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Este mes en... African Journal of Urology

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Este mes en... African Journal of Urology:

  • Hernie Inguinoscrotale de l’Uretère: Fait Clinique et Revue de la Littérature

    Résumé  
    la hernie intrascrotale de l’uretère est une situation rare, nous rapportons un cas clinique, compliqué d’hydronéphrose gauche chez un patient de 83ans, l’anomalie avait été reconnue en peropératoire.

    • Content Type Journal Article
    • Category Cas Clinique
    • Pages 108-110
    • DOI 10.1007/s12301-011-0020-4
    • Authors
      • Taher Ould Ismail, Services d’urologie, centre hospitalier de Meaux, rue Saint Fiacre, Meaux, France
      • S. Boukamel, Services d’urologie, centre hospitalier de Meaux, rue Saint Fiacre, Meaux, France
      • A. Benyoussef, Services d’urologie, centre hospitalier de Meaux, rue Saint Fiacre, Meaux, France
      • M. Haj Hamdi, Services d’urologie, centre hospitalier de Meaux, rue Saint Fiacre, Meaux, France
      • E. Chartier, Services d’urologie, centre hospitalier de Meaux, rue Saint Fiacre, Meaux, France
  • Range of urologic surgical procedures in two district tertiary care hospitals in Abuja, Nigeria

    Abstract
    Objectives  
    To assist the surgical workload and the spectrum of urological procedures performed by a single urologist in two tertiary referral hospitals in Abuja, Nigeria, between February 2007 and December 2008.
    Patients and methods  
    Data on patient demographics and urologic procedures performed were extracted from the clinical not and operating room registers of Asokoro District General Hospital and Wuse General Hospital, two tertiary referral health facilities in Abuja.
    Results  
    In total, 858 urologic surgical procedures were performed, of which 123 (14.3%) were emergency and 735 (85.7%) elective. Of the 858 patients, 852 (99.3%) were males and 6 (0.7%) were females, 657 (77.2%) were adults and 195 (23%) were children. The procedures were therapeutic in 736 (85.8%) and diagnostic in 122 patients (14.2%). Minimally invasive procedures were performed in only 30 (3.5%) of cases. The five most common procedures performed, accounting for 53.7% of the total, were difficult male urethral catheterization (186), herniorrhaphy (83), varicocoelectomy (68), exploration for acute scrotum (64) and transrectal prostate biopsy (60).
    Conclusion  
    A modest number of 858 urological procedures were performed in the period under review in two health facilities where specialist urologic surgery care had just been introduced. An unexplained observation was that female patients constituted a minute proportion (<1%) of the patients treated. The small proportion of minimally invasive procedures (3.5%) was due to the lack of instruments and consumables available for uroendoscopic surgery.

    • Content Type Journal Article
    • Category Original Article
    • Pages 92-96
    • DOI 10.1007/s12301-011-0017-z
    • Authors
      • Oseremen Aisuodionoe-Shadrach, Department of Surgery, College of Health Sciences, University of Abuja, Abuja, Nigeria
  • Sclerosing PEComa: A histologic surprise

    Abstract  
    PEComa represents a group of mesenchymal tumors consisting of perivascular epithelioid cells. We present a 50-year old female patient with a rare distinctive variant, sclerosing PEComa, characterized by extensive stromal hyalinization and a predilection for the pararenal retroperitoneum.

    • Content Type Journal Article
    • Category Case Report
    • Pages 97-100
    • DOI 10.1007/s12301-011-0018-y
    • Authors
      • Manna Valiathan, Kasturba Medical College and Hospital, Manipal University, Manipal, India
      • B. P. Sunil, Kasturba Medical College and Hospital, Manipal University, Manipal, India
      • L. Rao, Kasturba Medical College and Hospital, Manipal University, Manipal, India
      • V. Geetha, Kasturba Medical College and Hospital, Manipal University, Manipal, India
      • P. Hedge, Kasturba Medical College and Hospital, Manipal University, Manipal, India
  • Prostate cancer screening, detection and treatment practices, among Sub-Saharan African urologists

