A rare case of successful endoscopic management of a fibroepithelial polyp with intussusception of the ureter and periodic prolapse into bladder.

Fibroepithelial polyps of the ureter are rare non-epithelial benign tumours with a slight female predominance. They are primarily located in the upper left ureter, incidentally diagnosed in patients who are evaluated for gross haematuria or renal colic. Fibroepithelial polyps are traditionally managed by open surgery with resection of the polyp and its stalk or partial resection of the ureter. We describe the case of a fibroepithelial polyp located in the distal right ureter, which occurred in a 42-year-old man with lower urinary tract symptoms, haematuria and flank pain. To our knowledge, this is the first reported case of ureteral fibroepithelial polyp acting as a lead point for ureteral intussusception and to protruding periodically into the bladder cavity, which was successfully resected by ureteroscopic electrocauterisation with good outcome.

A rare case of pelviureteric junction obstruction in the uncrossed kidney of a crossed fused renal ectopia.

Crossed renal ectopia with fusion is an extremely rare congenital anomaly with few reported cases of pelviureteric junction obstruction, which often involves the crossed-over kidney. To our knowledge, we describe the second case in literature to report an uncrossed kidney with pelviureteric junction obstruction and giant hydronephrosis, which obstructs the pelviureteric junction of the crossed-over kidney. The grossly hydronephrotic kidney was found to be poorly functioning and an aberrant crossing vessel was considered to be potentially involved, raising both diagnostic and management challenges. By reporting this case, we aim to stress the importance of adequate mapping collecting systems, drainage patterns and vascular supply in such crossed fused anomalies.

Transperitoneal Laparoscopic Pyelopyelostomy for Retrocaval Ureter without Excision of the Retrocaval Segment: Experience on Three Cases.

Introduction. Retrocaval ureter is a rare congenital anomaly. Open surgery was the classic treatment for this condition. Laparoscopy is currently an admitted procedure to treat many urological diseases. The objective of our study is to present our experience and discuss the safety and the feasibility of transperitoneal laparoscopic pyelopyelostomy for treatment of retrocaval ureter (RCU). Materials and Methods. Three symptomatic patients underwent laparoscopic repair for RCU in our department. The diagnosis was suspected on the computed tomography scan (CT) and confirmed on ascending pyelography. After placement of a JJ stent, and, using the transperitoneal approach, the retro peritoneum was exposed; the ureter was identified in both sides of the vena cava. The retrocaval segment was entirely mobilized and pulled from behind of the vena cava after section of renal pelvis. A pyelopyelostomy was done in a normal anatomic position. Results. All operations were achieved laparoscopically without conversion to open surgery. The mean operative time was 140 minutes (110-190). No intraoperative complication occurred. Blood loss was less than 50 mL in all patients. The mean hospital stay was 5 days (4-6 days). All patients were symptom-free after surgery and had reduction of hydronephrosis in control imagery. Conclusion. Laparoscopy seems safe, feasible, and reproducible in managing retrocaval ureter.

Ureteral stenting after uncomplicated ureteroscopy for distal ureteral stones: a randomized, controlled trial.

Objectives. We compared outcome and complications after uncomplicated ureteroscopic treatment of distal ureteral calculi with or without the use of ureteral stents. Materials and Methods. 117 patients, prospectively divided into three groups to receive a double j stent (group 1, 42 patients), ureteral stent (group 2, 37 patients), or no stent (group 3, 38 patients), underwent ureteroscopic treatment of distal ureteral calculi. Stone characteristics, operative time, postoperative pain, lower urinary tract symptoms (LUTS), analgesia need, rehospitalization, stone-free rate, and late postoperative complications were all studied. Results. There were no significant differences in preoperative data. There was no significant difference between the three groups regarding hematuria, fever, flank pain, urinary tract infection, and rehospitalisation. At 48 hours and 1 week, frequency/urgency and dysuria were significantly less in the nonstented group. When comparing group 1 and group 3, patients with double j stents had statistically significantly more bladder pain (P = 0.003), frequency/urgency (P = 0.002), dysuria (P = 0.001), and need of analgesics (P = 0.001). All patients who underwent imaging postoperatively were without evidence of obstruction or ureteral stricture. Conclusions. Uncomplicated ureteroscopy for distal ureteral calculi without intraoperative ureteral dilation can safely be performed without placement of a ureteral stent.

