Isolated hydatic cyst of seminal vesicle: A new case.

We present a rare case of a hydatid cyst involving the seminal vesicle of a 39-year-old man. Left lumbar pain was the initial symptom. CT-scan and MRI revealed a retro vesical cystic mass arising from the seminal vesicle. Surgical excision of the lesion was carried leaving the seminal vesicle preserved. Histopathological report was hydatid cyst of the seminal vesicle. No recurrence has been found after a 1-year follow-up.

A rare case of acute urinary retention in a woman caused by primary retro vesical hydatid cyst.

Hydatid disease is a parasitic infestation that is endemic in many sheep and cattle-raising geographic areas including Mediterranean countries. Primary retro vesical hydatid cyst is a very rare entity. It can be revealed by urinary and gynecological signs. We reported a case of a retro vesical hydatid cyst in a 67-years old woman revealed by an acute urinary retention.

Lower urinary tract symptoms in rheumatoid arthritis and spondyloarthritis male patients versus controls.

Background. We aimed to evaluate the severity of lower urinary tract symptoms (LUTS) in rheumatoid arthritis (RA) and spondyloarthritis (SpA) male patient versus control, then to determine the relation of LUTS with rheumatic diseases (RD) characteristics and with erectile dysfunction (ED).Methods. We conducted a cross-sectional case control study including 50 men with RA or SpA and 50 healthy controls. LUTS were evaluated by the International Prostate Symptom Score (IPSS). LUTS bother was evaluated by the Quality of life (QoL) score, which ranges from 0 to 6. LUTS bother was considered if QoL score exceeded 2. Moreover, erectile function was assessed by the International Index of Erectile Function-5 (IIEF5) (ED if score < 21).Results. LUTS were significantly more severe in RD patients than controls (p = 0.03). However, there was no difference between the two groups in LUTS bother (QoL) (p = 0.2). Comparing RA and SpA showed no difference as to the severity of LUTS or effect of bother on QoL (p = 0.13, p = 0.5). The prevalence of ED in RD patients was not significantly higher than controls (80% versus 70%; p = 0.2).There were also no differences either between RA and SpA groups (p = 0.74).The severity of LUTS for patients with RD (RA and SpA) was significantly associated with age (p = 0.001), age at disease onset (p = 0.002) and ED (p = 0.008).Conclusion. According to our study, men with RD seem to be exposed to more severe LUTS than controls. Also, the severity of LUTS was associated with ED, age of patients and the age of disease onset.

Double Retroperitoneal Hydatid Localization: A Case Report

The hydatid cyst is a parasitic pathology which is endemic in Tunisia and presents a public health problem. Hydatid cysts located in the retroperitoneum, especially around or in the kidney, are rare and only represent 5% of visceral locations. The kidney is the most commonly affected organ of the urinary tract. The psoas muscle is an uncommon location and not less than 70 cases have been cited. We report the case of an unusual presentation of a right kidney hydatid cyst associated with a psoas muscle location. To our knowledge, this association of double retroperitoneal location has not been reported in the literature.

Does BCG protect against SARS-CoV-2 infection ?: elements of proof.

BackgroundThere are several factors explaining the difference in the spread of SARS-CoV-2 infection including the BCG vaccination. This fact is supported by the concept of beneficial non specific effect of this live vaccine associated to its interaction with the immune system. Our study aims to identify the correlation between the universal BCG vaccination policy and the mortality attributed to COVID-19. MethodsWe conducted an epidemiological study in which we collected COVID-19 pandemic data of April 11th, 2020 from the web site worldometers.info. The exclusion criteria for our study were a number of inhabitants less than one million, low-income countries according to the World Bank classification, a total number of infection cases less than 500 and countries that have performed less than one hundred tests per million inhabitants. ResultsCountries that never had universal BCG vaccination policy have a higher mortality (correlated to performed diagnostic tests) attributed to SARS-CoV-2 infection (p<0.001). We found that the year of introduction of vaccination influenced significantly the mortality. Countries that started immunization policy before 1960 had more favorable results (p=0.049). For countries that started the BCG vaccination after 1960, countries with current policies have lower mortality attributed to SARS-CoV-2 infection than countries that have stopped immunization (p=0.047). ConclusionsCountries that have a BCG vaccination policy have a lower mortality attributed to SARS-CoV-2 infection. The populations of countries that applied this immunization before 1960 are more protected even if this universal policy has been interrupted.

A case report of prostate cancer presenting as a symptomatic pelvic mass mimicking lymphoma.

