Multiple unusual locations of hydatid cysts including bladder, psoas muscle and liver.

Our case concerns 66-year-old female with a multiple unusual locations of hydatid cysts including bladder, psoas muscle and liver. Coexistence of hydatid cysts in these localizations has not been previously reported. The diagnosis of vesical hydatid cyst was facilitated by the coexistence of other echinococcosis locations. Treatment consists of the excision of the cysts in the same session without any postoperative anthelmintic drugs. In a two-year follow-up no recurrence has occurred.

[Place of endoscopic treatment of complicated ureteroceles in adults]. / Place du traitement endoscopique des urétérocèles compliquées de l'adulte.

INTRODUCTION: Ureterocele is a congenital malformation that is rarely diagnosed in adults. Treatment is indicated for complicated or symptomatic forms, but has not been clearly standardized. The objective of this study was to evaluate the results of endoscopic meatotomy according to the Rodriguez technique. MATERIAL AND METHOD: Retrospective study of 26 adult patients with ureterocele treated between Jan uarv 1987 and December 2004. RESULTS: The mean age of this population was 41 years and the sex ratio was 1.7/3. Thirty-two intravesical ureteroceles were diagnosed, six of which were bilateral. Eighteen ureteroceles were complicated by in situ stones, nine were complicated by moderate proximal dilatation and three presented both complications. Two ureteroceles were asymptomatic and uncomplicated, justifying conservative management. Endoscopic treatment was performed in 30 cases and consisted of a curved meatotomy with concomitant treatment of stones, when present. No operative incidents were recorded and the postoperative course was uneventful. Clinical and radiological improvement was obtained in 23 of the patients reviewed. Two of the 12 patients assessed by retrograde cystourethrography presented grade I vesicoureteric relux that had resolved at 6 months. No case of meatal stenosis was observed. CONCLUSION: Endoscopic meatotomy appears to be the treatment of choice for complicated or symptomatic ureterocele in adults. It is a minimally invasive, easy, reproducible and effective technique.

Recurrent obstructions after resonance stent placement in the treatment of ureteral compression from malignant disease.

BACKGROUND: The Resonance ureteral stent is a newly developed all-metallic double-pigtail ureteral stent allowing a palliative diversion on a patient with malignant ureteral obstruction. AIM: To define selection criteria of good candidates for Resonance stent. CASE: A 62-year-old woman was admitted to the emergency department with complaining of severe right flank pain and anuria. Twelve days earlier, we had placed retrogradely a ureteral metallic Resonance stent (Resonance; Cook Ireland Ltd,Limerick, Ireland) for the treatment of a ureteral compression from pelvic recurrence of an appendical colloid mucosal carcinoma in a solitary functioning right kidney. A percutaneous nephrostomy catheter was placed, and an antegrade nephrostogram demonstrated complete distal ureter obstruction. The patency of the ureteral stent was restored spontaneously and then, nephrostomy catheter was removed. Two weeks later, she presented with obstructed ureteral stent. Percutaneous nephrostomy was performed and Resonance stent was removed definitively. Ureteroscopy with biopsy confirmed the tumour extension into the ureteral lumen. CONCLUSION: The risk of subsequent obstruction after Resonance metallic ureteral stent placement is real. Patients with intra-ureteral tumour extension are presumably not good candidates for Resonance stent management.