Ureteral duplicity with a left ureterocele: a case report.

An intravesical ureterocele is a rare condition in which a terminal ureter terminates in a cystic dilation of the bladder. We present the case of a 42-year-old female who presented with irritative lower urinary tract symptoms and left lower back pain. Computed tomography (CT) urography revealed ureteral duplication with a ureterocele complicated by upper tract obstruction. Treatment involved endoscopic ureterocelotomy, which successfully relieved symptoms and resolved renal obstruction.

Successful conservative management of a spontaneous intraperitoneal urinary bladder rupture secondary to benign prostatic hyperplasia: a case report.

A spontaneous intraperitoneal bladder rupture is a rare, serious and life-threatening surgical emergency of various etiologies, with unspecific clinical presentation, and difficult diagnosis. Surgical treatment is the standard therapy for intraperitoneal bladder rupture; however, there is an increasing tendency toward conservative management in selected patients with favorable characteristics. Herein, we report a rare case of a 65-year-old male patient presented to the emergency department with intraperitoneal bladder rupture following an episode of acute urinary retention due to benign prostatic hyperplasia, and which was successfully managed conservatively with urinary bladder catheterization and antibiotic therapy, without any complication.

Medullary Aplasia Revealing a Metastatic Prostatic Adenocarcinoma.

In this case report, we are reporting the case of a 68-year-old male patient who was admitted in our hospital for unintended weight loss, asthenia, and anorexia. Physical examination showed clinical signs of anemia such as pallor of skin and mucous membranes; hemodynamic parameters were normal. Complete blood count (CBC) analysis showed a pancytopenia with anemia, thrombocytopenia, and leukopenia. BM biopsy was performed, showing a malignant infiltration of bone marrow by a metastatic prostate cancer confirmed by immunohistochemistry. Prostate biopsy confirmed the diagnosis of acinar adenocarcinoma with Gleason score 8 (4 + 4), ISUP grade group 4. Our patient underwent chemical castration using LH-RH analogs in association with second-line hormone therapy by abiraterone acetate. The evolution was good on both the oncological and hematological levels.

Scrotal gunshot injury: A case report.

Incidence of firearm injuries generally and scrotal injuries specifically varies between regions and countries. Patients admitted to the emergency department for gunshot wounds to external genitalia require a thorough assessment. We report the case of a 33-year-old patient who was shot in the thigh and scrotum resulting in a unilateral orchidectomy. In this article, we detail key elements of care for this type of injuries.

Sarcomatoid carcinoma of the urinary bladder: analysis of five cases and literature review.

Sarcomatoid carcinomas of the bladder represent a tiny part of bladder tumors and are characterized by a high potential for malignancy. Very aggressive and affecting mainly men, these tumors present both a urothelial and sarcomatoid contingent. The treatment of these tumors is not well codified given the rarity of cases reported in the literature, however, it seems that the treatment is essentially based on radical cystectomy with extensive pelvic lymph node dissection. We report the experience of our departement in the management of this type of tumor in a series of five cases collected over a period of 8 years.

Pathogenesis, Diagnosis, and Management of Splenogonadal Fusion: A Literature Review.

