Laparoscopic transabdominal preperitoneal repair of inguinal bladder hernia: a case report.

Inguinal bladder hernia is a rare clinical condition, and only a small number of reported cases have been treated by laparoscopic surgery. We report a case of a patient aged 65-year-old who presented to our outpatient care unit for a right inguinal swelling. Computer tomography (CT) imaging showed a direct inguinal hernia with bladder and epiploic content. We performed a laparoscopic transabdominal preperitoneal repair, which involved carefully reducing the bladder's protrusion from the hernial orifice. Subsequently, a mesh prosthesis was employed to treat the right inguinal hernia. This case represents an unusual instance of a successful laparoscopic repair for a right direct inguinal bladder hernia.

Poorly differentiated squamous cell carcinoma of unknown primary location a case report of perineal presentation.

INTRODUCTION: Cancers of unknown primary origin (CUP) pose a significant clinical challenge, representing a small percentage (1 to 5 %) of overall cancer cases. The patient is a 31-year-old male who has been diagnosed with poorly differentiated infiltrating squamous cell carcinoma, which has been classified as CUP. The exceptional perineal presentation and diagnostic process serve as a reminder of the diverse nature of CUPs and the crucial role played by advanced imaging methods and a multidisciplinary approach. The inclusion of this case, the seventh one in the literature, deepens our understanding of CUPs. PRESENTATION OF CASE: A 31-year-old man came in with a gradual onset of perineal pain that had been worsening for the past six months. A nodular lesion in the urogenital triangle, infiltrating the bulbo spongiosus muscle, was surgically removed. The histopathology results confirmed a poorly differentiated squamous cell carcinoma. Despite conducting extensive examinations, the multidisciplinary team was unable to determine the source of the tumour, classifying it as CUP. One year post-surgery, the patient remains in complete remission. DISCUSSION: The management of CUPs can be challenging because of the variety of their origins and presentations. The importance of advanced imaging, pathological and biological techniques, as well as meticulous surgical intervention, is emphasized in this case, as it helps in avoiding unnecessary adjuvant therapies. CONCLUSION: This case highlights the significance of a customized and interdisciplinary approach in effectively managing CUPs, especially when they present in unusual ways. Timely surgical intervention, backed by comprehensive imaging and pathological analysis, can result in positive results.

Human urinary myiasis due to larvae of Telmatoscopus (Clogmia) Albipunctata in Morocco: A case report.

This is the first case of urinary myiasis in the Morocco region caused by Clogmia albipunctata. Also known as Telmatoscopus albipunctata, is a fly species in the Psychodidae family. These flies thrive in unsanitary environments like bathrooms and sewers. Transmission occurs when flies lay eggs on moist surfaces such as urogenital discharge. The larvae hatch and can traverse the urethra, entering the bladder. Clogmia albipunctata larvae and adults decompose organic matter and pose health risks as vectors of pathogens and allergens. In our case, larvae were discharged through urine by a 46-year-old female cleaner from a low socioeconomic background who presented with intermittent emission of worms in her urine. She had mild hypogastric tenderness and a history of lower urinary tract symptoms without fever. Initially misdiagnosed with cystitis, her symptoms persisted, leading to the discovery of small, mobile vermiform organisms in her urine. Living in fly-infested conditions, she had no recent travel or medical history. Urine analysis confirmed the presence of Clogmia albipunctata larvae, diagnosing urinary myiasis. Treated with ivermectin and hydration, her symptoms resolved within a week. A follow-up cystoscopy showed no larvae, confirming a complete cure.

Urethral Calculus as an Uncommon Cause of Acute Urinary Retention in Women Diagnosis and Management: A Case Report.

Background: Urethral calculi causing acute urinary retention is a highly uncommon condition in women, which poses distinctive difficulties in diagnosis and treatment. This report presents the case of a 52-year-old woman who experienced acute urinary retention caused by a urethral stone. It emphasizes the effective use of minimally invasive methods and underscores the importance of comprehensive multidisciplinary treatment. Case presentation: A 52-year-old woman patient arrived with acute urinary retention symptoms that lasted 6 hours. She complained of pain in the perineal and periurethral regions. She struggled with poorly managed type 2 diabetes, metabolic syndrome, and frequent cystitis. The examination showed the presence of a 2-cm stone in the urethra. The treatment utilised retrograde propulsion and laser fragmentation. Postoperative magnetic resonance imaging results were normal, and follow-up care involved managing diabetes and adopting lifestyle changes to prevent the recurrence of cystitis and stones for 6 months. Conclusion: Urethral calculi exceptionally cause acute urinary retention in women. To achieve successful outcomes and prevent recurrence, it is crucial to prioritize prompt, minimally invasive treatment, and comprehensive management.

Ischemic penile necrosis following embolization of the prostate for benign prostatic hyperplasia: A case report.

Prostatic artery embolization (PAE) provides a minimally invasive approach for treating benign prostatic hyperplasia (BPH) by occluding prostatic arteries to decrease prostate volume. While offering benefits, PAE can lead to severe complications, such as ischemic necrosis of the penis, due to unintended embolization of penile arteries. This is highlighted by the case of a 62-year-old man who, after PAE, suffered from glans necrosis accompanied by intense perineal pain and acute urinary retention. Although conservative treatment facilitated recovery, his erectile function remains compromised and urinary symptoms have worsened. This underscores the importance of discussing potential risks and alternatives with patient.

