[Encrusted cystitis due to Corynebacterium urealyticum]. / Cystite incrustante àCorynebacterium urealyticum.

We reported the case of a 61 year-old man who presented an encrusted cystitis by Corynebacterium urealyticum associated with bilateral hydronephrosis four months after adenomectomy complicated by vesicocutaneous fistula. Medical treatment by quinolones and oral acidification of the urine allowed regression of the encrusted calcifications and resolution of the hydronephrosis.

[Bladder infiltrating tumor: retrospective study of 225 cases]. / Tumeurs infiltrantes de vessie: étude rétrospective à propos de 225 cas.

The authors report a retrospective serial of 225 patients presenting an infiltrating bladder tumor. The infiltrating tumors represent 29.2% of bladder tumors. The middle age of our patients is 59 years with a sex-ratio of 7.3. In the histology, 80% of the tumors are a cell transitional carcinoma and 65% of the patients are classified stage T3T4. The surgical treatment has could be achieved at 73.3% of the cases and 66.7% of the patients had a radical cystectomy. The urinary diversion was essentially an continent urostomy using Benchekroun's hydraulic valve. At 28 months mean follow-up, a locoregional recurrence has been noted from 18% of the Tur achieved alone and 4% of the radical cystectomy. A metastasis has been noted from 18% of the patients and this in a mean delay of 12 months.

[Neurogenic bladder: report of 73 cases]. / Les vessies neurogènes: à propos de 73 cas.

The authors report their experience of neurogenic bladder about 73 cases during 16 years. The analysis of the data permits to affirm that the neurogenic bladder remained a rare pathology, that their aetiologies is acquired in 87.6% of the cases with a predominance of spinal cord traumatisms, which explains the predominance of the pathology among the young subject of masculine sex (middle age of 32 years, sex-ratio is 2.5). The clinical signs are represented by urinary incontinence that constitutes the main motive of consultation, followed by obstructive signs and frequent miction associated to urge miction. The explorations put in evidence an important rate of complications because of the diagnostic delay. The therapeutic management aims to assure a most complete draining of the bladder to low pressure, to assure the continence or at least to manage the incontinence while assuring the comfort and the patient's autonomy.

[Perinephretic phlegmon: about 36 cases]. / Le phlegmon périnéphrétique: à propos de 36 cas.

The authors report a series of 36 cases of perinephric phlegmon during 15 years. The patients are 27 men and 9 women. Mean age was 37 years (ranging between 25 and 70). The promoting factors of PPN are diabetes (27.8%), and kidney calculi (22.3%). Delay diagnosis is more than 3 weeks in 80% of the patients. The clinical symptomatology was dominated by pain, fever and flank mass. Diagnosis is carried out by ultrasonography in 84% and by CT scan whenever it is done. The common germs are negative Gram bacilli and staphylococcus. The treatment consists in antibiotherapy associated to a percutaneous drainage of the collection in 6 patients (16.7%) and a surgical drainage in 30 patients (83.7%). The follow-up are favorable in all cases.

[Vesico-vaginal fistula: report of 1050 cases]. / Les fistules vésico-vaginales: à propos de 1050 cas.

The authors reports their experience of a large series of 1050 cases of vesico-vaginal fistulas recorded during 30 years and analyse their epidemiological, anatomo-clinical, and therapeutic aspects. Patients could be classified as a function of site of fistula into 3 types, according to the Benchekroun's classification: type I ureto-vaginal fistula (30%); type II cervico-vaginal fistula (22%); type III vesico-vaginal fistula (48%). Etiology was mainly obstetrical (93%). An associated lesion was detected in 10.4% of cases (uterine, ureteral and rectal). Treatment was only performed after a minimal period of three months with the following results in obstetrical vesico-vaginal fistulas. Type I fistula, using a low approach and requiring urethral refection in 100 cases, showed good results in only 60% of cases. Type II fistulae, usually treated through a low approach (80%), were treated with 80% good results. Type III fistula, were nearly always corrected (98%) after two procedures. The overall results are good in 80% of cases. The failures concerned in majority the complex vesico-vaginal fistulas type I, are treated by urinary diversion (51 Coffey, 5 Bricker) and since 1975, 73 continent ileocecal or ileal bladders using Benchekrouns' technique.