    Abstract
    Introduction  
    Prostate cancer is reported to be the leading cancer in men in Sub-Saharan Africa (SSA) and the number of prostate cancer deaths is expected to double in the next 20 years. Despite the importance of this public health issue in SSA, there remains relatively limited information about practices related to prostate cancer treatment in this population.
    Objective  
    We conducted a survey of 28 urology practices in SSA to evaluate the scope of available screening, detection and treatment.
    Materials and Methods  
    Screening was more commonly reported as a part of general medical care in South Africa (SA) compared with East or West (EW) Africa. However, use of digital Rectal Examination (DRE) and Prostate Specific Antigen (PSA) were used at similar rates for screening in all locations. Screening is primarily focused in men over age 50 and those with symptoms. Routine screening was the primary reason for screening use in SA, while symptoms were the primary reason for screening use in EW. Financial and cultural barriers to screening were more commonly reported in EW than SA. Similar detection approaches were used in all regions, with free PSA and PSA velocity being more commonly used in SA than EW. Six core biopsies were more commonly used in EW and 12 core biopsies were more common in SA. Trans urethral ultrasounds and bone scans were more commonly used in SA than EW. Treatment options were similar in all regions, with brachytherapy less likely to be used in EW than SA.
    Results  
    The descriptive data suggest that differences in patterns of screening, detection and treatment exist across Africa. Differences by geography may also reflect differences in SES and racial composition of the populations in each region.

    • Content Type Journal Article
    • Category Original Article
    • Pages 85-91
    • DOI 10.1007/s12301-011-0016-0
    • Authors
      • Timothy R. Rebbeck, Center for Clinical Epidemiology and Biostatistics and Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA
      • C. M. Zeigler-Johnson, Center for Clinical Epidemiology and Biostatistics and Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA
      • C. F. Heyns, Tygerberg Hospital and University of Stellenbosch, Cape Town, South Africa
      • S. M. Gueye, Hôpital Général de Grand Yoff and Université Cheikh Anta Diop de Dakar, Dakar, Senegal
  • Survival following kidney sparing management of upper urinary tract transitional cell carcinoma is adversely affected by prior history of bladder cancer

    Abstract
    Objective  
    To evaluate oncological outcomes of Kidney Sparing Surgery (KSS) for upper urinary tract transitional cell carcinoma (UUT-TCC).
    Patients and Methods  
    We performed a retrospective review of patients who underwent segmental ureterectomy or endoscopic treatment (percutaneous nephroscopy or retrograde ureteroscopy) for UUT-TCC between 1991 and 2006 at our institution. We evaluated recurrence-free and overall survival rates following KSS. There were 40 renal units in 38 patients. Three patients had bilateral synchronous disease. Mean patient age (±SD) was 69.8±12.3 years. Eighteen (47%) patients had a prior history of bladder TCC. Sixteen (40%) segmental ureterectomies and 24 (60%) endoscopic treatments were performed. Six (16%) patients received adjuvant BCG. Grade distribution was 24 (60%) low-grade, 12 (30%) high-grade and 4 (10%) Gx. The mean follow-up was 47 months.
    Results  
    Recurrence rate was 32.5%. The three and five-year recurrence-free survivals were 59.5% and 42.4%. Tumor location was predictive for recurrence (p<0.03). The three and five-year overall survivals were 91.6% and 79.8%. Predictive variables for overall survival were tumor grade (p<0.008) and stage (p<0.018) and previous history of bladder TCC. There was a statistically significant correlation (r= 0.3539) between tumor grade and stage (p= 0.027).
    Conclusions  
    KSS offers good oncological outcomes in selected patients with UUT-TCC. The tumor biology rather than the surgical approach dictates prognosis. Patients with higher stage and grade disease may be better served with a more aggressive treatment approach.

    • Content Type Journal Article
    • Category Original Article
    • Pages 72-78
    • DOI 10.1007/s12301-011-0014-2
    • Authors
      • S. M. Khaled, Department of Urology, Al-Azhar University, Cairo, Egypt
      • M. Laplante, McGill University Health Center, Montreal, QC, Canada
      • M. Elhilali
      • Assaad El-Hakim, McGill University Health Center, Montreal, QC, Canada
  • The treatment of complex urethral strictures using ventral onlay Buccal Mucosa Graft or ventral onlay penile Skin Island Flap urethroplasty: A prospective case series

