[Bladder exstrophy with adenocarcinoma in an adult patient: a case report]. / Adénocarcinome sur une exstrophie de vessie chez un patient adulte: à propos d'un cas.

Bladder exstrophy is rare malformation pathology with an incidence of about 1 in 50,000 newborns. Not treated in time exposes to two main complications: kidney failure and bladder plaque cancer with a risk up to 200 times normal, which usually occurs around the fourth and fifth decade. In 95% it is adenocarcinoma and 5% squamous cell carcinoma. We present a rare case of adenocarcinoma developed on a bladder exstrophy in a 61-year-old patient who underwent an excision of the bladder plate carrying the whole tumor mass with a non-continent urinary diversion type bricker.

Cause rare d'insuffisance rénale aigue: géant calcul de vessie chez une jeune femme: A rare cause of acute renal failure: giant urinary bladder stone in a young woman.

Giant urinary bladder stone is defined as a stone with a weight higher than 100 g. It is rare in women, accounting for approximately 2%. Its occurrence in the urinary bladder does not exceed 5% of the whole of the urinary tract. In women, the occurrence of urinary bladder stone is often secondary to a predisposing factor including intravesical foreign body, neurogenic bladder, repeated urinary infections, a history of surgery treating stress urinary incontinence. Therefore, there are some patients with a bladder stones without any obvious cause, such as primary idiopathic stone. We here report the case of a 31-year old patient with giant urinary bladder stone affecting the superior part of the urinary tract causing acute renal failure. The patient initially underwent bilateral nephrostomies to drain the superior part of the urinary tract; then giant urinary bladder stone was removed by open cystolithotomy. Etiological assessment didn't show any obvious cause.

Applicability and outcome of laparoscopic adrenalectomy for large tumours.

Laparoscopic adrenalectomy has been shown to be as safe and effective as conventional open surgery for small and benign adrenal lesions. With increasing experience with laparoscopic adrenalectomy, this approach has become the procedure of choice for the majority of patients requiring adrenalectomy. In our department, from 2011 to 2016, a total of 28 patients with 31 adrenal tumours underwent laparoscopic adrenalectomy regardless of tumour size. Our policy in the department is to exclude adrenal tumours that are potentially malignant or metastatic adrenal tumours for laparoscopic resection. In this a retrospective study, we divided patients into two groups according to tumour size: < 5 or ≥ 5 cm, which was considered as the definition of large adrenal tumours. We compared demographic data and per- and postoperative outcomes. There was no statistical difference between the two groups for per-operative complications (16,6% vs 18,75% , P = 0.71), postoperative complications (16,6% vs 18,75% , P = 0.71), postoperative length of hospital stay (5 vs 8 days P = 0.40), mortality (0% vs 0%) or oncologic outcomes: recurrence and metastasis (8.3% vs 6.25% P = 0.70). The only statistical difference was the operating time, at a mean (SD) 194 (60) vs 237 (71) min (P = 0.039) and the conversion rate (0% vs 12.5% P < 0.01). Laparoscopic adrenalectomy can be done for all patients with adrenal tumours regardless of tumour size, even it needs more time for large tumour but appears to be safe and feasible when performed by experienced surgeons.

[Urinary incontinence revealing vescicouterine fistula: about a case]. / Incontinence urinaire révélant une fistule vésico-utérine: à propos d'un cas.

Vescicouterine fistula (VUF) is a rare lesion accounting for only 4% of all urogenital fistulas. It is most often secondary to cesarean section and forms a connection between the bladder and the uterus. We report the case of a young patient with VUF secondary to cesarean section. This study aims to investigate the clinical and therapeutic features of this disorder.