[Renal cell carcinoma mimicking a renal abscess]. / Carcinome rénal se présentant sous forme d'un abcès rénal.

With the development of modern imaging, incidental findings of renal neoplasia are increasingly frequent. However, renal cell carcinoma can also rarely present as an atypical form and can be confused with benign pathologies such as renal abscess or pyelonephritis. We present the case of a renal neoplasia largely mimicking a renal abscess.

Avec le développement de l'imagerie moderne, la découverte fortuite des néoplasies rénales est de plus en plus fréquente. Néanmoins, le carcinome rénal peut également rarement se présenter sous une forme atypique et peut alors être confondu avec des pathologies bénignes comme un abcès rénal ou une pyélonéphrite. Nous présentons le cas d'une néoplasie rénale se manifestant trompeusement sous la forme d'un abcès rénal.

[Favorable impact of left antegrade sclerotherapy of clinical left varicocele on spermogram]. / Impact de la sclérothérapie antégrade de varicocèle gauche clinique sur le spermogramme.

OBJECTIVES: Study the early postoperative course of sperm parameters after antegrade sclerotherapy (AS) of clinical left varicocele (CLV) in men consulting for infertility with sperm disruption, and to validate the efficacy and safety of treatment. MATERIALS AND METHODS: Monocentric retrospective observational study of men with CLV, consultant in medically assisted procreation center for primary or secondary infertility of the couple. All patients were operated by SA via scrotal approach. After clinical and ultrasound checks at 6 weeks, a control spermogram was performed at 3-6 months of surgery. The following parameters were analyzed: sperm count, motility, percent of normal form, and total number of motile sperm ("total motile sperm count" [TMSC]). RESULTS: The study involved 138 men (median age 33 years) with sperm alteration. All patients benefited from AS of their CLV. No Clavian complication > 1 was observed. Postoperative control demonstrated a significant improvement in all spermogram parameters, with a median progression of 40% of the count (55 vs 32×106), 80% of the concentration (20.3 vs 11.1×106/ml), 30% of the motility (34.7% vs 26.5%), 60% of the normal form percentage (4.0 vs 2.5%) and the 75% TMSC (41.5 vs 23%), 7×106) (p<0.005). CONCLUSIONS: SA is an effective and safe technique for treating CLV and improving sperm parameters fertility indicators. Our results suggest that this treatment may be recommended to infertile men with CLV in the management of infertility of the couple. LEVEL OF EVIDENCE: 3.

[How I TREAT... A RENAL COLIC]. / COMMENT JE TRAITE ... une colique néphrétique.

Renal colic (RC) represents nearly 2% of emergency department admissions. RC is defined by the occurrence of back pain which may radiate towards the abdomen and external genitals. In adults, the obstruction is caused by a urinary stone in 80% of cases. The 20 % of non-stone related RCs are due either to an intrinsic obstruction (pyeloureteral junction stenosis, ureteral tumor, ...) or an extrinsic compression (pelvic tumor, lymphadenopathy ...). In over 90% of cases, an RC does not require hospitalization and is treated with medication. In contrast, complicated renal colic (CRC) requires hospitalization with specialized care. Obstructive pyelonephritis (OPN) is a form of CRC and the diagnosis should be considered in a clinical presentation of "renal colic" with acute pyelonephritis. This is a true emergency requiring surgical drainage of the upper urinary tract upstream of the obstacle, as well as antibiotic therapy. It must be kept in mind that some clinical presentations may be atypical, especially in the elderly, which can delay the diagnosis and, thus, the management. The gold standard for diagnosis is CT urography.