Fibrous pseudo tumor of the tunica vaginalis mimicking paratesticular cancer.

Fibrous pseudo tumor of the tunica vaginalis is a rare lesion affecting men representing a challenge in its diagnosis and treatment. We reported the case of a 17 year old male patient who presented for a right scrotal mass. Surgical resection of the mass was performed and the histological diagnosis was a fibrous pseudo tumor of the tunica vaginalis. It is usually affecting men in the third decade and the fear is to miss its main differential diagnosis which is testicular cancer. Studies should give more concern to this entity, so that we can avoid unnecessary orchiectomy.

Massive hydronephrosis due to obstruction by upper urinary tract urothelial carcinoma with compression of the inferior vena cava.

A 78-year-old woman presented with tachypnea, abdominal distension, bilateral lower limb edema, and hematuria. A contrast-enhanced CT scan of the abdomen and pelvis was performed, which revealed a significant left-sided hydronephrosis upstream of an upper urinary tract urothelial carcinoma (UUT-UC). The patient underwent a left open nephroureterectomy, and approximately 10 L of fluid were evacuated. Follow-up examinations did not show any recurrence of abdominal swelling.

Ocular abscess: An extremely rare complication of transurethral resection of the prostate.

Ocular abscess following transurethral resection of the prostate is an rare complication. We report the case of a male who developed an ocular abscess with purulent melting of the eye after undergoing TURP for benign prostatic hyperplasia. The patient successfully underwent the TURP procedure. However, he developed a right epididymitis and subsequently an ocular abscess on the same side. Treatment involved dual antibiotic therapy for the epididymitis, followed by incision of the ocular abscess and intravenous antibiotics. Multidrug-resistant Escherichia coli was identified in both ocular and postoperative urine cultures. This case highlights the rarity and potential serious complications following TURP.

Intrascrotal self insertion of foreign body: Form of entry to schizophrenia.

A 23-year-old boy was referred to Urology because of a nail self insertion on the scrotum. Examination revealed a visible big nail within the scrotum, lateralized to the right at 1 cm from the median raphe. Scrotal exploration and debridement of non-viable tissue was performed, and no testicular or surrounding structure injury was found. Referred to a psychiatrist the diagnosis of schizophrenia was retained in our patient in front of several arguments including the self-mutilation and his psychiatrist concluded that this was secondary to delusions.

Pelvic ureteral angiomyoma mimicking urothelial carcinoma: A case report.

BACKGROUND: Angiomyoma is a rare benign tumor that can occur in any organ with smooth muscles. No one has already described an angiomyoma of the ureter. CASE PRESENTATION: We report the case of a 44 year old woman who presented with intermittent hematuria and left flank pain. The diagnosis of left ureteral tumor was evoked by the scannographic aspect. She underwent a radical nephro-ureterectomy. Final histological examination concluded to ureteral angiomyoma. DISCUSSION: Angiomyoma is rare benign smooth muscle tumor with a vascular component. Symptomatology depends on the organ that angiomyoma is developed from, and is usually mimicking malignant tumors. CONCLUSION: Symptomatology, radiologic findings are mimicking urothelial carcinomas, however the pathology corrected the diagnostic error.

A round cell sarcoma of the bladder following radiotherapy: A case Report.

Sarcomas are uncommon and extremely aggressive malignancies. Sarcomas of the bladder are exceedingly rare. We report the case of 67-year-old female patient having had 20 years ago a total hysterectomy with bilateral adnexectomy followed by adjuvant external radiotherapy to an undifferentiated uterine sarcoma, was presented with hematuria. An abdomino-pelvic Computed Tomography (CT) Scan was done showing a 5 cm budding lesion of the bladder floor. An anterior pelvectomy with external urinary diversion was undergone. The histological examination showed a high grade urothelial carcinoma infiltrating the muscle with a sarcomatoid component.

Pancreatic pseudocyst mimicking a left kidney abscess: a case report.

BACKGROUND: Pancreatic pseudocyst are fluid filled sacs that develop as a result of dissection of pancreatic enzyme tissue. While most commonly found near the pancreas, they can also rarely occur in other areas such as the perirenal region. CASE PRESENTATION: This study reports a new case of an infected perirenal pancreatic pseudocyst mimicking a left kidney abscess in a 46-year-old North African patient with history of recurrent acute pancreatitis, who presented with left lumbar region pain and fever. Computed tomography revealed a left perirenal collection that turned out to be an infected pancreatic pseudocyst, The diagnostic was first suspected based on the medical history of the patient and confirmed by biochemical examination detecting a high level of pancreatic enzymes in the computed tomography-guided percutaneous drainage fluid. The patient evolved well after early resuscitation, rapid and effective antibiotic therapy, and computed tomography-guided percutaneous drainage of renal collection. CONCLUSION: Pancreatic pseudocyst is an uncommon disorder, which may present at a complicated stage and that must be considered in patients with a history of pancreatitis.

