"Diabetic penile necrosis'': A rare but serious complication of diabetes mellitus.

Penile tissue death caused by impaired blood flow and nerve damage is a severe but uncommon complication of diabetes mellitus known as diabetic penile necrosis. Diabetes related vascular and neurological issues result in reduced sensation and limited blood supply to the penis leading to this condition. The consequences on sexual function and quality of life are catastrophic though it's rare, hence early identification, treatment intervention cannot be over emphasized since they help prevent further deterioration including infections that arise from complications occasioned by delayed management.

A case report of giant paratesticular myxoid liposarcoma.

Liposarcomas are an uncommon occurrence in the paratesticular region that makes about 20 % of all sarcomas. The clinical appearance is an inguinal lump, which can resemble a hydrocele or hernia. There would be no conventional treatment accessible because it is such a rare disease. We report the case of a 68-year-old man with paratesticular myxoid liposarcoma. Ultrasound and CT-scan came back in favor of a paratesticular tumor. A high inguinal orchidectomy has been done and the diagnostic of myxoid liposarcoma was first evoked by histology and confirmed by molecular biology. At 12 months follow up the patient remains tumor free.

Crossed renal ectopia: A case report and review of the literature.

Rarely occurring at birth, crossed renal ectopia is an abnormality in which both kidneys occupy the same side of the body while one ureter - its length based on kidney location - traverses across midline to graft into opposite-side bladder. McDonald and McClellan classified renal ectopia into 4 types. Solitary crossed renal ectopia (SCRE) is an extremely uncommon abnormality of the urinary system. To date, only 35 instances have been documented in published literature. Typically, these cases are detected by chance during patient assessments for related issues such as genitourinary, cardiovascular, hematological or vertebral abnormalities.

Total clipless laparoscopic nephrectomy carried out with the LigaSure device: Preliminary experience.

BACKGROUND: Total laparoscopic nephrectomy has become the standard method for the removal of diseased kidneys. OBJECTIVES: The purpose of this study was to evaluate the feasibility of the LigaSure vessel closure system during laparoscopic nephrectomy. METHODS: From January 2018 to June 2018, the LigaSure device was used in 5 patients undergoing laparoscopic nephrectomy for non functional kidney. Nephrectomy was carried out without the use of clips or sutures for vessel closure. We report intraoperative findings, conversion rates, blood loss, operative time, morbidity, and postoperative outcomes. RESULTS: Median operative time was 45minutes (range 25 to 60min). Median blood loss was 30mL (range 10 to 50mL). No conversions to open surgery were necessary. No patients experienced major bleeding intraoperatively or postoperatively. All patients left the hospital one day after the procedure. Histopathological examination of the removed kidneys was in favor of chronic non specific pyelonephritis. CONCLUSIONS: For the treatment of the renal pedicle during total laparoscopic nephrectomy of a destroyed kidney, the LigaSure device appears to be feasible and effective. Our experience is the first to demonstrate the advantages of LigaSure® in laparoscopic nephrectomy: reduction in operating time, blood loss, transfusions and length of stay in hospital.

Transvaginal and transobturator autologous vaginal tape cystocele treatment: About an uncommon case.

BACKGROUND: Pelvic organ prolapse (POP) significantly impairs women's quality of life. The literature reports that nearly one in five women will require surgery in their lifetime, and nearly 40.6% involve anterior wall repair, specifically cystocele. Several techniques and surgical approaches have been used for cystocele management. These were performed by transvaginal and/or transabdominal approach and involved the use of native tissue or prosthesis. Nevertheless, since the transvaginal mesh ban recommended by the FDA and learned societies, autologous tissue repair has become the cornerstone of all vaginal prolapse surgery. CASE PRESENTATION: We hereby present the case of a 71-year-old widow who had undergone three vaginal deliveries. The patient reported that she no longer had sexual intercourse. The preoperative functional signs observed included: stress urinary incontinence, urinary urgency, dysuria and disabling vaginal ball feeling. The management strategy chosen in consultation with the patient was a repair using autologous material via the vaginal route. The vaginal strips were passed through trans-obturator and retro pubic route allowed support of the bladder. CONCLUSIONS: This technique using autologous material was easy, fast and inexpensive. It was developed on the basis of the TVT and TOT techniques and stood out for its tolerance and long-lasting functional effectiveness. It avoids all the complications due to polypropylene trans-vaginal prostheses that led to the banning of trans-vaginal mesh.

Prostatic Abscess on Xanthogranulomatous Prostatitis: Uncommon Complication of an Uncommon Disease.

Xanthogranulomatous prostatitis is a rare benign inflammatory process of the prostate. Only few cases have been reported in the English literature. Xanthogranulomatous prostatitis is usually an incidental finding after needle biopsy or transurethral resection of the prostate in patients suffering from low urinary tract symptoms. We report the case of a 59-years-old patient diagnosed with prostatic abscess managed by transurethral resection of the prostate. Histopathological examination of resected prostatic tissue revealed abscessed xanthogranulomatous prostatitis with no evidence of malignancy. Xanthogranulomatous prostatitis presenting as a prostatic abscess is a rare finding. To the best of our knowledge our case represents the fourth case of xanthogranulomatous prostatitis presenting as prostatic abscess reported in the English literature so far.

Lymphoepithelioma-Like Carcinoma of the Bladder: A Case Report of a Rare and Particular Variant of Urothelial Carcinoma.

