[Bladder stone surrounding a foreign body: a case report]. / Lithiase vésicale englobant un corps étranger: à propos d'un cas.

The bladder can be the site of various foreign bodies. We report one case of bladder stone including a foreign body in a 24 years old man with a psychomotor deficiency who was admitted for pyuria, block miction and bladder symptoms. The pelvic X-Ray film showed a bladder stone including a sewing needle. We analysed the diagnosis, aspect and therapeutic management of this case.

[Anatomoradiologic correlations in prostate benign hypertrophy. Report of a series of 220 cases]. / Corrélations anatomoradiologiques dans l'hypertrophie bénigne de la prostate. A propos d'une série de 220 cas.

In our daily practice, the reliability of ultrasonography (US) and digital rectal examination (DRE) is limited by many factors. The aim of our study is to correlate between the prostatic volume assessed by the DRE, the pre operative US results and the actual weight of the enucleated or endoscopic resection benign prostatic hyperplasia (BPH). We report a serie of 220 patients with BPH treated by endoscopic resection or by open surgery. The mean age is 65 years (40-90 years old). Ultrasonography was performed in 92% of the cases, and transrectal ultrasound only in 8%. All our patients either underwent endoscopic resection (49.6%) or adenomectomy (50.4%). We found a high correlation between the prostatic volume assessed by DRE and by ultrasonography (r = 0.79; P < 0.0001) and the weight of the piece of surgical adenomectomy (r = 0.701, P < 0.0001). However, the volume of benign prostatic hyperplasia assessed by US did not correlate with the piece of endoscopic resection (r = 0.214, P < 0.05). This study and a review of recent literature enabled us to notice the various anatomical and radiological factors implicated in this correlation.

[Retrovesical pseudocyst : difficult diagnosis of one case and literature review]. / Pseudokyste rétrovésical: difficulté diagnostique à propos d'un cas et revue de la littérature.

Retrovesical localization of a cystic mass is rare. The authors report one observation of hematic retrovesical pseudocystic formation having a difficult diagnosis. In the light of this observation, different diagnostic patterns of cystic and pseudocystic retrovesical formation are discussed.

[Diffuse xanthogranulomatous pyelonephritis: clinical, anatomopathologic, and therapeutic features. Report ot 9 cases and review of the literature]. / Pyélonéphrite xanthogranulomateuse diffuse: aspects cliniques, anatomopathologiques et thérapeutiques. A propos de neuf cas et revue de la littérature.

Diffuse xanthogranulomatous pyelonephritis is a rare chronic pyelonephritis. This study permitted us to notice the various histological, clinical, radiological, and the different means diagnoses of this affection. Retrospectively series of nine patients is reported. The median age was 43 years. The commonest clinical presentation was urinary tract infection, and lumbar pain. Urine culture identified a bacteria in seven cases (77%). Intravenous urography recovers silent kidney (five cases), hydronephrosis (two cases), chronic pyelonephritis (one case) and renal stones in six cases (67%). Treatment consisted of nephrectomy. No specific biological or radiological signs of this affection can be identifying this lesion in preoperative. The diagnosis was revealed by the histological examination of the removed kidney. The outcome is favorable after a follow-up of six months to four years. The clinical features of the pyelonephritis xanthogranulomatous is not specific. Magnetic resonance imaging can give a specificity to this affection. Only histological examination is able to established the definitive diagnosis.

[Treatment of primary pyogenic abscess of the psoas: retrospective study of 18 cases]. / Traitement de l'abcès primitif à pyogène du muscle psoas: étude rétrospective à propos de 18 cas.