[Superficial pT1G3 bladder tumor: 24 case reports]. / Les tumeurs superficielles de vessie pT1G3: à propos de 24 cas.

The authors report 24 patients presenting a transitional tumor of bladder pT1G3 collected between January 1996 and December 2000. They represent 19% of the superficial tumors of bladder. Two patients had of straightaway a cystectomy after resection for an unverifiable tumor by endoscopy and another after a second resection discovering a real pT2. Only 5 patients received a BCG therapy is 24% of the cases. A recurrence without progression has been noted in 38% of the cases and a progression in 19% of the patients. These last patients had a cystectomy and with a follow-up to 28 months, no recurrence has been noted.

[Prostatic tuberculosis. Two case reports]. / La tuberculose prostatique. A propos de 2 cas.

The authors report 2 cases of prostatic tuberculosis. The patients are 59 and 62-years-old respectively. They presented obstructive and irritative symptoms of the lower urinary tract. The prostatic finding and PSA were abnormals. The prostatic biopsy was negative. The diagnosis of prostatic tuberculosis was made by histologic analysis after transuretral resection of prostate. The treatment is based on chemotherapy anti-tuberculosis.

[Giant hydronephrosis: two case reports]. / Hydronéphrose géante: à propos de deux cas.

Giant hydronephrosis is uncommon. Ureteropelvic obstruction represent the more frequent cause. In 1939, Stirling defined it as the presence of more than 1000 ml of fluid in the collecting system. The Authors report two cases with ureteropelvic obstruction causing giant hydronephrosis. The treatment includes pyeloplasty in the first case and nephrectomy in the second case.

[Anterior urethral injury. Report of 23 cases]. / Traumatismes de l'urètre antérieur. A propos de 23 cas.

UNLABELLED: We reviewed our experience in managing anterior urethral traumatic rupture. PATIENTS AND METHODS: Between January 1986 and December 1998 a total of 23 consecutive male patients with anterior urethral trauma were studied prospectively, including a clinical and radiographic of the pelvis examination, excretory urography and retrograde urethrography. The average patient age was 29 years (range 19 and 65 years). The mechanism of injury was represented by the blunt perineal trauma in 17 cases and the cavernous body rupture in six cases. Clinical manifestations are dominated by the urethrorragia (19 cases), urinary retention (16 cases), perineal hematoma (14 cases). Radiological imaging have shown a pelvic fracture (six cases), urethral rupture (17 cases) and bladder rupture (three cases). Therapeutic procedure realized in emergency in six patients having a cavernous body lesion and delayed repair in 17 other patients. RESULT: The outcame was favorable in 12 patients and recurrence stenosis has occurred in 11 patients who are corrected by optical urethrotomy (four cases), end-to-end anastomosis (two cases), B. Johanson urethroplasty (three cases) urethroplasty by penile skin (one case), dilations (one case). CONCLUSION: Suprapubic cystostomy with healing control of the partial ruptures, delayed end-to-end anastomosis for total ruptures and immediate reparation of the urethral rupture when associated with a penile fracture are even the best warrant of a correct functional recovery.

[Cutaneo-reno-colonic fistula in tubercular kidney with staghorn calculus: report of a case]. / Fistule cutanéo-réno-colique sur rein tuberculeux avec calcul coralliforme: à propos d'un cas.

We report a rare case of colorenocutaneous fistula, in a patient with a stone of the left kidney. The fistula was successfully managed by single stage surgery (nephrectomy, fistulectomy and suture of colon). Histopathological examination revealed renal tuberculosis. Surgery was completed by an anti-tubercular treatment.

[Foreign bodies of the bladder. Report of a new case]. / Corps étrangers de la vessie. A propos d'une nouvelle observation.

In this paper we are relating the medical history of 30 year-old female patient with psychiatric medical background. This patient introduced multiple foreign bodies in her bladder via the urethra. Throughout this observation, we analyse diagnosis and therapeutic aspects of bladder foreign bodies.

