Transperitoneal Laparoscopic Pyelopyelostomy for Retrocaval Ureter without Excision of the Retrocaval Segment: Experience on Three Cases.

Introduction. Retrocaval ureter is a rare congenital anomaly. Open surgery was the classic treatment for this condition. Laparoscopy is currently an admitted procedure to treat many urological diseases. The objective of our study is to present our experience and discuss the safety and the feasibility of transperitoneal laparoscopic pyelopyelostomy for treatment of retrocaval ureter (RCU). Materials and Methods. Three symptomatic patients underwent laparoscopic repair for RCU in our department. The diagnosis was suspected on the computed tomography scan (CT) and confirmed on ascending pyelography. After placement of a JJ stent, and, using the transperitoneal approach, the retro peritoneum was exposed; the ureter was identified in both sides of the vena cava. The retrocaval segment was entirely mobilized and pulled from behind of the vena cava after section of renal pelvis. A pyelopyelostomy was done in a normal anatomic position. Results. All operations were achieved laparoscopically without conversion to open surgery. The mean operative time was 140 minutes (110-190). No intraoperative complication occurred. Blood loss was less than 50 mL in all patients. The mean hospital stay was 5 days (4-6 days). All patients were symptom-free after surgery and had reduction of hydronephrosis in control imagery. Conclusion. Laparoscopy seems safe, feasible, and reproducible in managing retrocaval ureter.

Percutaneous endoscopic nephropexy with a percutaneous suture passed through the kidney.

OBJECTIVES: To report a technique of percutaneous endoscopic nephropexy, using a polyglactin suture passed through the kidney, in patients with nephroptosis. PATIENTS AND METHODS: Four women presenting with symptomatic right nephroptosis underwent a percutaneous endoscopic nephropexy. An upper-pole calyx was accessed percutaneously and a 24-F working sheath was placed. Another needle access was made through a lower-pole calyx and a #2 polyglactin suture was passed into the renal pelvis. It was then pulled out through the upper-pole tract using the nephroscope. A retroperitoneoscopy was performed and the tip of the nephroscope was used to cause nephrolysis. After inserting the nephrostomy tube the polyglactin suture was passed into the subcutaneous tissue and then tied without too much tension, to avoid cutting the parenchyma. RESULTS: The operative duration was 33 min and the hospital stay after surgery was 3.5 days. The nephrostomy catheter was removed 5 days after surgery. There were no complications, especially no haemorrhagic, infectious, lithiasic or thoracic complications. The four patients were relieved of their initial symptoms, with a mean follow-up of 28 months. Ultrasonography and/or intravenous urography showed the kidney at a higher location with the patient standing. CONCLUSIONS: This technique combines the nephrostomy tract used in percutaneous techniques with the suture and nephrolysis used in laparoscopic techniques. Moreover, this procedure seems to be safe, with satisfactory anatomical and clinical results and a lower morbidity. However, a larger series will be necessary to establish its long-term morbidity and success rate.

[Metastatic cerebral abscess from Klebsiella pneumoniae after extracorporal shock wave lithotripsy for kidney stone (a case report)]. / Abcès cérébraux métastatiques à Klebsiella Pneumoniae après lithotritie extracorporelle pour lithiase rénale (une observation).

Extra-corporeal Shock Wave Lithotripsy (ESWL) is widely used to treat urinary calculi. With increasing numbers of ESWL, more patients prone to infectious complications. A 62-year-old man presented with cerebral abscess following ESWL. The authors discuss presenting conditions, risk factors and preventive measures.

[Pathological pelvic kidney. Apropos of 11 cases]. / Le rein pelvien pathologique. A propos de 11 cas.

The diseases ectopic kidney is a rare malformation. It can be associated with other urological or nonurological malformation. We report 11 cases observed between 1980 and 1998. They were five females and six males with a mean age of 28 years. The clinical symptomatology was dominated by pain and urinary symptoms. Diagnosis was based on the IVP data and ultrasonography. Renal stone and hynronephrosis were each associated in five cases and one patient had renal stone associated with hydronephrosis. The treatment consisted on a iliopelvic approach and extraction of the stone and or pyeloplasty. In three cases a nephrectomy was realised for muet kidney or pyonephrosis. The outcome was good in ten cases and one patient had a pyelo-ureteral secondary stenosis managed by endoscopy.

[A supernumerary kidney. Apropos of a case]. / Le rein surnuméraire. A propos d'un cas.

Supernumerary kidney is a rare poorly documented anomaly. It's generally discovered in stage of complications. Preoperative diagnosis is difficult. The authors report a case of hydronephrotic supernumerary kidney, diagnosed preoperatively, in a 45 years old patient with a review of the literature.

