[Retroprostatic cyst draining ejaculatory ducts with secondary obstructive azoospermia]. / Kyste rétroprostatique drainant les canaux éjaculateurs avec azoospermie obstructive secondaire.

Obstructive azoospermia constitutes 35 to 40% of azoospermia. Etiologies may be acquired or rarely congenital. Congenital utricular or Mullerian duct cyst may result in compression of ejaculatory ducts. However, they must be differentiated from exceptional wolffian or urogenital cysts, which are located at the same site but in which ejaculatory ducts may drain inside. We report a case of retroprostatic duct cyst diagnosed during work up of male infertility where magnetic resonance imaging (MRI) showed the drainage of both ejaculatory ducts inside and the presence of a thin canal ended blindly in the wall of prostatic urethra. Transurethral resection guided by MRI has been performed resulting in urethral drainage of the cyst, relieving of obstruction and normalization of spermogramm.

[Malakoplakia involving kidney, both ureters and bladder: a case report and review of the literature]. / Malakoplakie rénale, urétérale bilatérale et vésicale : à propos d'un cas et revue de la littérature.

Malakoplakia is an unusual chronic inflammation characterized macroscopically by pseudotumoral lesions and histologically by the presence of "Michaelis-Gutman" bodies in macrophages. It affects principally the urinary tract and is probably secondary to an unusual macrophagic reaction to recurrent urinary tract infections. If the bladder is the most frequent site of occurrence, the ureters can very rarely be affected resulting in urinary tract obstruction. We presented here a unique presentation of renal, bilateral ureteral and bladder malakoplakia.

[Gadolinium digital cavography with ultrasound guidance in renal failure: report of 2 cases]. / Cavographie au gadolinium avec écho-guidage dans l'insuffisance rénale: à propos de 2 cas.

Iodine-induced renal failure is a major concern when considering angiography in patients with renal insufficiency. Previous studies have shown that gadolinium can perform well as a radiographic contrast agent and is not nephrotoxic at doses < or = 0.4 mmol/kg. We report high-quality images of the inferior vena cava, obtained by digital subtracted venography using power-injected gadodiamide through the common femoral vein. This technique, in combination with ultrasound, appears as a good alternative for insertion of vena cava filters in patients with renal failure or those with prior episodes of contrast induced renal failure or allergy.

Systemic cytokine response to hepatic resections under total vascular exclusion.

OBJECTIVE: To investigate the systemic cytokine response to major liver surgery as the basis for assessing potential new treatments. DESIGN: Open prospective study. SETTING: University hospital, UK. SUBJECTS: Thirteen patients undergoing elective hepatic resections that involved total vascular exclusion of the liver. INTERVENTIONS: Blood samples were taken preoperatively, during the operation, and during the first four postoperative days. Concentrations of endotoxin, interferon gamma (IFN-gamma), tumour necrosis factor alpha (TNFalpha), interleukin-1 (IL-1), and interleukin-6 (IL-6) were measured. RESULTS: Endotoxin concentrations were raised in 3/13 patients before operation and in 6 patients during the postoperative period. TNFalpha concentrations were undetectable. IFN-gamma and IL-1 responses followed a low and inconclusive pattern. IL-6 was significantly increased from 6 hours after operation to the third postoperative day, peaking at 699 (+/-277) pg/ml at 24 hours (p < 0.01). The two patients who died had the highest postoperative concentrations of IL-6. CONCLUSIONS: There is a pronounced systemic response to hepatic resection under total vascular exclusion that is reflected by the increase in IL-6 concentration and correlates with the operative blood loss and postoperative outcome. This might be used as an indicator of the response to specific treatments in this type of surgery. Treatments that minimise the IL-6 response to major hepatic resection may be of value.

Mycotic aneurysms of the carotid artery: ligation vs. reconstruction--case report and review of the literature.

Mycotic aneurysms of the extracranial carotid artery are very uncommon, with only twenty-nine cases reported in the medical literature. This is a report of a mycotic aneurysm of the common carotid artery caused by septic cervical lymphadenopathy. A review of the literature is presented in an attempt to elucidate which surgical approach is superior, ligation or repair of the carotid artery.