    Abstract
    Objectives  
    To compare the outcome of free onlay Buccal Mucosa Graft (BMG) with onlay penile Skin Island Flap (SIF) urethroplasty in the treatment of complex urethral strictures.
    Patients and Methods  
    A prospective comparative study was conducted at the Universitas Academic Hospital in Bloemfontein, South Africa. Patients presenting with complex urethral strictures were allocated to receive either ventral onlay penile SIF urethroplasty or ventral onlay BMG urethroplasty. A complex urethral stricture was defined as a stricture length of more than 2.5 cm or previous failed procedures, including urethral dilatation, internal Optical Urethrotomy (OU) and urethroplasty. Successful treatment outcome or cure was defined as no further treatment of the urethral stricture required after urethroplasty. Statistical analysis was performed with the t-test or chi-square test as appropriate.
    Results  
    BMG and SIF urethroplasty were performed on 18 and 17 patients, respectively. The mean age of the patients was 49.1 years (range 21–77) for the SIF group and 44.3 years (range 27–73) for the BMG group (p= 0.28). The mean urethral stricture length in the BMG group was 2.9 cm (range 2.4–4.0) and 4.5 cm (range 2.4–7.0) in the SIF group (p= 0.002). The urethral stricture site was bulbar in 67% in the BMG group and 59% in the SIF group. The cure rate was 11/17 (64.7%) for the SIF group and 13/18 (72.2%) for the BMG group (p= 0.63).
    Conclusions  
    No statistically significant difference in outcome between BMG and SIF urethroplasty was observed. However, given the longer operation time and more extensive surgical dissection of SIF reported in other studies, we recommend onlay BMG urethroplasty for the treatment of complex strictures.

    • Content Type Journal Article
    • Category Original Article
    • Pages 79-84
    • DOI 10.1007/s12301-011-0015-1
    • Authors
      • Freddie Claassen, Department of Urology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
      • S. Wentzel, Department of Urology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
  • Angiomyolipome Rénal et Sclérose Tubéreuse de Bourneville: Revue de la Littérature à Propos de Deux Cas.

    Résumé
    Objectif  
    La sclérose tubéreuse de Bourneville est une affection héréditaire caractérisée par le développement de tumeurs bénignes à type d’hamartomes au niveau de la peau, du rein, du cou, du cerveau et de l’oeil. Le but de rapporter nos deux observations est de rappeler les différentes caractéristiques de cette pathologie.
    Observations  
    Nous rapportons deux cas de sclérose tubéreuse de Bourneville avec manifestation rénale. Il s’agit de deux jeunes patients suivis pour sclérose tubéreuse de Bourneville et chez qui l’atteinte rénale sous forme d’angiomyolipome est venue corroborer le diagnostic.
    Discussion  
    L’atteinte rénale doit être dépistée systématiquement chez les patients ayant une sclérose tubéreuse de Bourneville. A côté des kystes corticaux et de l’angiomyolipome bénins, la malignité n’est pas exclue soulignant l’intérêt de la biopsie rénale devant le doute.

    • Content Type Journal Article
    • Category Cas Clinique
    • Pages 101-107
    • DOI 10.1007/s12301-011-0019-x
    • Authors
      • Omar Ghoundale, Service d’urologie, Hôpital Militaire Avicenne, Marrakech, Maroc
      • N. Hjira, Service de dermatologie, Hôpital Militaire Avicenne, Marrakech, Maroc
      • Y. Erregragui, Service de dermatologie, Hôpital Militaire Avicenne, Marrakech, Maroc
      • D. Touiti, Service d’urologie, Hôpital Militaire Avicenne, Marrakech, Maroc
  • Comparison of pelvic plexus blockade to other conventional techniques of analgesia in transrectal ultrasound guided prostate biopsy

    Abstract
    Objectives  
    To compare the degree of pain, efficacy and safety of pelvic plexus block to other conventional techniques of analgesia in 12 core transrectal ultrasound guided biopsy of prostate.
    Materials and Methods  
    The study included 160 consecutive cases of prostate biopsy, prospectively randomized into four groups of 40 each -Men in group 1 (control arm) received lignocaine gel (2%) only; Group 2 received lignocaine gel with basal periprostatic nerve block (BPNB) with 2% lignocaine; Group 3 received lignocaine gel (2%) with apical periprostatic block (APNB) with 2% lignocaine and Group 4 received lignocaine gel with pelvic plexus block. Pain was recorded on a 10 point visual analogue scale by a nurse.
    Results  
    Patients in pelvic plexus block group had lowest pain score (1.25±0.43) while lignocaine injection than BPNB (1.53±0.45) and APNB (1.58±0.50, P value = 0.008). The mean pain score among 4 groups while taking the biopsy cores were 4.85, 2.67, 2.48 and 1.95, respectively. Patients who received pelvic plexus block experienced least pain than BPNB and APNB groups (p value 0.001 and 0.002, respectively). Perineal pain persisted longer in pelvic plexus block group than apical and periprostatic groups. Duration of dysuria was less in pelvic plexus nerve block group. Hematuria and rectal bleed complications were comparable in all groups.
    Conclusion  
    Prostate biopsy should be performed with either periprostatic nerve block (basal or apical) or pelvic plexus block under Doppler ultrasonography guidance. Pelvic plexus block provides superior analgesia to basal and apical periprostatic block.

