Bilateral ectopic pelvic kidney associated to left ureteropelvic junction syndrome: A case report.

Bilateral ectopic pelvic kidney is an exceptional finding and it may be associated rarely with other abnormalities of the kidney such as uretero-pelvic junction syndrome. We report a case of bilateral ectopic pelvic kidney revealed by left flanc pain with a left uretero-pelvic junction syndrome and a right ureteral duplication proved by computed tomography. A MAG3 renal scintigraphy was performed confirming the obstructive uretero-pelvic junction. An open left Anderson-Hynes pyeloplasty was performed without objectifying, preoperatively, any extrinsic compression without any postoperative complication. This case emphasizes on the possibility of the reconstructive management in such cases.

Primary hydatid cyst of the kidney revealed by hydatiduria: A case report.

Hydatid disease is frequent in endemic regions especially in sheep farming areas. Kidneys are uncommonly affected (2%-4%). We report a case of right renal colic with hydatiduria revealing a primary renal hydatid cyst ruptured in the mid calyx proved by computed tomography scan and laboratory testing. A kidney sparing surgery was performed by excision of the protruding dome and suturing of the fistula without any postoperative complication. This case emphasizes on further studies to define a standard treatment modality for renal hydatidoses.

Are Diabetic Patients at Increased Risk for Biochemical Recurrence After Radical Prostatectomy?

Introduction Diabetic patients are at a lower risk for prostate cancer. However, the relationship between diabetes mellitus (DM) and biochemical recurrence (BCR) after radical prostatectomy (RP) is less clear. The goal of our study was to determine diabetes's value as a biochemical recurrence predictor. Materials and methods We conducted a retrospective analysis of 117 patients who had undergone open radical prostatectomy between 1999 and 2021 at our institution. Univariate and multivariate statistical analyses were used to identify factors associated with biochemical recurrence. Results On univariate analysis, factors associated with biochemical recurrence were diabetes (p=0.002), preoperative prostate-specific antigen (PSA) levels (p=0.022), positive digital rectal exam (p=0.035), number of positive biopsy cores (p<0.001), unfavorable intermediate risk group (p=0.014), peri-neural invasion (PNI) on RP specimen (p=0.043), tumor volume (p=0.011), and positive surgical margins (p<0.001). Multivariate analysis showed that factors independently associated with biochemical recurrence were diabetes (p=0.039; OR=2.788), number of positive cores (p=0.016; OR=4.124), and positive surgical margins (p=0.008; OR=3.876). Conclusion A history of diabetes mellitus should be taken into consideration when assessing patients' risk of biochemical recurrence after radical prostatectomy. More research on a larger scale is needed to determine diabetes' value as a biochemical predictor.

Idiopathic scrotal calcinosis: A new case report.

Scrotal calcinosis is a rare benign pathology and its etiology is still discussed. The main complaint is mostly aesthetic. The treatment of extended forms is a one-staged excision. The aim of our study was to study clinical and anatomopathological aspects and report our surgical management of a case of diffuse scrotal calcinosis. We report a case of 24-year-old patient who consulted for painless scrotal nodules lasting for 2 years. Scrotal calcinosis diagnostic was based on clinical examination. The treatment was a one-staged scrotal excision taking all nodules and the plasty of the scrotum. The diagnosis was confirmed by a histopathological examination of surgical specimen.

A Mislocated Intrauterine Device Migrating to the Urinary Bladder: An Uncommon Complication Leading to Stone Formation.

Intrauterine devices are a popular form of reversible contraception among women. Its administration can lead to some uncommon but serious complications such as perforation leading to its migration into adjacent organs. Like any foreign body, the presence of an IUD in the bladder can result in stone formation due to its lithogenic potential. We report a case of an IUD migrating from its normal position in the uterine cavity into the urinary bladder causing chronic low urinary tract symptoms in a 43-year-old female patient. The device was securely removed without complications using grasping forceps under cystoscopy, and no parietal defect was detected. A mislocated IUD is a rare complication that should be considered in female patients presenting with chronic urinary symptoms.