[Nephroblastoma in adults: apropos of 2 cases]. / Le néphroblastome de l'adulte: à propos de deux observations.

Adult nephroblastoma is a rare tumor. The authors report two new cases observed in a 30 and 34 years old men in whom the diagnosis was made by histo-pathology. They were admitted for enormous kidney mass. We performed nephrectomy in one case, and surgical biopsy in the other. No adjuvant treatment was given. The prognosis was fatal. They study the particular features of this tumour. Its prognosis appeared to be poorer than that of renal adenocarcinoma.

[Detrusor-sphincter dyssynergia: four case reports and literature review]. / La dyssynergie vésicosphinctérienne: présentation de quatre cas et revue de la littérature.

UNLABELLED: Detrusor-sphincter dyssynergia is responsible for major impairment and is factor for social and professional activity repercussions. METHODS: We have studied the clinical and urodynamic finding in four patients (two men and two women) with detrusor-sphincter dyssynergia. Mean age is 36 years (26-44 years). Dyssynergia was secondary to tuberculosis meningitis in one case, surgery for rectal adenocarcinoma in one case, tight vertebral canal in one case and in one case the cause is indeterminate. The detrusor-sphincter dyssynergia were treated by autocatheterism in two cases, antibiotherapy antituberculosis associated with an anticholinergic drugs in one case and by alpha-blockers agent in another. RESULTS: Quasi-complete salvage of the motor deficit and the dysfonctional voiding in a patient treated by antibiotherapy antituberculosis associated with an anticholinergic drugs. As well, maid evolution in patient treated by alpha-blockers agent and who practice self catheterization. CONCLUSION: Optimal treatment is unknown, and the existence of several cures indicated the limit of all therapeutic methods.

Adrenal myelolipoma. A case report.

We report a new case in a 56 years old patient who manifested right side's pains. The abdominal CT scan showed a tumor of the right adrenal gland with fat density (size: 8 x 6 x 6 cm). This tumor was removed surgically (weight: 300 g). The histological finding revealed a proliferation of adipocyts and myeloid tissue which contains megakaryocytes, erythroid cells and lymphocyts. The outcome is good after three years of surgery. The surgical treatment becomes necessary when the tumor's size increases or it becomes symptomatic.

[Paratesticular malignant mesothelioma. Report of a new case]. / Le mésothélium malin paratesticulaire. A propos d'une nouvelle observation.

Malignant mesothelioma of the tunica vaginalis is a rare and aggressive tumor. It appears that surgery have a high value in the treatment. We report a case of malignant mesothelioma of the tunica vaginalis in 65 years old patient and a review of the literature is presented.

[Treatment of ureteral calculi with rigid ureteroscopy. Report of 67 cases]. / Le traitement des calculs de l'uretère par urétéroscopie rigide. A propos de 67 cas.

PURPOSE: To evaluate the results obtained by rigid ureteroscopy to treat ureteral calculi. MATERIALS AND METHODS: Between May 1998 and September 2000, 63 patients underwent 67 rigid ureteroscopies (URS) with three endoscopic retreatments and one bilateral URS, for 48 distal, ten mid and nine proximal ureteral calculi. RESULTS: After URS 77.6% of the patients were free of the stones. Success rate was respectively 85.4%, 60% and 55.5% in distal, mid and proximal uretero. Morbidity was 10.4% and there have been one stricture treated by endoscopy. CONCLUSION: Our series demonstrates that rigid URS is safe and effective procedure to treat distal, ureteral calculi. Thus, it should be considered a treatment of choice for distal ureteral calculi.

[Testicular metastasis of prostatic adenocarcinoma. Report of a case]. / Métastase testiculaire d'un adénocarcinome prostatique. A propos d'un cas.

Metastasis involvement of the testis form prostatic carcinoma is rare. Seventy cases have been reported between 1938 and 1990. We report another case treated by transurethral resection of the prostate, bilateral orchiectomy and nonsteroid androgens and a review of the literature is presented.

[Syringocele: report of 2 cases]. / Syringocèle: à propos de 2 cas.

Cowper's syringocele, dilatation of bulbo-urethral glands, is a rare disease, usually congenital. The authors report two cases of perforated syringocele and analyse the clinical, radiological and therapeutic aspects of this disease.

[Hydatid cyst of the psoas. Report of a case]. / Kyste hydatique du psoas. A propos d'un cas.

The authors report a case of hydatid cyst of the psoas muscle in 23 years old woman who presented a left lumboiliac mass. Ultrasonography and computed tomography contributed to the preoperative diagnosis. The cyst was removed by retroperitoneal approach by left lumbotomy. In the light of this case and the literature data, the authors discuss the diagnosis and therapeutic problems raised by hydatid cyst of the psoas muscle.