[Hydatic kidney cyst: 90 case reports]. / Kyste hydatique du rein: à propos de 90 cas.

The hydatid cyst of kidney is rare, it ranks third among all visceral localisations. The authors report a series of 90 cases renal hydatid cyst from 1972 to 2000. The middle age is 36 years with female predominance. Renal hydatid cyst often has a suggestive clinical presentation; flank mass in 84%, pain in 74% and sometimes a specific presentation hydaturia in 29%. The hydatid serology is positive in 55% and preferring ultrasonography and computed tomography in diagnosis of renal hydatid cyst. Surgical treatment is now well defined. Conservative treatment occupes a predominant place 84% and resection of the proeminent dome is usually efficient. Total nephrectomy should only be considered in the case of a completely destroyed kidney (16%) of cases. Post-operative course is generally uneventful and reexpansion of renal parenchyma is observed in 93% indicating the benign nature of this disease.

[Renoduodenal fistula. A case report]. / Fistule rénoduodénale. A propos d'un cas.

The fistula between kidney and duodenum is rare. It occurs mostly in case of pyonephrotic kidney. The authors report one case of renoduodenal fistula, discovered peroperatively in 41 years old man who underwent a subcapsular nephrectomy for right pyonephrosis upon pelvic lithiasis. Through a review of literature, the authors discuss diagnostic aspects of this complication.

[Symptomatic bladder calculi: diagnostic and therapeutic aspects]. / Hydrocalice symptomatique: aspect diagnostique et thérapeutique.

The authors report the case of a 50 years old woman who consulted with bilateral lumbar pain and urinary infections. Intravenous Urography (IVU) showed bilateral renal and bladder stones. Treatment was by upper polary nephrectomy in the left kidney. Removing all urinary and bladder stone. We then the removed surgically renal stones in the right kidney. Using this case as an we discuss the diagnosis and therapeutic aspects of the hydrocalyx.

A baseline-controlled, open-label, flexible dose-escalation study to assess the safety and efficacy of sildenafil citrate (Viagra) in patients with erectile dysfunction.

Although sildenafil citrate (Viagra) has demonstrated effectiveness in the treatment of erectile dysfunction (ED), the dosing regimens often used in clinical trials may not always match those employed in clinical practice. This study was undertaken to further assess the efficacy and safety of sildenafil taken as required in male outpatients 18 years of age and older with ED (n=71). It was conducted as a placebo-baseline-controlled, open-label, flexible dose-escalation study, with sildenafil (25,50, or 100 mg) administered for 8 weeks following a 4-week placebo run-in. Efficacy variables included questions 3 and 4 of the International Index of Erectile Function (IIEF), other IIEF domains, patient event logs, and quality-of-life (QOL) assessments. Treatment with sildenafil resulted in improvements from baseline in all IIEF domains analyzed (all P<0.0001), as well as overall QOL and amelioration of specific sexual and social relationships (all P&<0.0001). Sildenafil was well tolerated. One participant discontinued treatment because of adverse events. Results suggest that flexible dosing with oral sildenafil is safe and has beneficial effects on all indices of erectile function and QOL.

[Emphysematous pyelonephritis: a case report]. / La pyélonéphrite emphysémateuse: à propos d'un cas guéri.

Diabetic patients with urinary tract infections had a certain risk of developping emphysematous pyelonephritis with gas producting bacteria. This disease was accompagned with high mortalité. We will report one case who was treated successfully by high dose antibiotic regim and emergency nephrectomy.

[Emphysematous pyelonephritis: review of the literature concerning a case report]. / La pyélonéphrite emphysémateuse: revue de la littérature à propos d'un patient décédé.

Emphysematous pyelonephritis is defined as the presence of gas-producing bacteria in the kidney and in peri-nephretic areas. Even if it is rare, the mortality rate of this affection is between 50% and 90%. The E. coli is responsible in 60% of the cases. We report a case of a 50 years old male patient, with under diagnosed diabetics, how is admitted with pains in the left flank, fever, troubled urine, hematuria and worsening of general state. The diagnostic of emphysematous pyelonephritis was confirmed by CT Scan. In spite of adapted antibiotherapy to the renal function, insulinotherapy and correction of hydro-electrolytic troubles, the patient died with septic shock associated to digestive bleeding. Based on this case and a review of the literature, the authors describe the different features of this disease. Only an urgent nephrectomy after a short reanimation can improve the prognostic.

[Retroperitoneal fibrosis with pelvic extension: a case report]. / La fibrose rétropéritonéale à extension pelvienne: à propos d'un cas.