INTRODUCTION: Splenogonadal fusion is a rare congenital anomaly, defined by the presence of ectopic splenic tissue caused by an abnormal connection between the spleen and the gonad or mesonephrotic derivatives during the embryonic period. MATERIALS AND METHODS: By reporting an observational case and performing a review of the literature according to the CARE guidelines (using the PubMed database and guidelines from urology, general surgery, and pediatric learned societies), we present the embryological genesis of the splenogonadal fusion, the associated anatomical anomalies, and the diagnostic procedure. Observation. We report the case of a patient aged 45, with no notable history, reporting left testicular pain. A small nodule on the upper pole of the left testicular was clinically palpable. Tumor markers were normal, and scrotal ultrasound depicted a hypoechoic hypervascular nodule measuring 8∗6∗8 mm. After validation in a multidisciplinary oncology consultation meeting and opinion from a uro-andrologist expert, the patient underwent an inguinal lumpectomy with an extemporaneous examination which did not objectify any signs of malignancy. Ultimately, it is a normal spleen tissue in the testicular ectopic position. Discussion. Splenogonadal fusion corresponds to a rare congenital malformation; less than 200 cases have been published in the literature, most often affecting boys, with a sex ratio of 15/1. Two types are described, depending on the continuity of the link between the orthotopic spleen and the gonad: the continuous and discontinuous forms. In a third of the cases, there are associated congenital malformations and particularly in the continuous forms (44 to 50% of the cases): anomalies of the limbs, micrognathia, microgyria, and hepatic and digestive abnormalities. Cryptorchidism is associated with the continuous form in 31% of cases. The preoperative diagnosis remains difficult because of its morphological and clinical characteristics suggesting a tumor process.

Early post-traumatic renal vascular hypertension a rare complication of severe renal trauma.

Severe renal trauma is a particular entity, although rare, but most often involves the risk of short-term death from hemorrhagic shock and long-term death from infectious complications or secondary renal dysfunction, exceptionally post-renal vascular hypertension. Which is generally a late complication, we will report the case of a patient suffering from grade v renal trauma with early post-traumatic renal vascular hypertension, suppressed by medical treatment, then the surgical indication was kept in the second phase in front of a mute kidney.

Scrotal Skin Metastases Revealing a Prostatic Adenocarcinoma.

INTRODUCTION: Prostate cancer is the most common cancer in men. Cutaneous metastasis from prostate cancer is an unusual clinical finding. Scrotal skin metastasis revealing a prostate adenocarcinoma is even rarer. Case Report. We report the case of a 78-year-old patient, who initially consulted for nonspecific scrotal skin lesions evolving for 4 months. Patient's past history revealed urinary disorders. Physical examination and PSA levels led to perform a prostate biopsy, and the diagnosis of prostate adenocarcinoma was made. Bone scintigraphy showed that the cancer has spread to the bones. Imaging studies showed that the cutaneous lesions were limited to the scrotal wall. Cutaneous metastasis was suspected and was proven on skin biopsy. The patient received second-generation hormone therapy with good clinical and biological outcomes. Discussion. Based on literature review of nearly 2,500 skin metastases, we found that only 436 were spreading from the genitourinary tract. Skin metastasis from prostate adenocarcinoma is a rare entity with a low incidence rate (0.36%). CONCLUSION: Skin metastases, and especially in the scrotum, are exceptional in prostate cancer. However, in any patient with a prostate adenocarcinoma, nonspecific cutaneous lesions should lead to perform skin biopsy in order to identify and initiate treatment of cutaneous metastases.

[Squamous cell carcinoma of the bladder: a retrospective study conducted in a Moroccan University Hospital and literature review]. / Carcinome épidermoïde de la vessie: expérience rétrospective dans un hôpital universitaire marocain et revue de la littérature.

Squamous cell carcinoma of the bladder is a rare form of bladder tumor, accounting for less than 5% of bladder cancers. Sex ratio is balanced and the black population is more affected by this disease. It manifests with non-specific clinical symptoms and it is dominated by haematuria. Diagnosis is based on endoscopic resection of the bladder with anatomopathological examination. Treatment remains controversial because of the rarity of cases reported in the literature. However, radical cystectomy with extensive lymph node dissection is the treatment of choice. We here report a series of 10 cases of squamous cell carcinoma treated and followed up in our department. Our study highlights the epidemiological, clinical, anatomopathological, therapeutic and evolutionary features of squamous cell carcinoma as well as its prognostic factors.

[The role of open nephrolithotomy in the treatment of coralliform stones: a series of 53 patients]. / Place de la néphrolithotomie à ciel ouvert dans le traitement du calcul coralliforme: à propos d'une série de 53 patients.

