[Renal stab wounds: about 20 cases]. / Plaies rénales par arme blanche: à propos de 20 cas.

OBJECTIVE: To assess the indication for operative and nonoperative management of renal stab wounds in patients hospitalised over the last six years. PATIENTS AND METHODS: Retrospectively studied of 20 cases over the last six years with penetrating kidney trauma, managed in two urologic departments of Marrakech and Casablanca. We studied the signs on admission (haematuria, blood pressure, haemoglobin and serum creatinine), associated lesions, treatment and complications. The imaging procedures comprised abdomen ultrasonography and abdomen computed tomography scan (CT). RESULTS: The mean age was 25-year-old (range: 14-50 years), macroscopic hematuria was present in 95%. The weapon introduction site was the left lumbar fossa in 15 cases, the right lumbar fossa in four cases and the left flank in one case. Six patients (30%) presented with haemodynamic instability. Anaemia (<10g/dl) was found in 14 cases (70%) and blood transfusion was necessary in eight cases (40%). According to the American Association of Trauma Surgery (AATS) classification of kidney trauma, our patients were classified as follows: Grade I (two cases), Grade II (four cases), Grade III (six cases), Grade IV (five cases) and Grade V (three cases). The conservative management was adopted for 15 patients (75%), and two patients had a double pigtel ureteric stent for an important leakage of the contrast product. A CT scan was systematically performed ten days after the trauma and the kidney traumas lesions were often stabilized. Nephrectomy was performed for 5 patients (25%) grade IV (two cases) and grade V (three cases). The patients were discharged after a mean period of 12 days (six to 33 days). CONCLUSION: The development of interventional radiology, endourological drainage techniques and medical intensive care helps to limit the complications and to manage conservatively with a correct resuscitation for selected patient. A grade V is a surgical indication.

[Combined inguinal hernia repair and transurethral resection of the prostate (TURP) for benign prostatic hypertrophy]. / Cure de hernie inguinale et résection transurétrale de l'adénome de prostate en un seul temps opératoire.

OBJECTIVE: Our aim was to evaluate the outcome of transurethral resection of prostate (TURP) and inguinal hernia repair performed in a single session. METHODS: Data was obtained retrospectively for 31 patients (mean age 65 years) who underwent simultaneous TURP and inguinal hernia repair. Most patients had lower urinary tract symptoms related to BPH such as acute urinary retention, recurrent bladder retention, or severe dysuria. Twenty-one patients had simple inguinal hernia and ten had large inguinoscrotal hernia. Operations were performed in 23 patients under spinal anesthesia. Bassini's operation was the most common herniorrhaphy technique (23 patients). RESULTS: We observed good outcomes in 86% of the patients. The morbidity rate was 10.7%, the mean postoperative stay was 3.6 days (2-6 days). There was no recurrence of inguinal hernia. CONCLUSION: Combining TURP and inguinal hernia repair in one session decreases the number of procedures and anesthesias, hospital stay, and thus direct health costs and does not result in an increase in operative or postoperative morbidity.