The retroperitoneal fibrosis is a rare pathology, whose physiopathologic mechanism is poorly known. It characterizes by the training of a benign fibrous prevertebral plate. This plate is in rule limited between the renal pedicle in high and the promontory anointed down. However, extensions to the great peritoneal cavity, the mediastinum and especially the pelvis have been brought. Authors bring a case of retroperitoneal fibrosis at a woman of 54 years, that spreads to the pelvic region complicated of an obstructive renal insufficiency. The ureteral catheterism has allowed the standardization of the renal function. The uroCT-scan has allowed to make a complete lesion statement. The patient has been operated on with realization of ureterolysis and ureteral intraperitonization. Through this observation, therapeutic and diagnostic aspects will be discussed.

[A rare cause of urinary obstruction: urogenital tuberculosis]. / Cause rare d'anuries obstructives: la tuberculose urogénitale.

The authors reported a rare cause of urogenital tuberculosis complicated by an obstructive acute renal failure in 44 years old man with solitary anatomic kidney. The authors insisted of using the upper urinary tract opacification by percutaneous nephrostomy for diagnosis, the urogenital tuberculosis with this exploration, we can suspected the tuberculosis by abnormalities of the radiologic imagine, and confirmed the koch bacilli urinary into urinary tract. The upper chance of positives of finding koch bacilli in higher than urinary bladder.

La fracture du corps caverneux: à propos de 123 cas

Objectif : Analyser les aspects diagnostiques et thérapeutiques de la fracture du corps caverneux et comparer nos résultats avec ceux de la littérature. Patients et méthodes : Entre janvier 1976 et juin 2002, 123 cas de fractures du corps caverneux ont été traités dans notre service. L'âge moyen des patients était de 25 ans. Dans la majorité des cas (71,5), la fracture du pénis s'est produite par manipulation forcée du pénis en érection. Le diagnostic était basé sur un examen clinique. Les patients ont été traités chirurgicalement par réparation de la tunique albuginée, le plus souvent (74 cas) après dégantage de la peau du pénis. Un cas de rupture de l'uretère a été rencontré après la fracture des deux corps caverneux. Résultats : Chez 95 patients ; le résultat postopératoire a été satisfaisant. Cependant, 8 cas de plaques fibreuses et 4 cas de courbure du pénis ont été rencontrés. Aucun de nos patients n'a présenté de dysfonctionnement érectile postopératoire. Conclusion : La fracture du corps caverneux est une pathologie qui reste assez rare. Le diagnostic est basé sur l'examen clinique et le traitement est chirurgical dans la majorité des cas. Le résultat du traitement de ces fractures est généralement satisfaisant à condition que les patients se présentent à un stade précoce

[Local recurrence of paratesticular rhabdomyosarcoma]. / Récidive locale d'un rhabdomyosarcome paratesticulaire.

We report an uncommon case of scrotal recurrence of embryonal paratesticular rhabdomyosarcoma in 19 year old man after 3 years later. The diagnosis was suspected clinically and confirmed by histopathology study after resection of the scrotal tumor. About this case, the authors discuss the diagnosis and the management of this tumor.

[Pheochromocytoma and von Recklinghausen's disease]. / Phéochromocytome et maladie de von Recklinghausen.

The association between von Recklinghausen's disease and pheochromocytoma is present about 10% of cases. We report a case of 49 years old women who presented with elevated blood pressure and von Recklinghausen's neurofibromatosis. Laboratory examination showed a marked level in the urinary excretion of cathecholamine. The computed tomography showed a right adrenal tumor suggesting a pheochromocytoma. The adrenalectomy was realised by transabdominal approach and the histological examination confirmed a benign pheochromocytoma. The authors discuss the pathogenetic hypothesis of this rare pathological association, the diagnostic methods and the therapeutic procedure.

[Surgical complications of nephrectomy in living donors]. / Les complications chirurgicales de la néphrectomie chez le donneur vivant.

Renal transplantation from a living donor is now considered the best treatment for chronic renal failure. We reviewed the operative complications in 38 living related donor nephrectomies performed at our institution over the past 14 years. The mean age of our donors was 30 years old with age range between 18 and 58 years old and female predominance (55.2%). These swabs were realized by a posterolateral lumbar lombotomy with resection of the 11 third. The left kidney was removed in 34 donors (90%), surgical complications were noted in 39.4% of the cases: one case of wound of inferior vena cava (2.6%), one case of release of the renal artery clamp (2.6%), four cases of pleural grap (10.5%), one case of pneumothorax (2.6%), one case of pleurisy (2.6%), three cases of urinary infection (7.8%), three cases of parietal infection (7.8%) and one case of patient pain at the level of the wound (2.6%). There were no mortalities. We conclude that the morbidity of living donor nephrectomy is negligible compared with the advantages for the recipient.