The primitive abcess of psoas muscle is a rare affection which involves mainly the young. The authors report 18 cases of primitive pyogenic abcess of psoas collected during a period of six years in the urology service of UHC Ibn Rochd Casablanca. The purpose of this review is to discuss the different therapeutic attitudes. The study concerned 11 men and seven women, their mean age was 35 years. The mean delay of evolution was 45 days. The physical exam found a psoitisis (five cases) and a flunk swelling (14 cases). The ultrasound exam showed the collection which was hypoechogenic in seven cases and heterogenous in 11 cases. The CT scan showed an heterogenouse hypodense collection without enhansment in seven cases. The use of antibiotherapy alone (four cases) and percutaneous drainage (four cases) permitted the recovery just respectively in one and two cases. Fifteen patients (83%) were operated through a postero-lateral lumbotomy route without costal resection. The bacteriological exam of the pus found a Staphylococcis aureus (ten cases) and Escherichia coli (two cases). The evolution was favorable in 14 cases; one patient was dead at fifth day post operatively by heart infarction. For the authors, the surgical drainage remains the treatment of choice.

[Urachal adenocarcinoma]. / Adénocarcinome de l'ouraque.

Cancer of the urachus is very unusual. The lesion is a mucosecretory adenocarcinoma. The diagnosis is usually established late, and has a serious prognosis because of a long clinical latency. We report a case of metastatic adenocarcinoma of the urachus revealed by hematuria. A review of the literature allows us to demonstrate the rarity of this tumour and to demonstrate its various clinical, histological, radiological and therapeutical aspects.

[Augmentation enterocystoplasty. Apropos of 15 cases]. / L'entérocystoplastie d'agrandissement. A propos de 15 cas.

We reviewed the efficacy of augmentation enterocystoplasty about 15 cases, based on technical modalities and intestinal loop used. There were 10 tuberculosis bladders, 2 bilharzial bladders, 2 interstitial cystitis and one neurogenic bladder. We used for bladder augmentation the sigmoid (7 cases), ileum (6 cases) and coeco-ileum (2 cases). Ureteroileoplasty is associated in three cases for large tuberculous ureteral stenosis, and reimplantation of ureter in the neobladder is realised in seven cases. The results with detubularized ileum were excellent. We observed in one patient persistence of dilatation of upper urinary tract after use of detubularized sigmoid. The results with use of ileocoecum are poor. We observed good results by using detubularized ileum, so we prefer this intestinal loop than the others. There was no significative difference between different detubularisation technics. Reimplantation of ureter inneobladder is indicated when there is terminal ureteral lesions.

[Vesico-uterine fistulas. Analysis of 19 cases]. / Les fistules vésico-utérines. Analyse de 19 dossiers.

Over a 15 year period (1977-1992), the authors have collected 19 cases of vesico-uterine fistulas. These vesico-uterine fistulas rank in third place of genito-urinary fistulas and occur in young patients (mean age is 30 years). Obstetrical etiology is recognised in .95% of cases (cesarean section and dystocic delivery). Leak of urine is present in 95% of cases, and is isolated in 47% or associated with intermittent hematuria in 48%. Diagnosis of this affection is based upon clinical examination with methylene blue test. Communication between bladder and uterus is proved by the issue of methylene blue through the uterus cervix. This communication may be confirmed by opacification (urography and hysterography). Perfect continence is obtained by surgical treatment. Fertility of these patients is often affected.

[Hydatid cyst of the kidney (apropos of 45 cases)]. / Le kyste hydatique du rein (à propos de 45 cas).

Based on a series of 45 cases of renal hydatid cysts, the authors present a general review of the multiple aspects of this rare disease. The mean age at the time of diagnosis is 30 years with a slight female predominance. Renal hydatid cyst often has a suggestive clinical presentation (flank mass in 84% of cases, pain in 73% of cases) and sometimes a specific presentation (hydatiduria in 29% of cases). The authors emphasise the value of laboratory tests, bearing in mind that serology is positive in about one half of cases (57%) and prefer ultrasonography and computed tomography to arteriography for the diagnosis of renal hydatid cyst. Surgical treatment is now well defined. A lumbar incision is performed in 60% of cases and an anterior incision is used in 40% of cases. Conservative treatment occupies a predominant place (84.5% of cases), as resection of the prominent dome is usually sufficient. Total nephrectomy should only be considered in the case of a completely destroyed kidney (15.5% of cases). The postoperative course is generally uneventful and re-expansion of the rénal parenchyma is observed in 78% of cases, indicating the benign nature of this disease.