Penoscrotal elephantiasis: A severe form of genital lymphedema.

Penoscrotal lymphedema is a manifestation of disrupted lymphatic drainage, causing a significant increase in scrotal volume. impacting both aesthetics and quality of life. Elephantiasis, classified as stage III by the International Society of Lymphology, represents the advanced stage of scrotal lymphedema, often linked to parasitic diseases. The diagnosis is clinical, and the treatment involves mass excision. The lymphatic reconstruction is an innovative therapeutic approach that improves postoperative results and better quality of life. In this case report, we present the case of massive genital elephantiasis managed surgically, and we will focus on surgical techniques and reconstructive approaches.

Scrotal gunshot injury: A case report.

Incidence of firearm injuries generally and scrotal injuries specifically varies between regions and countries. Patients admitted to the emergency department for gunshot wounds to external genitalia require a thorough assessment. We report the case of a 33-year-old patient who was shot in the thigh and scrotum resulting in a unilateral orchidectomy. In this article, we detail key elements of care for this type of injuries.

Sarcomatoid carcinoma of the urinary bladder: analysis of five cases and literature review.

Sarcomatoid carcinomas of the bladder represent a tiny part of bladder tumors and are characterized by a high potential for malignancy. Very aggressive and affecting mainly men, these tumors present both a urothelial and sarcomatoid contingent. The treatment of these tumors is not well codified given the rarity of cases reported in the literature, however, it seems that the treatment is essentially based on radical cystectomy with extensive pelvic lymph node dissection. We report the experience of our departement in the management of this type of tumor in a series of five cases collected over a period of 8 years.

Management of the Uncommon Bladder Cancers: A Single-Center Experience over 10 Years.

BACKGROUND: Under the name of uncommon bladder cancers are gathered rare histological entities which represent less than 5% of bladder tumors. There is not a clear and consensual therapeutic management for these entities. PURPOSE: To review a single-institution 10-year experience with rare form of bladder cancers detailing the diagnosis, treatment, and patient outcome. MATERIALS AND METHODS: We performed a retrospective review of 27 medical records of rare bladder cancer form treated at our center between February 2006 and February 2015. The clinicopathologic features are reported with emphasis on treatment and survival. RESULTS: Mean patient age was 65.5 ± 20 yr and 70% of patients were males. Smoking background was found in 16 cases, chronic bladder irritation factors were found in 12 cases, and past urinary tract infection was found in 11 cases. The main symptom was total hematuria (93%) causing an anemia in 16 cases. The two mean histological forms were epidermoid carcinoma (37%) and adenocarcinoma (22%). 26% of patients were found to have extended invasive tumors (T4) at diagnosis. Metastatic disease was confirmed in 8 cases. Our patients were managed by a wide range of therapeutic modalities as total cystectomy with bilateral lymph node dissection (63%), palliative chemotherapy (30%), or concomitant radiochemotherapy (7%). 55.6% of patients were alive one year after diagnosis. Epidermoid carcinoma has the best prognosis followed by leiomyosarcoma and sarcomatoid carcinoma. Neuroendocrine carcinoma has the worst outcome. The overall 5-year survival rate is 33.3%. CONCLUSION: The rarity and small size of these tumors justify the absence of clear and consensual therapeutic management. No role of total cystectomy concerning the conclusions could be drawn but elements suggest this may be the treatment of choice. The highly aggressive nature of those lesions justifies an aggressive and fast therapy when feasible which gives the best outcomes.

Pathogenesis, Diagnosis, and Management of Splenogonadal Fusion: A Literature Review.

INTRODUCTION: Splenogonadal fusion is a rare congenital anomaly, defined by the presence of ectopic splenic tissue caused by an abnormal connection between the spleen and the gonad or mesonephrotic derivatives during the embryonic period. MATERIALS AND METHODS: By reporting an observational case and performing a review of the literature according to the CARE guidelines (using the PubMed database and guidelines from urology, general surgery, and pediatric learned societies), we present the embryological genesis of the splenogonadal fusion, the associated anatomical anomalies, and the diagnostic procedure. Observation. We report the case of a patient aged 45, with no notable history, reporting left testicular pain. A small nodule on the upper pole of the left testicular was clinically palpable. Tumor markers were normal, and scrotal ultrasound depicted a hypoechoic hypervascular nodule measuring 8∗6∗8 mm. After validation in a multidisciplinary oncology consultation meeting and opinion from a uro-andrologist expert, the patient underwent an inguinal lumpectomy with an extemporaneous examination which did not objectify any signs of malignancy. Ultimately, it is a normal spleen tissue in the testicular ectopic position. Discussion. Splenogonadal fusion corresponds to a rare congenital malformation; less than 200 cases have been published in the literature, most often affecting boys, with a sex ratio of 15/1. Two types are described, depending on the continuity of the link between the orthotopic spleen and the gonad: the continuous and discontinuous forms. In a third of the cases, there are associated congenital malformations and particularly in the continuous forms (44 to 50% of the cases): anomalies of the limbs, micrognathia, microgyria, and hepatic and digestive abnormalities. Cryptorchidism is associated with the continuous form in 31% of cases. The preoperative diagnosis remains difficult because of its morphological and clinical characteristics suggesting a tumor process.