[Kidney cancer. Report of 170 cases]. / Le cancer du rein. A propos de 170 cas.

PURPOSE: The goal of this study is the analysis of the diagnostic and therapeutic aspects of this affection which is usually discovered at a delayed stage in our context. MATERIAL AND METHODS: A retrospective study of 170 renal cancer, collected during a period of 15 years (1985-2000). Ninety-two men and 78 women were studied, their mean-age was 50 years (15-81 years). The diagnosis was relied on clinical, radiological and histological arguments. RESULTS: Lumbar pain, hematuria and enormous mass were present in 85 cases (50%). The ultrasound and computed exams permitted the diagnosis and also evaluated the venous and locoregional extension. The treatment consisted on large nephrectomy practiced in 114 patients (67%), abstention in 56 cases (33%) due to the advanced stage of the tumor. The histological exam concludes to clear cell adenocarcinoma in 91.2% of cases. CONCLUSION: The authors deplore the delayed diagnosis of renal cancer in our context which is responsible of a high rate of abstention (33%); and underline the interest of the early diagnosis for an adequate management.

[Extra-adrenal pheochromocytoma discovered peroperatively]. / Phéochromocytome extrasurrénalien découvert en peropératoire.

In this study, an uncommon case has been reported of an ectopic pheochromocytoma without the presence of any clinical symptoms. The radiological investigations showed a right retroperitoneal tumor without any kidney involvement. The diagnosis was established by biopsy and subsequent histological findings. In the course of surgery as the large tumor mass was being removed, tachycardia was observed which caused the resection to be performed as rapidly as possible. Once the tumor had been removed, bradycardia occurred, followed by cardiac arrest: although the latter was stabilized after cardiac massage, the patient died one hour after the operative field had been closed. In addition to this case report, the diagnosis, therapeutic strategy and prognosis regarding an ectopically located pheochromocytoma have been discussed.

[Acute renal insufficiency due to hydronephrosis]. / Insuffisance rénale aiguë par hydronéphrose.

Acute renal failure due to hydronephrosis is a rare pathology. It can occur unilaterally, or as a pyelo-ureteral junction (PUJ) bilateral syndrome. In the present study, two cases have been reported. The diagnosis was based on ultrasonographic findings which showed hydronephrosis, and on descending pyelo-ureterography (DPU), which demonstrated an absence of opacification. Infection was present in one case. Preliminary treatment consisted of percutaneous nephrostomy, followed by surgical pyelo-ureteral resection and Anderson-Hynes pyeloplasty which gave good results (95% success rate), and which enabled a satisfactory recovery of renal function to be obtained.

[Phenotype B primitive adrenal lymphoma, diagnosed by percutaneous aspiration biopsy]. / Lymphome primitif de la surrénale de phénotype B, diagnostiqué à la ponction-biopsie percutanée.

The authors report a case of primary adrenal lymphoma in a 30-year old-female who complained of lumbar pain and was in poor general condition. Ultrasonography and CT scan revealed a heterogeneous mass with necrosis in the left adrenal gland. Non-Hodgkin's lymphoma of B-cell origin was determined by ultrasound-guided aspiration biopsy of the adrenal mass. Taking this case and the findings in the literature into consideration, the features of this disease have been reviewed and the problem of diagnosis, treatment and prognosis have been examined.

[A new case of pseudotumoral renal tuberculosis]. / Un nouveau cas de tuberculose rénale à forme pseudotumorale.

The incidence of urogenital tuberculosis is still frequent and constitutes a current public health problem in Morocco, a country in which tuberculosis is endemic. The clinical presentation of this form of the disease may be misleading. The pseudotumoral type of renal tuberculosis is extremely uncommon, and in this study this disease has been described in a young patient. The radiological findings suggested the possibility of this lesion being renal cancer. The preliminary diagnosis was corrected and a definitive diagnosis of pseudotumor was made following pathological examination of the surgically-removed kidney.

[Leiomyoma of the urinary tract]. / Les léiomyomes de la voie excrétrice urinaire.

Leiomyomas of the urinary tract are benign and uncommon forms of tumor. In the present study, two cases have been described of leiomyomas situated in the bladder. Following this description, the pathological characteristics and the diagnostic and therapeutic aspects of these lesions have been examined. The clinical symptomatology depends on the tumor site, and this type of lesion is more frequently found in women.. Treatment mainly consists of endoscopic resection, but may involve cystectomy. The prognosis for patients with this type of tumor is invariably favorable.