Le drainage pelvien apres adenometomie prostatique transvesicale reste-il indispensable?

Objectif: La chirurgie ouverte garde encore sa place dans la prise en charge de l'hyperplasie benigne de la prostate (HBP). Nous rapportons notre experience preliminaire d'adenomectomie par voie haute sans drainage sous peritoneal. Patients et methodes: Nous avons evalue de facon prospective 100 adenomectomies consecutives pour (HBP); effectuees par voie haute entre juin 2007 et juillet 2009. L'enucleation de l'adenome etait faite par voie transvesicale. Chez les 50 premiers patients (groupe 1); un drain de Redon aspiratif a ete place en sous peritoneal. Chez les 50 suivants (groupe 2); apres une epreuve d'etancheite; aucun drain n'a ete mis en place. Resultats: Les deux groupes avaient un age moyen et un volume prostatique comparables. Le sejour hospitalier etait superieur d'un jour dans le premier groupe. Le taux global de complications postoperatoires etait identique dans les deux groupes (10). Conclusion: L'absence de drainage sous peritoneal apres adenomectomie de la prostate ne s'accompagne pas de plus de complications que dans la technique classique avec drainage. Un gain en jours d'hospitalisation peut au contraire s'en suivre

Genital self-amputation or the Klingsor syndrome: Successful non-microsurgical penile replantation.

Self-mutilations of the external genitals in psychiatric patients also known as Klingsor syndrome is a rare urologic trauma. Men with religious conflicts, low self-esteem, unresolved transsexual issues and feelings of guilt are the most vulnerable. This condition requires immediate surgical intervention. Currently replantation involves meticulous microsurgery and has become the primary method for managing these patients. In this paper, we report a case of self amputation of penis in a patient with a psychiatric history significant for schizopfrenia. Because of the unavailability of a microscope in our department, a non-microsurgical replantation without microscopic magnification was attempted. After surgery, normal appearance and function including a good normal voiding, sensation, and erections were observed.

[Retroperitoneal sarcoma: therapeutic and prognostic characteristics, report of 6 cases]. / Les sarcomes rétropéritonéaux: aspects thérapeutiques et pronostiques, à propos de 6 cas.

Retroperitoneal sarcoma is a rare solid tumor that accounts for less than 15% of soft tissue sarcoma. The authors conducted a retrospective study about 6 cases to evaluate the natural history of the tumors and the causes of treatment failure in an attempt to develop a rational approach to the management of the neoplasm. The histological grade and complete resection are the most important prognosis factors.

[Urinary and nephrologic aspects of Von Recklinghausen disease. Two case reports and review of the literature]. / Aspects urogénitaux et néphrologiques de la maladie de Von Recklinghausen. A propos de deux observations et d'une revue de la littérature.

Urinary tract involvement in neurofibromatosis type 1 is rare and uncommon entity. The syndrome is transmitted as an autosomal dominant trait and is characterized by cutaneous pigmentation and tumors as neural crest origin. Two cases of kidney involvement by Von rechlinghausen's disease with in one case a consequent hydronephrosis with arterial hypertension and in the second a nephrocalcinos without hyperparathyroidism are present. The literature of urogenital and nephrologic neurofibromatosis is reviewed. The authors suggest that the patient with neurofibromatosis be screened annually with medical history, physical examination, urinalysis and serum chemistry for tumors that affect the urinary particularly in children.

[Cystic lymphangioma in the adrenal gland: a case report]. / Le lymphangiome kystique de la surrénale: à propos d'une observation.

Cystic lymphangioma of the adrenal gland are rarely encountered tumoural formations with no clinical expression. Pre-operative diagnosis is difficult. Echography and CT scan are essential exploratory techniques, diagnosis is histological. Usually surgical exploration is indicated due to uncertain diagnosis. We report a new case of cystic lymphangioma of the adrenal gland and a review of recent literature.