INTRODUCTION: Metastatic prostate cancer is a relatively common condition in elderly men. The aim of this paper is to report a rare case of metastatic prostate cancer presenting as a large pelvic mass mimicking lymphoma and to discuss its management. PRESENTATION OF CASE: An 85-year-old patient was complaining of lower urinary tract symptoms, and significant pelvic swelling. On physical examination, a 15-cm pelvic mass and lumpy prostate were found. Laboratory investigations revealed elevated PSA levels (PSA=300g/mL). CT scan showed a large lobulated necrotic pelvic mass and multiple swollen lymphnodes. The diagnosis of an atypical pelvic lymphoma associated with a metastatic prostate cancer was first evoked. An ultrasonography-guided biopsy of the mass was carried. The immunohistochemical study confirmed prostate adenocarcinoma. A bilateral orchiectomy was performed. A follow up of 3 months showed a decrease of PSA without shrinkage of the mass. DISCUSSION: A metastatic prostate cancer presenting as a compressive pelvic mass mimicking other diagnosis such as lymphomas, is a rare circumstance of discovery. In our case, atypical pelvic lymphoma was evoked based on the association of multiple retroperitoneal enlarged lymphnodes. Histological findings of the biopsy rectified the diagnosis and confirmed prostate adenocarcinoma. The main treatment for such metastatic prostate cancers remains hormone therapy. Some authors reported external beam radiotherapy in order to reduce prostate volume. CONCLUSION: Prostate cancer should be considered in the assessment of large pelvic masses. Digital rectal examination and testing PSA levels can lead to the diagnosis. After histological confirmation, the androgen deprivation is the main treatment.

[Local anesthesia in transrectal ultrasound-guided prostate biopsy: apical periprostatic nerve block versus endorectal lidocaine gel. A randomized controlled trial of 100 patients]. / L'anesthésie locale pour les biopsies prostatiques echoguidées: blocage nerveux périprostatique au niveau de l'apex versus gel de lidocaine intrarectal. Etude randomisée sur 100 malades.

BACKGROUND: Intrarectal lidocaine application and apical periprostatic nerve block are a safe technique that significantly reduces pain during transrectal prostate biopsy. AIM: We compare prospectively the effectiveness of intrarectal lidocaine gel versus periprostatic lidocaine injection during transrectal ultrasound -guided prostate biopsy. METHODS: From June 2005 to February 2006, 100 consecutive patients underwent prostatic biopsies. Patients were randomized to receive 10 cc of 2% lidocaine gel in endorectally (Group I), 10 cc of 1% lidocaine solution injected into the prostate apex to induce bilateral periprostatic nerve block (Group II), or intrarectal 10 cc of ultrasound gel as placebo (Groupe III). Pain was evaluated by a 10-point linear visual analogue pain scale (VAS), and a 5-point digital visual scale (DVS). The side effects of the drugs and complications were also evaluated. RESULTS: The three groups counted respectively: 33, 33 and 34 patients and were statically comparable as the age, prostate volume, PSA level and the number of biopsies. The mean pain score on the VAS was respectively 4,1;4,6 and 3,5 for the three groups. The DVS score was 2,5; 2,8 and 2,15 (p < 0.001). Pain scores were significantly lower in Group 3 and equivalent between Groups 1 and 2. There is no difference in complication rate between the three groups. CONCLUSION: Compared to intrarectal lidocaine application, apical periprostatic nerve block is a safe technique that significantly reduces pain during transrectal prostate biopsy, with no increase in the complication rate.

[Bladder neck sclerosis after surgical or transurethral resection of the prostate: a report of 40 cases]. / La sclerose secondaire du col vesical apres traitement chirurgical ou endoscopique de l'hypertrophie benigne de la prostate: a propos de 40 cas.

AIM: To describe diagnostic and therapeutic particularity of complication through a sample of 40 patients. METHODS: We collected 40 cases of secondary bladder neck sclerosis after surgical or endoscopic treatment for patients with benign hypertrophic prostate. Mean age was 71.5 years. RESULTS: This complication followed a prostate resection trought bladder in 52% it a urethral resection in 48%. Mean follow up of to observe this complication was 46.5 months. All patients had obstructive urinary signs revealed by clinical examination and, showing blader distension in 15 patients. Treatment was based on resection of sclerosis lesions in 27 patients, and incision of sclerosis tissues in 13 patients. After mean follow up of 32 months, 11 patients had recurrence of bladder neck sclerosis treated endoscopically. three patients had several endoscopic treatment followed by urinary incontinence. CONCLUSION: secondary sclerosis of bladder neck is a rare late complication of benign hypertrophic prostate surgery. It was very because of recurrence. Treatment needs endoscopic procedures.