[Sarcomatoid carcinoma of the prostate]. / Carcinome sarcomatoïde de la prostate.

The authors report a case of sarcomatoid carcinoma of the prostate in a 49-year-old patient. The clinical symptoms were dominated by dysuria and frequency. Digital rectal examination showed a very large, hard and irregular prostate. Serum PSA was normal. Transrectal ultrasonography and abdominopelvic computed tomography showed a heterogeneous mass occupying the vesico-prostatic junction. The patient underwent cystoprostatectomy. Histological examination of the cystoprostatectomy specimen revealed a tumour composed of spindle cells expressing epithelial markers on immunohistochemical analysis and concluded on a diagnosis of sarcomatoid carcinoma of the prostate. The patient died seven months after cystoprostatectomy.

[Giant retroperitoneal hemangiopericytoma: a new case]. / Hémangiopéricytome rétropéritonéal géant: une nouvelle observation.

Hemangiopericytomas are a rare vascular tumours that are derived from Zimmermann pericytes. Retroperitoneal hemangiopericytoma is usually bulky, clinical silent, and malignant. We present a 48 years old man, with compressive symptoms and a painless mass due to a giant retroperitoneal hemangiopericytoma weighing 3 kg. We are prompted to present this case as it is believed to be the largest hemangiopericytoma reported to date.

[Percutaneous nephrolithotomy. Report of 211 cases]. / La néphrolithotomie percutanée. A propos de 211 cas.

The case files of 198 patients with a stone, treated by percutaneous nephrolithotomy between 1985 and 1999, were studied. This series consisted of 113 men and 85 women with a mean age of 41 years (17-71 years). The stone was in the pelvis (167 cases) of the kidney, multiple in 40 cases and staghorn in four cases. The complications were septic in six cases and hemorrhagic in five cases. The overall stone-free rate at three months was 92%.

The hydraulic antireflux valve: a new technique for reimplanting dilated ureters.

PURPOSE: Wide ureters have a high risk of urinary reflux if they are implanted in the intestinal segment. Since 1978, we used the continence hydraulic valve as an antireflux device without staples. MATERIALS AND METHODS: A total of 40 patients, 20-65 years old (mean age 50), 36 with bilaterally severely dilated ureters and 4 with unilaterally dilated ureters underwent reconstructive surgery by intestinal segments with a hydraulic antireflux valve (HAV). RESULTS: Mean follow-up was 62 months (range 14-110); upper tract dilatation had improved or stabilized in all patients but one in whom bilateral dilatation occurred with HAV stenosis. All patients underwent follow-up loopogram studies which revealed 2 cases of reflux (4 ureterorenal units). In 1 of the 2 patients the urinary reflux occurred after dessusception (disinvagination) of the nipple. CONCLUSIONS: The HAV is a safe and reliable procedure in preventing reflux when implanting wide ureters into intestinal segments. This technique can be used in continent urinary diversions with intestinal pouches, and can also be used at the proximal level of an ileoureteroplasty. There is no need for staples.

[Nephrogenic metaplasia of the ureter]. / Métaplasie néphrogénique de l'uretère.

The authors report a case of nephrogenic metaplasia of the ureter in a 35-year-old patient presenting with left low back pain, haematuria and frequency. Physical examination was not contributive. IVU showed a filling defect in the left iliac ureter. Ureteroscopy demonstrated a tumour nodule in the left iliac ureter. Ureteroscopic biopsy with histological examination showed nephrogenic metaplasia of the ureteric mucosa. Treatment consisted of ureterotomy with resection of the ureteric polyp, followed by closure of the ureterotomy over a double J stent. The course was favourable and postoperative follow-up (IVU, cystoscopy) at 6 months and 12 months was normal.

[Staghorn lithasis. Report of 98 cases]. / La lithiase coralliforme. A propos de 98 cas.

