Quality of life in men after total cystoprostatectomy: Perceptions of Tunisian patients.

INTRODUCTION: Total cystoprostatectomy (TCP) causes many changes in the postoperative quality of life leading to psychological, physical, social and sexual repercussions that are difficult to manage. This study aims to describe the postoperative quality of life of elderly Tunisian men who had a TCP as a result of a bladder cancer. METHODS: A descriptive quantitative study was conducted with 40 cystoprostatectomized men. Data collection tools were the Stoma-quality of life (QOL) questionnaire of Prieto, Thorsen, and Juul (2005) translated and validated to the Arabic language, and the Arabic version of the International Index of Erectile Function (IIEF5) questionnaire validated by Shamloul, Ghanem and Abou-Zeid (2004). RESULTS: 77.5% of participants had a very low quality-of-life score. All dimensions of quality of life-body image, physical, psychological, family and social life, and sexuality-were affected. In addition, all participants have suffered from severe sexual impotence after surgery. CONCLUSION: Counselling pre and postoperatively needed to facilitate the postoperative transition and ensure a better quality of life related to the health of men with bladder cancer.

Factors affecting the outcome of ureteroscopy in the management of ureteral stones in children.

PURPOSE: To identify the factors involved in failure and post-operative complications of retrograde rigid ureteroscopy (URS) in the treatment of ureteric stones in children. METHODS: This is a retrospective study, including 33 children who underwent 34 rigid URS (one case bilateral) for obstructive ureteric stones over a period of 10 years. Patient age, sex, presenting symptoms, stone size and location, operative technique, surgical outcomes and complications were recorded. Ureteroscopy was done in a manner similar to that in adults. Statistical analysis was performed using the Mann-Whitney U, the Chi-square or Fisher's exact test. RESULTS: There were 33 children (22 girls and 11 boys) with a mean age of 10.8 years (range 4-16 years) presenting 34 stones. The site of stones was pelvic in 24 cases (70.5%), iliac in 2 cases (6%) and lumbar in 8 cases (23.5%). The mean size of stones was 10.9 mm (5-22 mm). The success rate was 91%. There were no intraoperative complications. Post-operative complications rate was 21%. Factors associated with failure were size, localization of the stone, and delay of surgery. Factors associated with post-operative complications were size of the stone and operative time. CONCLUSION: The rigid URS in children is a reliable and effective treatment option in the management of ureteric stones. Favorable factors for success of the procedure are pelvic stone and stone size <10 mm.

Bilateral renal infarction following atrial fibrillation and thromboembolism and presenting as acute abdominal pain: a case report.

INTRODUCTION: Renal infarct is rare and often misdiagnosed because the symptoms are misleading. The mechanisms are various, mainly thrombotic and embolic. CASE PRESENTATION: In this review, we report the case of a 61-year-old Tunisian woman presented to the emergency unit with a 4-hour history of abdominal pain diffused at both flanks, ultrasounds was performed to remove a surgical emergency, showed a peri-renal fluid collection with heterogeneous parenchyma.We followed by a CT scan, which confirmed the diagnosis of renal infarct. The patient was treated by heparin at a curative dose, and the outcome was favorable. CONCLUSION: Diagnosis is difficult and should be considered in patients with inexplicable flank or abdominal pain and with risk factors to this disease. Our purpose is to raise clinician's awareness for this condition so that they will be more likely to diagnose it. This will facilitate prompt diagnosis and treatment.A review of the literature was performed and the case is discussed in the context of the current knowledge of this condition.

An acute urinary retention in an old man caused by a giant Müllerian duct cyst: a case report.

Müllerian duct cysts result from an abnormality in regression of the Müllerian system. They may occasionally give rise to symptoms. We report an unusual case of acute urinary retention in an old man caused by a giant Müllerian duct cyst. A 77-year-old man presented with of acute urinary retention. After bladder drainage, digital rectal examination found a large soft supraprostatic mass. Transrectal ultrasound and computed tomography scans revealed a large multilocular retrovesical cystic mass. The patient underwent open surgical resection of the cyst. Histologically, the cystic lesion was lined with stratified cubocolumnar cells, consistent with a Müllerian duct cyst. Acute urinary retention in the elderly is not always related to prostatic diseases. Other causes, even congenital ones, may be involved.

Gastric metaplasia of posterior urethral polyp: a case report.

Congenital polyps of the posterior urethra are rare lesions, and have often been described in boys. The polyps are benign lesion usually lined by a transitional epithelium, but cases of squamous or intestinal metaplasia have been reported.We report a case of a 10 years old boy referred for hematuria and dysuria.The voiding cysto urethrogram revealed a filling defect in the posterior urethra. At cystourethroscopy, a polyp of the posterior urethra was found and resected transurethrally. Histological examination showed a polyp with a fibro muscular core covered by focal gastric metaplasia with fundic gland. To our knowledge this is the first reported case of gastric metaplasia of urethral polyp.

Eosinophilic cystitis induced by bacillus Calmette-Guerin (BCG) intravesical instillation.

Eosinophilic cystitis is a rare and uncommon inflammatory bladder disease, in which the pathophysiology is unclear; only a few cases of such disease induced by intravesical instillations have been described. We report a case of eosinophilic cystitis after intravesical bacillus Calmette-Guerin (BCG) instillation for nonmuscle-invasive transitional cell carcinoma of the bladder. To our knowledge, this report is the first case of eosinophilic cystitis induced by intravesical BCG therapy.