[Multiple leiomyoma of the scrotum. A case report]. / Léiomyome scrotal multiple. A propos d'une observation.

A variety of neoplasms derived from mesechymal elements may arise on the tunica dartos, the tunica albuginea or, more rarely, within the testis or the epididymis. The authors report a case of leiomyoma of the scrotum in a 33-year-old man. This rare and benign tumour is localized in the tunica dartos in 8% of cases. The positive diagnosis is based on histological examination after conservative treatment by local excision which gives excellent results.

[Hemospermia: diagnosis and therapeutic aspects. Seven case reports]. / Les hémospermies: orientation diagnostique et thérapeutique. A propos de sept cas.

Hemospermia or hematospermia is a common benign condition, but its prevalence remains unknown and can result from several causes. The aetiology is idiopathic in about 30-70% of the cases. The hemospermia is first of inflammatory origin, in the young patients, where it is due to uretroprostatitis or orchi-epididymitis, but in the older, it is due to a benign of malignant prostatic tumors. Transrectal ultrasonography and magnetic resonance imaging can afforded the opportunity to best investigate the patients with hemospermia. Hemospermia is not an uncommon problem and in most instances has little clinical significance other than evoking much anxiety for the patient. In view of the literature, the authors discus the diagnostic and therapeutic approach of hemospermia through a series of seven cases.

[Multiocular renal cysts in adults. Two case reports]. / Les kystes multiloculaires du rein chez l'adulte. A propos de deux observations.

The authors report two cases of renal multilocular cyst and review the cases reported in the literature, revealing the original features of this benign tumour which has an equal incidence in children and adults with a controversial acquired or malformative aetiopathogenesis, precise histological features, but a difficult preoperative and intraoperative diagnosis despite modern imaging techniques. In the great majority of cases, treatment consists in nephrectomy.

[Rare cause of iatrogenic stenosis of the penile urethra. Case report]. / Cause inhabituelle de sténose iatrogène de l'urètre pénien. A propos d'un cas.

We describe the case of a 32 year old man who developed such a stenosis after surgery for traumatic rupture of the corpus cavernosum. The aetiology of this rare complication is also given. The stenosis was well outlined by cystography and responded successfully to conservative treatment.

[Hydatid cyst of the Douglas' cul-de-sac with fistula to the bladder. Report of 2 cases]. / Le kyste hydatique du cul-de-sac de Douglas fistulisé dans la vessie. A propos de deux cas.

The present study reported two cases of hydatid cysts localized in Douglas space and that broke in the bladder. The clinical course was characterized by urinary symptoms and by presence the cysts in urine. Abdominopelvic ultrasonography is essential for diagnosis and identification of other sites. When diagnosis is unclear, then CT scan plays a role. Therapy included cystectomy and pericystic resection in one case and intravescical injection of H2O2 in the second case. The course was favorable in both cases.

[Retroperitoneal foreign body mimicking pararenal tumor]. / Corps étranger rétropéritonéal simulant une tumeur pararénale.

We report the case of a 48 year-old woman presently with a pararenal tumor, with a history of pyelotomy in 1978 for the extraction of a renal pelvic stones. Results of surgery showed a foreign body. The clinical and diagnostic aspects of retained surgical gauze have been discussed and the need for radio-opaque markers in them have been emphasized.

[Pyelocolic fistula: a case study]. / Les fistules pyélocoliques: à propos d'une observation.

In this study, the case has been reported of a left renocolic fistula that was detected in a patient with hepatitis C and cirrhotic complications who was hospitalized for urogenital tuberculosis. It was decided to perform left nephrectomy and digestive suture, but surgery was delayed due to hemostatic abnormalities and massive cytolysis, and the patient died before surgical treatment, three days after the discovery of the fistula. The findings in the literature have been reviewed, and the common occurrence of this type of fistula has been underlined. They are the most frequently encountered type with of entero-urinary fistula, and account for 60% of documented cases. Their etiological and clinical characteristics of have been described in detail. In general, treatment consists of performing a nephrectomy and digestive suture.