Genital self-mutilation in psychiatric patients: A case report.

INTRODUCTION: Genital self-mutilation presents significant surgical challenges, particularly when complicated by psychiatric disorders. This case highlights the critical role of surgical intervention in the management of self-inflicted severe penile injuries and underscores the need to integrate surgical and psychiatric care to optimise results. CASE PRESENTATION: A 43-year-old man, with progressive psychiatric issues, self-inflicted penile amputation. He arrived late in the emergency room with a poorly preserved amputated penis, complicating potential reimplantation. The surgeons extensively debrided and created a urethrostomy on the anterior scrotum wall, preparing for future phalloplasty. This planning ensured tissue viability and minimised postoperative complications. Early psychiatric evaluations revealed hebephrenic schizophrenia. Unfortunately, after psychiatric stabilisation, he was lost to follow-up and was not present for phalloplasty. DISCUSSION: Severe penile lesions require restoration of appearance, preservation of functions, and minimisation of complications. The surgical approach depends on the hospital capabilities, expertise, and patient condition, our patient's case required an anterior urethral anastomosis of the scrotum wall in consideration of phalloplasty. Pairing surgical intervention with immediate psychiatric care is crucial for optimal outcomes. However, the loss of follow-up postpsychiatric discharge in our patient highlights the need for improved monitoring to ensure adherence to treatment. CONCLUSIONS: This case highlights the interaction between severe genital trauma, psychiatric instability, and surgical management in patients who engage in self-genital mutilation. It underscores the importance of a multidisciplinary approach that involves both surgical and psychiatric. Enhanced strategies for psychiatric involvement and monitoring are crucial, especially for people scheduled for complex reconstructive surgeries such as phalloplasty.

Epidermoid cyst discovered concomitant with torsion of the spermatic cord: A case report.

Testicular epidermoid cysts, accounting for 1%-2% of all testicular masses, present a diagnostic challenge often identified post-orchiectomy. Conservative surgery is recommended, emphasizing the need for accurate preoperative diagnosis. A 28-year-old patient with acute left scrotal pain, initially suggestive of testicular torsion, underwent intraoperative exploration revealing extra-vaginal torsion with an incidentally discovered 2-cm intra-testicular mass. Due to suspected malignancy, a total orchiectomy was performed. Pathological analysis confirmed an epidermoid cyst with normal postoperative tumor markers. The patient had a good postoperative outcome and underwent testicular prosthesis placement 3 months after the surgery. Epidermoid cysts, often identified incidentally during urgent scenarios, underscore the importance of accurate preoperative diagnosis. Conservative surgery remains the preferred approach, emphasizing the consideration of benign factors to prevent unnecessary orchiectomies.

Prostatic cyst: A rare entity with differential diagnostic challenges in urology - A case report.

A 62-year-old man presented with a Prostate Specific Antigen (PSA) level of 9.89 ng/mL during routine screening. The clinical examination revealed lower urinary tract symptoms, along with a soft, bulging, painless mass in the left lobe of the prostate during digital rectal examination. Imaging confirmed the presence of a left latero-prostatic cystic formation with a low level of malignancy. A prostate biopsy indicated a benign prostatic parenchyma with no signs of malignancy. Medical treatment with alpha-blockers resulted in improved urinary symptoms, and follow-up monitored PSA levels at 3 and 6 months, recording 8.05 ng/mL and 6.87 ng/mL, respectively.

Intravesical Textiloma: A Rare Complication Following Laparoscopic Inguinal Hernia Repair - A Case report.

Introduction: Today, surgical errors are becoming less and less frequent, thanks to the development of new techniques and the choice of different approaches. Nevertheless, they are still possible, and it is important to mention them in order to prevent them and avoid their recurrence. Case Presentation: We report a case of intravesical textiloma, rarely observed in urological surgery, in an 80-year-old patient who underwent laparoscopic inguinal hernia repair and presented to a urological consultation with hematuria and irritative lower urinary tract signs. Abdominal ultrasound revealed a hyperechoic tissue-like formation in the posterior wall of the bladder. The diagnosis of a bladder tumor was therefore raised, and cystoscopy was performed, which revealed an intravesical textiloma. All foreign bodies were removed endoscopically, and the patient had a good post-operative outcome. Conclusion: The rarity of the urological location of textilomas and the importance of their prevention remain a goal in surgery, whatever the specialty.

Stereotactic Body Radiation Therapy (SBRT) for prostate cancer: Preliminary results of toxicity.

To the Editor, Prostate cancer is the second most common cancer in men in Morocco after lung cancer. External radiotherapy (RTE) is a curative therapeutic option for localized prostate cancer, However the conventional RTE remains a long treatment (7- 8 weeks, 5 days a week) which is demanding for patients and make difficult to manage the waiting lists. The development of imaging and irradiation techniques over the last decades has allowed a high precision in the delivery of the dose to the target organ and a better protection of the organs at risk (OAR), which has encouraged the hypo fractionated irradiation of localized prostate cancer, especially after the results of radiobiology studies that suggested a low report a/b for the prostate.