Lymphoepithelioma-like carcinoma of the bladder (LELCB) is a rare variant of urothelial carcinoma first described by Zukerberg in 1991 and confirmed as a variant of urothelial carcinoma by the WHO classification of tumors of the urinary system. LELCB is characterized by a marked infiltration of lymphocytes in the area involved by the tumor which may coexist with the conventional urothelial carcinoma. LELCB are classified according to the percentage of lymphoepithelioma component within the tumor with the prognosis depending on the percentage. We report a new case of pure LELCB occurring in 63-year-old woman presenting with hematuria. Ultrasonography and cystoscopy revealed a large tumor on the left lateral wall of the bladder. Transurethral resection of the bladder tumor (TURBT) was performed. Pathological and immunohistochemical analysis revealed a high-grade muscle-invasive LELCB (G3pT2). The patient underwent an adjuvant systemic chemotherapy with no recurrence after a ten-month follow-up. To our knowledge, this is the second Moroccan case of LELCB reported in the English literature. Although its rare occurrence prognosis and ideal therapeutic management of LELCB have not been clearly established yet, literature findings encourage the adoption of a conservative approach in treatment of LELCB.

Penile Gangrene and Necrosis Leading to Death Secondary to Strangulation by Condom Catheter.

Condom catheters are widely used in the management of male urinary incontinence, bedridden patients, and geriatric population. They are considered to be safe; however they are associated with serious complications in case of an incorrect use. We report a dramatic case of penile strangulation by condom catheter tardily discovered till occurrence of necrosis and gangrene leading to death in an elderly bedridden and diabetic man. Through this case we emphasize the importance of patient education for the correct use of condom catheters and remind care providers to maintain a high level of sensibility to complication generated from long-term use of condom catheters.

Zinner's syndrome: report of two cases and review of the literature.

BACKGROUND: Congenital malformations of the seminal vesicle are uncommon, and most of them are cystic malformations. If an insult occurs between the 4th and the 13 h gestational week, the embryogenesis of the kidney, ureter, seminal vesicle, and vas deferens could be altered. Cysts of the seminal vesicle may appear with a mass effect, dysuria, epididymitis, or obstruction of the gastrointestinal and genitourinary tracts. Approximately two thirds of them are associated with ipsilateral renal agenesis, because both the ureteral buds and seminal vesicles originate from the mesonephric (Wolffian) duct. They were first described by Zinner in 1914, and 200 cases of seminal vesicle cysts associated with ipsilateral renal agenesis have been reported in the literature. Most patients with this anomaly are asymptomatic until the third or fourth decade of life. Some cases have nonspecific symptoms such as prostatism, urinary urgency, dysuria, painful ejaculation, and perineal discomfort. Transrectal ultrasonography provides good visualization of the pelvic structures and allows guidance for aspiration of the cysts. CASE PRESENTATION: We present two cases of seminal vesicle cyst. The first patient had dysuria, increased frequency of urination, and haematuria. He was operated and benefited from a removal of the cyst with right ureterectomy and left ureteral reimplantation. The second patient had disorder of the digestive transit and he benefited from a laparoscopic removal of the cyst. CONCLUSIONS: Seminal vesicle cysts combined with ipsilateral renal agenesis are rare urological anomalies. Usual symptoms that are caused by the seminal vesicle cysts are bladder irritation and obstruction as well as pain in the perineum and scrotum. Epididymitis is frequently found. Treatment consists to removing the seminal vesicle cyst.

Urethral hemangioma: case report and review of the literature.

Hemangiomas are benign vascular tumors. They are the prerogative of the liver and skin. And genitourinary localizations are rare and have only been rarely reported in the prostat, bladder, ureter or the perineum. In the light of published cases, urethral hemangiomas are mostly found in males. Few cases of hemangioma in the female urethra were reported. We report a cavernous hemangioma of the urethra in a 61 years old patient who presented bleeding from the urethra and micturition disorders. Physical examination revealed a tumor 3 cm x 2 polyploid arising from the terminal urethra (urethral hemangioma). We performed surgical resection of the tumor, along with bladder drainage. The postoperative course was simple. We update through a review of the literature aspects of the diagnostic and therapeutic care of the urethral hemangioma.

[Seminal vesicle cyst: about a case]. / Kyste de la vésicule séminale: à propos d'un cas.

We report the case of a patient with symptomatic seminal vesicle cyst on the right side. Imaging examinations (pelvic and endorectal ultrasound, abdominal-pelvic tomodensitometry and MRI) were perdormed and the patient underwent surgical removal of the cyst. In light of this case study, epidemiology, diagnosis and treatment options are discussed.

[Neoplastic Vesico-vaginal Fistula (VVF) secondary to bladder cancer: a rare entity]. / Fistule vésico-vaginale néoplasique secondaire à une tumeur de vessie: une entité rare.

Vesico-vaginal Fistula (VVF) secondary to bladder cancer is extremely rare. We report the case of a 54-year old post-menopausal patient with neoplasic Vesico-vaginal Fistula (VVF), without any surgical antecedents or recent obstetric trauma. Biopsy of the edges of the fistula confirmed urothelial carcinoma. In light of this observation, we here discuss VVF etiological forms and their different therapeutic strategies.

Lymphoepithelioma-like carcinoma of the bladder: a case report.

INTRODUCTION: Lymphoepitheliomas are malignant epithelial tumors of the nasopharynx characterized by an important lymphoid proliferation at histological examination. Lymphoepithelioma-like carcinoma is a rare tumor of the bladder for which the therapeutic strategy is not clearly defined. CASE PRESENTATION: We report the case of a 64-year-old Moroccan man who presented with macroscopic hematuria. Investigations revealed a muscle-invasive lymphoepithelioma-like carcinoma of the bladder. Therefore he underwent a radical cystoprostatectomy with a good outcome. CONCLUSION: This case illustrates pathogenic, clinical and therapeutic features of this unusual tumor.