Functional Bladder Paraganglioma Treated by Partial Cystectomy.

Paraganglioma is a rare neuroendocrine tumor that arises from the autonomic nervous system. The urinary bladder paraganglioma accounts for less than 0.1% of bladder tumors. It remains a challenging entity to diagnose and treat due to its rareness and the lack of specific symptoms. Treatment modalities include transurethral resection and cystectomy (partial or total). The authors report a new case of an isolated paraganglioma of the urinary bladder in a 52-year-old female patient that underwent partial cystectomy. This case aims to remind the clinical, histological and therapeutic features of this rare tumor.

Non Typhoidal Salmonella Pyonephrosis in an Asymptomatic Immunocompetent Patient.

A 50-year-old man with no past medical history presented with 5 months history of right flank discomfort. Physical examination was unremarkable. CT-scan showed a large right renal pelvic calculi and upper pole hydronephrosis. He underwent open surgical procedure and we peroperatively discovered upper pole pyonephrosis. Bacteriological samples of pus grew group D Salmonella. We prescribed third generation cephalosporin for 14 days. The patient made a steady recovery. Non typhoidal salmonella (NTS) urinary tract infection (UTI) is extremely rare and usually associated with immunosuppressive chronic disease or genito urinary tract abnormalities. Pyonephrosis due to NTS have been reported twice. We report the first case of asymptomatic NTS pyonephrosis.

A Paratesticular Angiolipoma: A Case Report of a Rare Benign Scrotal Mass and Review of Literature.

We report a rare case of paratesticular angiolipoma in a young male. The patient is a 21-year-old male who presented with a palpable firm right intrascrotal mass of 21 mm. Ultrasound findings demonstrated that it is a solid mass. Under the diagnosis of an intrascrotal solid mass, a right inguinal radical orchiectomy was performed. Histopathological examination concluded to a paratesticular angiolipoma. Angiolipoma is a rare benign form of paratesticular tumour and its diagnosis is based on histological findings of the surgical specimen with no recurrence risk. This mesenchymal tumour should be distinguished from liposarcoma, which has malignant or aggressive clinical course.

Percutaneous Nephrolithotomy (PCNL): Standard Technique Versus Tubeless - 125 Procedures.

INTRODUCTION:  Tubeless percutaneous nephrolithotomy (PCNL) is the non-placement of a nephrostomy tube at the end of the procedure. The benefits of a nephrostomy tube placement are numerous as it provides adequate renal drainage. It may also tamponade bleeding and allow for an easier second-look nephroscopy. However, these advantages are mostly theoretical, and the majority of authors consider the nephrostomy tube as a source of morbidity. OBJECTIVES: The aim of this report was to study the efficiency, safety, and morbidity of tubeless PCNL by comparing it to the standard technique. METHODS: This is a unicentric retrospective study of 125 patients who had undergone PCNL for renal lithiasis. We divided the patients into two groups: the standard PCNL group (n = 74) and the tubeless PCNL group (n = 51). The rates of good outcomes, complications, duration of hospitalization, and the degree of postoperative pain were compared between these two groups. RESULTS: There were no statistically significant differences between the two groups in age, gender, history, and the number of stones treated. There were more staghorn stones in the PCNL group with nephrostomy (p = 0.007) and more pelvicalyceal stones in the tubeless group (p = 0.037). Patients who had the standard PCNL had larger stones (p = 0.008). Patients who had a tubeless PCNL had more postoperative infectious complications than the standard PCNL group (p = 0.042). No statistically significant differences were noted for other complications, good outcomes (p = 0.13), postoperative pain (p = 0.51), and duration of hospitalization (p = 0.16). CONCLUSION: According to the majority of authors, tubeless PCNL is considered a safe and efficient technique. It also provides advantages with less postoperative pain and duration of hospitalization. We believe that a selection bias may exist in most published work concerning routine nephrostomy tube placement.