Pauci-symptomatic disseminated tuberculosis revealed by an increase in the specific antigen of the prostate.

Tuberculosis remains a leading cause of morbidity and mortality in developing countries, including my country. It usually affects the lungs, but it can also affect other parts of the body. Its prostatic location is very rare, described for the first time by Jasmin in 1882. The diagnosis of certainty requires positive cultures, Ziehl - Nielsen staining, PCR and/or histological examination. Therapeutically, antituberculous chemotherapy has radically transformed the management of tuberculosis, and is currently the basis of treatment for this condition. We report an original observation of pauci-symptomatic disseminated tuberculosis revealed by an increase in the prostate specific antigen (PSA).

Early post-traumatic renal vascular hypertension a rare complication of severe renal trauma.

Severe renal trauma is a particular entity, although rare, but most often involves the risk of short-term death from hemorrhagic shock and long-term death from infectious complications or secondary renal dysfunction, exceptionally post-renal vascular hypertension. Which is generally a late complication, we will report the case of a patient suffering from grade v renal trauma with early post-traumatic renal vascular hypertension, suppressed by medical treatment, then the surgical indication was kept in the second phase in front of a mute kidney.

Microcystic urothelial carcinoma of the bladder: A case report.

Microcystic variant of urothelial carcinoma was recently added to the World Health organization classification of transitional cell carcinoma. This variant is characterized by its aggressiveness explaining the low long-term survival rate of the patients. Larger studies are needed to determine the adequate treatment course. We present the case of a 71-year-old patient who was diagnosed with muscle invasive microcystic variant of urothelial carcinoma of the bladder and remained free of tumor recurrence two year after surgery.

Multiples deep abscesses: A rare complications of bricker ileal conduit urinary diversion after bilateral stenosis of the uretero-ileal anastomosis.

The most common complications of ileal conduit can be linked to bowel function, uretero-ileal anastomosis, complications related to cutaneous stoma itself and infections in general. It is often suspected upon the discovery of obstructive kidney failure. The management of stenosis of the uretero-ileal anastomosis is delicate requiring first, an attempt by endourological maneuvers for the benefit of less morbidity, while raising that a tumor recurrence is possible specially if it's performed in a tumor context. We report an original observation of a bilateral ureteral stenosis of uretero-ileal anastomosis revealed by an obstructive anuria five years after a radical cystectomy.

[Primitive adenocarcinoma of the bladder: about 6 cases]. / Adénocarcinome primitif de la vessie: à propos de 6 cas.

Primitive adenocarcinoma of the bladder is a rare form of bladder tumor accounting for less than 2% of bladder cancers. It mostly affects male sex, with a sex ratio of 3/1 and an average age of onset between 60 years and 70 years. Clinical manifestation is non-specific and dominated by haematuria. Endoscopic resection of the bladder with anatomo-pathological examination allows the diagnosis. Treatment of primitive adenocarcinoma of the bladder is controversial due to the rarity of cases reported in the literature. However, the treatment of choice seems to be radical cystectomy with extended lymphadenectomy. We report a series of 6 cases of adenocarcinoma treated and followed-up in our hospital. Our analysis is based on the evaluation of the epidemiological, clinical, pathological and therapeutic features of adenocarcinoma of the bladder as well as on the study of the evolutionary features and prognostic factors.

A rare complication of the AMS Advance™ male sling system for the treatment of stress urinary incontinence: A case report.

Radical prostatectomy is the most common reason for male stress urinary incontinence. It affects around 10% of operated patients and can have a major impact on the quality of life of patients and affect various daily activities. There is still insecurity about its therapeutic management. We report the case of a 72-year-old patient, who underwent a radical prostatectomy 10 years ago, complicated by moderate post-operative urinary incontinence motivating the placement of an Advance sub-urethral sling, who presents for dysuria with micturition burns, the urethral fibroscopy objectify the presence of an erosion of the urethra by the sling under urethral.

[Squamous cell carcinoma of the bladder: a retrospective study conducted in a Moroccan University Hospital and literature review]. / Carcinome épidermoïde de la vessie: expérience rétrospective dans un hôpital universitaire marocain et revue de la littérature.

Squamous cell carcinoma of the bladder is a rare form of bladder tumor, accounting for less than 5% of bladder cancers. Sex ratio is balanced and the black population is more affected by this disease. It manifests with non-specific clinical symptoms and it is dominated by haematuria. Diagnosis is based on endoscopic resection of the bladder with anatomopathological examination. Treatment remains controversial because of the rarity of cases reported in the literature. However, radical cystectomy with extensive lymph node dissection is the treatment of choice. We here report a series of 10 cases of squamous cell carcinoma treated and followed up in our department. Our study highlights the epidemiological, clinical, anatomopathological, therapeutic and evolutionary features of squamous cell carcinoma as well as its prognostic factors.