Bilateral renal hydatid disease associated with complex urolithiasis: A case report.

INTRODUCTION AND IMPORTANCE: The association of bilateral renal hydatid cysts and complex urolithiasis is unprecedented. We herein report the case of a patient presenting with both diseases. CASE PRESENTATION: A 56-year-old female patient with a history of chronic kidney disease presented with right flank pain. Imaging revealed bilateral kidney cystic lesions associated with right spontaneous large ureteric streinstrasse and multiple calyceal stones. The right sided mass was exophytic and measured 56 mm and the left sided lesion measured 35 mm. Semi rigid right ureteroscopy was performed along with a right partial nephrectomy and a right pyelotomy which allowed for renal and ureteral stone extraction. Histopathology report concluded to a hydatid cyst. The decision was to monitor the left-sided lesion. CLINICAL DISCUSSION: The association of bilateral renal hydatidosis and right urolithiasis is unprecedented in literature. The lesion presented a differential diagnosis problem with a cystic malignancy. Thus, the decision was to perform a right partial nephrectomy. The combination of ureteroscopy and a single right flank incision was sufficient to treat the renal lesion as well as to obtain stone free status. Once the histopathological report concluded to a hydatid cyst, the decision was to monitor the left sided lesion. A more aggressive approach could be proposed however it would have been detrimental to the patient's renal function. CONCLUSION: When presented with an association of bilateral renal masses and urolithiasis, a methodical step-by-step approach is necessary in order to treat both diseases while minimizing patient morbidity.

A case report of perineal liposarcoma.

Perineal localization of liposarcoma is extremely rare among all localization of soft tissue sarcoma. We report the case of 33-year-old man presenting a large perineal swelling. Throughout this case, we bring new insights into the surgical management difficulty of this tumor and we review the place of adjuvant therapy and prognosis factors.

[Sclerotherapy of idiopatic hydrocele with polidocanol: a study about 190 cases]. / La sclérothérapie au polidocanol dans le traitement des hydrocèles vaginales idiopathiques : Etude à propos de 190 cas.

AIM: To evaluate the efficacy and side-effects of Polidocanol used as sclerosing agent for testicular hydrocele. METHODS: One hundred and ninety men, with a median age of 55,9 years (40-89), treated for idiopatic hydrocele were assessed. After puncture and aspiration, the empty sac was instilled with 3% Polidocanol. We recorded recurrence, complications and associated pain on a visual analogue scale. RESULTS: With a median follow-up of 19 months, The cure rate of hydroceles after one sclerotherapy session was 62,1%, and the overall cure rate using the procedure was 82,6%. Re-instillation was done for recurrences in 41% of patients. Polidocanol therapy was almost pain-free. A low rate of complications was observed. CONCLUSION: Polidocanol is a useful sclerosing agent for treating testicular hydrocele. Due to its ease of administration, low frequency of complications, high rate of effectiveness, and excellent tolerability; we recommend sclerotherapy with polidocanol as the primary treatment for hydroceles.

Focal xanthogranulomatous pyelonephritis: success of conservative treatment. A case report.

BACKGROUND: Focal xanthogranulomatous pyelonephritis is an atypical form of chronic renal infection. It is frequently misdiagnosed preoperatively because of its resemblance to malignancy. CASE REPORT: We report on a fifty-year-old woman who presented with a right kidney mass. The CT scan showed a solid renal mass with a lithiasis of the upper ureter. The diagnosis of focal xanthogranulomatous pyelonephritis was suspected by clinical and radiological findings and confirmed by histopathologic examination of percutaneous biopsy specimens of the lesion. Successful treatement of the patient was achieved with removal of the lithiasis and antibiotic therapy during eight weeks. Three months later the CT scan was completely normal. CONCLUSION: The conservative treatment of focal xanthogranulomatous pyelonephritis makes possible to avoid a needless nephrectomy usually on young patients. However a close follow-up must be undergone on these patients because of the possible association of focal xanthogranulomatous pyelonephritis and renal cell carcinoma of the kidney.

[Ureteral injuries in gynaecologic surgery]. / Les traumatismes de l'uretère d'origine gynécologique.

Surgical injury to the ureter is an important problem that confronts the urologist, the gynaecologist and the general surgeon. We report 38 cases of iatrogenic ureteral injuries observed after gynaecological surgery between January 1972 and December 2004. Hysterectomy accounted for 22 injuries. Injuries were intra-operatively recognized in 3 cases and were treated immediately. In the case of lesions identified secondarily, a ureter-vesical implantation was performed in 66% of cases with a good result in 84% of them. Four patients required nephrectomy. We discuss the cicumstances of development, diagnosis approach and treatment of this lesion and review the literature about this subject.

[Idiopathic renal vein thrombosis. About two cases]. / Thrombose idiopathique de la veine renale. A propos de deux cas.

Renal vein thrombosis is a rare pathology difficult to diagnose. It has quite various clinical expressions and biological consequences. The diagnosis is based upon radiologic explorations. This entity may have various causes. Detecting this condition may lead to restoration of renal function compromised by renal vein thrombosis. The treatment of renal vein thrombosis is mainly medical and based on anticoagulants. The role of fibrinolytic treatment is controversial. Surgery is exceptional. We report two cases of idiopathic thrombosis of the renal vein in adult patient. Also, we have done a review of the literature on this clinical syndrome and its diagnostic and therapeutic aspects.

Adrenal cystic phaeochromocytoma: a case report.

Cystic phaeochromocytoma is a rare occurrence. We report a case of a 42-year-old woman who presented with the cardinal symptoms of phaeochromocytoma with elevated serum catecholamine levels. Radiological investigations showed a cystic mass in the right adrenal. Right adrenalectomy through a subcosal incision was performed and pathological examination concluded to a cystic phaeochromocytoma. We discuss the pathophysiology of such cyst formation as well as differential diagnoses.

Pseudo-tumoral renal actinomycosis.

Actinomycosis is a rare granulomatous chronic infection that is localized most frequently in the cranio-cervical region. Renal localization is exceptional. The authors report a new case of pseudo-tumoral actinomycosis and discuss diagnostic and treatment issues of this disease.

[Association of benign prostatic hyperplasia and hernia inguinale. A report of 55 cas]. / Association hypertrophie bénigne de la prostate et hernie inguinale. Cure simultanée à propos de 55 cas.

THE AIM: of this study is to evaluate the results of combined surgery of prostatic disease and inguinal hernia repair. METHODS: We report a retrospective study of 55 patients operated in the same operating time for benign prostatic hyperplasia and hernia inguinale, and present our criteria for patient selection, operative technique, and postoperative results. RESULTS: The mean age of our patient was 69 years with a range of 56 to 85 years. Open suprapubic prostatectomy was done in 53% of cases, transurethral prostatic resection in 47% of cases and prothetic hernioplasty in 60% of cases. The incidence of postoperative wound infection and recurrent hernia was 5,4 % and 6% respectively, witch compares favorably to results of herniorraphy and prostatectomy performed separately. Simultaneous repair of inguinal hernias and surgery of prostatic disease is effective and technically feasible.

[Transrectal ultrasound in the diagnosis of prostate cancer]. / L'echographie transrectale dans le diagnostic du cancer de la prostate: mise au point.

Transrectal ultrasound is an important tool in detection and management of prostate cancer. Its role is to identify and characterize focal lesions before capsular invasion and metastases and to guide biopsy of the prostate. In this paper, we present a overview of the state of trans-rectal ultrasound imaging in prostate cancer.