Transformation of a prostatic adenocarcinoma into squamous cell carcinoma after luteinizing hormone-releasing hormone (LHRH) agonist and radiotherapy treatment.

Squamous cell carcinoma of the prostate is rare and represents 0.5% to 1% of prostatic carcinomas. Transformation of prostatic adenocarcinoma into squamous cell carcinoma after LH-RH agonist intake has been reported in only 8 cases in the literature. To our knowledge, our case is the second pure squamous cell carcinoma observed after hormonotherapy and radiotherapy. We reported a case of a patient with prostatic adenocarcinoma treated by radical prostatectomy followed by radiotherapy. Eleven years later, he had a vesical recurrence of prostatic adenocarcinoma. Our patient had an endoscopic resection followed by injections of Triptorelin. Six months later, he developed a local recurrence of a squamous cell carcinoma.

[Renal epithelioid angiomyolipoma mimicking renal carcinoma]. / Angiomyolipome épithélioïde rénal mimant un carcinome rénal.

Epithelioid angiomyolipoma is a rare form of potentially malignant angiomyolipoma, recently considered separate entity by the World Health Organization classification of renal tumors. This lesion poses a problem in differential diagnosis with clear cell carcinomas. There are no clinical or radiological specific criteria that characterize this tumor. Immunohistochemistry revealing epithelioid cells with positive HMB45 marker is essential for diagnosis. Treatment should be discussed during the multidisciplinary consultation.

[Prognostic value of markers of aggressiveness of urinary bladder tumours evaluated by immunohistochemistry]. / Valeur pronostique des marqueurs d'agressivité des tumeurs vésicales évalués par immunohistochimie.

BACKGROUND: The study of some immunohistochemical markers provides an objective and reproducible prognostic evaluation of urinary bladder tumour. aims: study the expression of the following immunohistochemical markers in Tumours of the bladder: Proliferating Cell Nuclear Antigen (PCNA), Ki67 antigen (MIB1), the C-erbB2 proto- antigene, the tumor suppressor gene p53, the receptor for epidermal growth factor (EGF-R), the apoptosis suppressor gene bcl2, the carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA). methods: Study of retrospective series of 30 patients having tumours of the urinary bladder. results: The expression of PCNA with a cut-off value of 14% is correlated with recurrence (P = 0.010). The expression of PCNA with a cut-off value of 1% is correlated with tumour stage (P = 0.003). The expression of MIB1 with a cut-off value of 47% is correlated with recurrence (P = 0.010). The expression of MIB1 with a cut-off value of 47% is correlated with the tumour progression in stage and\or in grade (P = 0.007). The expression of C-erbB2 with a cutoff value of 28% is correlated in the tumour grade (P = 0.007). The other antibodies didn't demonstrate a prognostic value. CONCLUSION: MIb1 and PCNA being correlated with recurrence, they can be useful with the decision of the rhythm of the endoscopy. The correlation of C-erbB2 with the tumour grade could serve to better graduating bladder tumours.

[Oncological and functional results of 50 consecutive radical prostatectomies]. / Résultats carcinologiques et fonctionnels de 50 prostatectomies radicales consécutives.

AIM: To evaluate the Oncological and functional results and to clear risk factors of biochemical recurrence in patients with prostate cancer treated by retropubic prostatectomy. METHODS: Retrospective analysis of 50 consecutive retropubic radical prostatectomies performed between January 1999 and january 2008. Biochemical recurrence was defined by PSA > 0.2 ng/ml. Univariate analysis of prognostic factors of biochemical recurrence was performed. The study of the urinary continence and the sexuality is essentially based on a meticulous interrogatory. RESULTS: The biochemical recurrence-free survival was 68%. Significant risk factors on univariate analysis were: number of positive biopsy, the percentage of positive biopsy, perineural invasion, Gleason score, clinical stage, pathological stage, and tumour volume. On the functional plan, only one patient is totally incontinent. The return to a normal sexuality appears uncertain, the sexual potency was satisfactory among 5 patients (10% of the patients operated and 55,5% of the patients having had a nervesparing techniques) CONCLUSION: Our oncological results is acceptable and are quite comparable to literature. This while guaranteeing the satisfactory functional results essentially basing on an acquirement of a continence quasi-perfect.