In cases of staghorn lithiasis, the calculus is formed in the excretory cavities of the kidney. It is considered to be a severe type of calculus due to its effect on renal function, associated urinary infection, and its frequent recurrence. In the present study, 98 cases of staghorn calculi have been reported, which were treated over an 8-year period (1990-1997). The patient population consisted of 56 women (62%) and 34 men (38%). The mean age was 46 years (age range: 20-73 years). A history of urolithiasis was noted in 23 cases (26%). The mean time from the onset of symptoms to diagnosis was four years. The clinical symptomatology was as follows: in the right kidney was involved in 54 cases, and both kidneys were affected in eight cases. The calculus was radio-opaque in 94 cases (96%), complete in 29 cases (29%), partial in 69 cases (71%), and associated with caliceal extension in 36 cases (40%). In 47 subjects (52%) other lithiasic sites were found, i.e., caliceal in 41 cases, and ureteral in six cases; Impairment of the renal parenchyma was noted in 33 cases (45%). Urinary infection were found in 30 cases (34%). Renal function was impaired in 15 patients. Staghorn lithiasis was severe in a significant number of subjects, i.e., in 59 cases (60%). Surgical treatment consisted of nephrolithotomy (37 cases), pyelonephrolithotomy (28 cases), pyelolithotomy (18 cases) total nephrectomy (14 cases), and partial nephrectomy (one case).

[Carcinosarcoma of the prostate. Case report]. / Le carcinosarcome de la prostate. A propos d'un cas.

We report one case of carcinosarcoma of the prostate in a patient of 43 years old. The clinical symptomatology was dominated by pollakiurie, dysuria digestive disorders, oedema of the lower limbs and the alteration of the general status. Digital rectal examination showed a big prostate, hard and irregular. The rate of PSA increased. Echography revealed a pelvic echogenic mass corresponding to a bulky prostate. CT scan of the abdomen and the pelvis showed a tissular, heterogeneous mass of 11 cm occupying the vesicoprostatic space and invading the basis of the bladder and the adjacent muscles (muscles obturateurs internes). Histology of a biopsy fragment of the mass revealed an adenocarcinoma and a mesenchymatous component calling up a prostatic carcinosarcoma. The treatment consisted in chemotherapy VAC. The evolution was deadly after 2 months.

[Inguinal hernia of the bladder. Report of 6 cases]. / Les hernies inguinales de la vessie. A propos de 6 cas.

The authors report 6 cases of inguinal hernia of the bladder seen between 1976 and 1996. All patients were males with a mean age of 67 years (range: 53 to 80 years). The hernia was situated in the right groin in all patients. No patients presented any suggestive clinical features. In 5 patients, the diagnosis was established by IVU, indicated for another disease associated with the hernia and, in one patient, the hernia was discovered after an operative wound to the bladder. Treatment consisted of elimination of bladder neck obstruction in 3 patients and reintegration of the bladder and abdominal wall repair in 4 patients. The postoperative course was uneventful.

[Traumatic rupture of the bladder. Report of 12 cases]. / Les ruptures traumatiques de la vessie. A propos de 12 cas.

Over the previous 8 years, the authors have treated 12 patients (11 males and 1 female with a mean age of 32 years (26 to 54 years)) with traumatic rupture of the bladder. Rupture was secondary to direct trauma to the full bladder in one case and pelvic trauma in 11 cases. Associated lesions were pelvic trauma (11 cases), head injury (4 cases), chest trauma (2 cases), rupture of the spleen (1 case) and small bowel perforation (1 case). The clinical features were dominated by suprapubic pain (11 cases), haematuria (10 cases), haemorrhagic shock (4 cases) and peritoneal syndrome (3 cases). IVU confirmed the diagnosis in 6 out of 8 cases. Retrograde cystourethrography was conclusive whenever it was performed. The retroperitoneal rupture was treated by indwelling catheter for 15 days. Intraperitoneal ruptures were treated surgically. The breach was situated in the dôme in 10 cases and on the posterior surface in 1 case. The size of the wound ranged from 2 to 8 cm. Treatment consisted of suture of the rupture and indwelling catheter for an average of 12 days. Cure was always obtained without sequelae.