Bladder colloid carcinoma: A case report.

Non-urothelial bladder cancers are rare. We report the case of a 72-year-old who consulted for terminal hematuria evolving for three months. Computed Tomography scan showed a tumor of the anterior wall of the bladder. The patient underwent a transurethral resection of the bladder tumor. The histological examination of the tumor showed a bladder colloid carcinoma. The extension evaluation showed pulmonary and bone metastases. The patient received chemotherapy.

Traumatic renal injury revealing a horseshoe kidney: A case report.

Having a kidney disease is a major risk factor of renal injury during blunt traumas. We present a case of abdominal blunt trauma due to motor-vehicle accident in a 48 year old male patient. Abdominal computed tomography scan showed a high-volume retroperitoneal hematoma with rupture in the isthmus of the horseshoe kidney with active contrast-enhanced extravasation. He underwent a partial nephrectomy of the left lower pole.

How a laparoscopy for ovarian cyst causes anuria?

Considering the proximity of the lower urinary tract to gynecologic organs, several iatrogenic injuries of the bladder or ureters can occur. We report the case of 25 year old woman who suffered from bilateral ureteral injury causing renal failure following a laparoscopic detorsion of the left ovarian cyst.Double J stents were placed for 2 months with a favorable post operative course.CTscan results after 2 months of urinary drainage showed normal kidneys with no ureteral dilatation nor contrast medium extravasation. Urinary tract injuries are rare in gynecologic laparoscopy but these lesions are associated with high morbidity.

Predictive factors of bladder tumor recurrence after radical treatment of upper urinary tract cancer.

INTRODUCTION: The main problem after Radical Nephroureterectomy (RNU) for localized non-metastatic upper urinary tract urothelial cancer (NM-UUT-UC) is bladder recurrence. AIM: To identify factors of bladder recurrence of localized NM-UUT-UC after radical treatment. METHODS: It is an analytical and observational study that was conducted in the department of urology of La Rabta Hospital in Tunis. We collected the data of patients diagnosed with localized NM-UUT-UC who had RNU between 2005 and 2019. RESULTS: The mean age of the 73 eligible patients was 68 years (±11). The sex ratio was 5/2. Macroscopic hematuria was the revealing clinical sign in 66% of patients, while low back pain was the most frequent sign in 88% of patients. The most frequent tumor stage was pT1 in 20 patients while 32% of them had a pT2-T3 stage. Bladder recurrence was reported in 22% of patients with a median time of nine months [4-27] and extremes of three and 69 months. Factors of bladder recurrence in the univariate analysis were smoking, tumor localization in the ureter and the extravesical excision of the intramural ureter and bladder cuff. On multivariate analysis, the only independent predictor of bladder tumor recurrence was ureteral location (OR=3.65; CI95%=[1.02-13.1] ; p=0.047). CONCLUSION: Tumor localization in the ureter was an independent predictor of bladder recurrence after radical treatment for localized NM-UUT-UC.

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.

Functional outcomes of surgical treatment of varicocele in infertile men: Comparison of three techniques.

Introduction: Among identified causes of male infertility, varicocele holds an important place and is significantly associated with sperm quality deterioration. Surgical management of this condition leads to an improvement in the sperm count and an increase in the spontaneous pregnancy rate. Objective: The goal of this study was to compare different surgical techniques in terms of morbidity and fertility results. Patients and methods: It is a retrospective study of interesting patients followed for infertility related to varicocele between January 2007 and December 2015. Three surgical techniques were compared: open inguinal surgery, antegrade sclerotherapy, and laparoscopy. Morbidity and pregnancy rate were assessed according to different techniques. Results: Post-operative complication rates were comparable (p = 0,94) between the 3 surgical techniques. An amelioration of sperm parameters has been noted in all operated patients, without statistical difference between the three techniques (p = 0,29 for the sperm concentration and p = 0,49 for the progressive mobility). Spontaneous pregnancy was better (p = 0,03) for patients who have had a varicocelectomy in a sub-inguinal way. Conclusion: All of the three surgical techniques used in this study showed an improvement of sperm parameters in an equal way with similar morbidity. However, the spontaneous pregnancy rate with open surgery was better.

Adult bladder rhabdomyosarcoma: A case report.

Rhabdomyosarcomas (RMS) are mesenchymal tumors that develop at the expense of striated muscle fibers. It accounts for 6% of childhood malignancies. Rhabdomyosarcomas of the genitourinary tract also occur in children but are distinctly uncommon in adults. We report a case of bladder rhabdomyosarcoma in a 72-year-old patient who presented with gross hematuria and discuss difficulties of diagnosis and treatment.