The 20-core prostate biopsy as an initial strategy: impact on the detection of prostatic cancer.

INTRODUCTION: To increase the detection rate of prostate cancer in recent years, we examined the increase in the number of cores taken at initial prostate biopsy. We hypothesized that an increasing number of cores may undermine the accuracy of models predicting the presence of prostate cancer at initial biopsy in patients submitted to 20-core initial biopsy. METHODS: A total of 232 consecutive patients with prostate-specific antigen (PSA) between 4 and 20 ng/mL and/or abnormal digital rectal examination (DRE) underwent 12-core prostate biopsy protocol (group 1) or 20-core prostate biopsy protocol (group 2). The patients were divided into subgroups according to the results of their serum PSA and prostate volume. We evaluated the cancer detection rate overall and in each subgroup. Clinical data were analyzed using chi-square analysis and the unpaired t-test or 1-way ANOVA with significance considered at 0.05. RESULTS: The 2 groups of patients were not significantly different with regard to parameters (age, abnormal DRE and serum PSA), although median prostate volume in group 1 (57.76 +/- 26.94 cc) were slighter greater than in group 2. Cancer detection rate for patients submitted to 20 prostate biopsy was higher than patients submitted to 12 prostate biopsy (35.2% vs. 25%, p = 0.095). Breakdown to PSA level showed a benefit to 20 prostate biopsy for PSA <6 ng/mL (37.1% vs. 12.9%, p = 0.005). Stratifying results by prostate volume, we found that the improvement of cancer detection rate with 20 prostate biopsy was significant in patients with a prostate volume greater than 60 cc (55% in 20 prostate biopsy vs. 11.3% p < 0.05). Morbidity rates were identical in groups 1 and 2 with no statistically significant difference. There appeared to be no greater risk of infection and bleeding with 20 prostate biopsy protocol. CONCLUSION: The 20-core biopsy protocol was more efficient than the 12-core biopsy protocol, especially in patients with prostate specific antigen <6 ng/mL and prostate volume greater than 60 cc.

A rare cause of a scrotal mass: primary leiomyosarcoma of epididymis.

Most masses encountered within the scrotal sac are neoplastic and occur within the testis; however a subset (2-3%) of these tumours is extra-testicular and usually arises from paratesticular tissue. Although uncommon, these tumours have a high incidence of malignancy reaching 30%, mainly represented by sarcomas (90%). Tumours occurring in the paratesticular region may be clinically indistinguishable from testicular tumours, thus resulting in initial misdiagnosis. In addition, the clinical findings are by no means specific to a tumour type and cannot distinguish between a benign and a malignant tumour, which results in difficulty in diagnosis and management. All paratesticular tumours are amenable to adequate surgical resection. Definite diagnosis is determined by histological evaluation.Leiomyosarcoma, the second most common paratesticular sarcoma after liposarcoma, is represented in the literature primarily as case reports. We report a case of LMS arising from the epididymis and focus on clinical presentation and differential diagnosis of such tumours.

Multiple unusual locations of hydatid cysts including bladder, psoas muscle and liver.

Our case concerns 66-year-old female with a multiple unusual locations of hydatid cysts including bladder, psoas muscle and liver. Coexistence of hydatid cysts in these localizations has not been previously reported. The diagnosis of vesical hydatid cyst was facilitated by the coexistence of other echinococcosis locations. Treatment consists of the excision of the cysts in the same session without any postoperative anthelmintic drugs. In a two-year follow-up no recurrence has occurred.