from testicular tumour.

[Encrusted cystitis]. / La cystite incrustée.

Encrusted cystitis is a chronic inflammation of the bladder mucosa associated with calcified deposits induced by numerous bacteria in an alkaline medium. Corynebacterium urealyticum or group D2 is most frequently incriminated. Encrusted cystitis is a rare disease with non-specific clinical features. The diagnosis may be suspected on imaging, but is often only established later on histological findings. Treatment of this disease is based on appropriate antibiotics with acidification of the urine. The authors report a new case of encrusted cystitis in a 78-year-old woman and review the literature on encrusted lesions of the urinary tract.

[Leiomyoma of the urinary bladder]. / Le léiomyome de la vessie.

Benign mesenchymal tumors of the bladder are rare. Leiomyoma is the most common mesenchymal tumor of the bladder. We report a new case. A 50-year-old woman presented with total hematuria. Complementary investigations (ultrasonographic, intravenous urography) showed an intravesical solid mass, arising from the bladder dome. Cystoscopic examination suggested a benign tumor, which was confirmed by pathologic assessment of biopsy. Partial cystectomy was performed. Postoperative course was uneventful. Pathologic examination showed a leiomyoma. Leiomyoma of the urinary bladder is a rare benign tumor. Its prognosis is good, the treatment being exclusively surgical.