This study aims to discuss the role of open surgery in the treatment of renal lithiasis, including coralliform stones, with the advent of new less invasive techniques. We report a series of 53 cases of coralliform stones whose data were collected in our Hospital during a period of 7 years, from January 2011 to January 2018. The patients underwent open nephrolithotomy by lombotomy. The mean post-operative length of stay was 10 days. The immediate and early postoperative outcomes were simple in 36 patients, 6 patients underwent blood transfusion, 2 had severe sepsis in the postoperative period, 5 had infection of the wall and 4 had urinary fistula, secondarily managed by endoscopic drainage. Residual stones were found in 9 cases (16.9%). Stones were essentially treated by extracorporeal lithotripsy. Late outcomes were characterized by renal atrophy in 2 patients, lithiasic recurrence in 9 patients, an improvement in creatinine clearance in 9 patients and a slight worsening in 5 patients. Open surgery presents the risk of multiple complications and it is not recommended for first-line treatment of renal lithiasis. However it is important to determine which patients would benefit from open nephrolithotomy.

[Metastatic paratesticular liposarcoma]. / Liposarcome paratesticulaire métastatique.

We report the dramatic case of a 18-year old patient with immediately metastatic round cells paratesticular liposarcoma. It is a rare tumor that develops in the fatty tissue surrounding the testicle and the spermatic cord. Clinical and radiological signs are nonspecific and diagnosis is usually based on surgical specimen examination. The treatment involves radical inguinal orchiectomy, sometimes extended to adjacent structures. Adjuvant radiation therapy could be used in the case of locally advanced mass or incomplete resection. Despite its slow progression, prolonged monitoring is required due to the high risk of late recurrence.

[Neuroendocrine carcinoma of the bladder: about 5 cases]. / Carcinome neuroendocrine de la vessie: à propos de 5 cas.

Neuroendocrine carcinoma of the bladder is a rare histological entity, characterized by the ability to metastasize quickly and associated with a poor prognosis. The purpose of this study was to analyze the clinical, histological, therapeutic and prognostic characteristics of neuroendocrine carcinoma of the bladder. We conducted a retrospective study collecting data from the medical records of 5 patients in the Department of Urology, at the Ibn Sina University Hospital during the period between January 2008 and June 2015. The average age was 63 years. Four males and one female were involved in the sudy. The neuroendocrine carcinoma was pure in four cases and impure or associated with urothelial component in one case. In two patients metastases were present at initial diagnosis. In one case, cystectomy was performed followed by neoadjuvant chemotherapy; chemoradiotherapy was performed in two cases and palliative chemotherapy in the other two cases. The median survival was 10 months. Only one patient was alive, with a follow-up period of 20 months. The management of neuroendocrine carcinoma of the bladder is not standardized, several therapeutic options have been proposed: surgery, radiation therapy and chemotherapy.

[What role does botulinum toxin play in the treatment of benign prostatic hyperplasia?] / Quelle est la place de la toxine botulique dans le traitement de l'hyperplasie bénigne de prostate?

Botulinum toxin (BT) was first used in urology for the treatment of neuro-urological disorders such as bladder sphincter dyssynergia and incontinence due to neuropathic detrusor overactivity. Its action is now clearly demonstrated and it is now widely used in treating neurogenic neuropathic detrusor overactivity. May the botulinic toxin constitute an effective treatment for benign prostatic hyperplasia (BPH)? Intraprostatic BT injection has recently been investigated as a treatment for BPH. It appears that intraprostatic BT injection produced a statistically significant improvement in urinary symptoms with no significant side effects and may therefore represent an interesting minimally invasive alternative to conventional treatment of BPH. The benefits of using it are the simplicity of its implementation, the lack of reported side effects and a longer duration of action. Carefully conducted prospective, controlled studies on larger number of cases are now needed to confirm these early results. This study aims to assess the state of current knowledge of the mechanisms of action of BT in prostate disease and the results of major clinical trials for BPH.