    • Content Type Journal Article
    • Category Original Article
    • Pages 48-55
    • DOI 10.1007/s12301-011-0010-6
    • Authors
      • Shailesh Chandra Sahay, Department of Urology, All India Institute of Medical Sciences, New Delhi, India 110029
      • N. Gupta, Academic and Research, Urology, Medanta-The Medicity, Gurgaon Delhi NCR, Haryana, New Delhi, India
      • P. Singh, Department of Urology, All India Institute of Medical Sciences, New Delhi, India 110029
  • Paratesticular liposarcoma: What is the best therapeutic strategy?

    Abstract
    Introduction  
    Liposarcomas are neoplasms of mesodermal origin derived from adipose tissue and correspond to 10–14% of all soft tissue sarcomas. Paratesticular liposarcoma is very rare.
    Case report  
    We report a 60-year old man who presented with a left testicular tumor 20 cm in diameter. Initial incisional biopsy was reported as fibromatosis. Chest and abdominal CT scan did not show distant metastases. Through an inguinal incision orchidectomy with homolateral inguinal node dissection was performed. Histopathological examination showed a paratesticular myxoid liposarcoma. Adjuvant radiotherapy without chemotherapy was administered. The patient remains well at 11 months followup, with no evidence of recurrence.
    Conclusion  
    Complete surgical extirpation reduces the risk of local recurrence. Neoadjuvant chemotherapy or radiotherapy may reduce the tumor size, thus facilitating complete excision.

    • Content Type Journal Article
    • Category Case Report
    • Pages 56-58
    • DOI 10.1007/s12301-011-0011-5
    • Authors
      • Amin Makni, Department of General Surgery (A), La Rabta Hospital, Tunis, Tunisia
      • W. Rebai, Department of General Surgery (A), La Rabta Hospital, Tunis, Tunisia
      • H. Azzouz, Department of Anatomopathology, La Rabta Hospital, Tunis, Tunisia
      • Y. Nouira, Department of Urology, La Rabta Hospital, Tunis, Tunisia
      • H. Magherbi, Department of General Surgery (A), La Rabta Hospital, Tunis, Tunisia
      • M. Jouini, Department of General Surgery (A), La Rabta Hospital, Tunis, Tunisia
      • M. Kacem, Department of General Surgery (A), La Rabta Hospital, Tunis, Tunisia
      • Z. Ben Safta, Department of General Surgery (A), La Rabta Hospital, Tunis, Tunisia
  • L’urethrorraphie Terminoterminale Dans Le Traitement des Retrecissements de L’uretre Bulbaire et Membraneux

    Abstract
    Objectifs  
    Evaluer les résultats de d’urétrorraphie termino-terminale dans le traitement des sténoses de l’urètre bulbaire et membraneux à travers l’étude de la série de notre service et une revue récente de la littérature.
    Patients et méthodes  
    Il s’agit d’une étude rétrospective basée sur la revue des dossiers médicaux des patients ayant bénéficiés d’une Urétrorraphie Termino-Terminale (UTT) dans notre formation entre Février 2006 et Février 2010. La moyenne d’âge des patients était de 38, 3 ans. L’étiologie du rétrécissement urétral était infectieuse et traumatique respectivement dans 40 % et 60% des cas. Chez 68 % d’entre eux, le rétrécissement urétral était localisé au niveau bulbaire et chez 32 % au niveau membraneux. Tous les patients avaient une sténose unique inférieure à 2 cm à l’urétro-cystographie rétrograde et mictionnelle.
    Résultats  
    La durée moyenne de suivi était de 28 mois. Le taux de succès de l’urétrorraphie termino-terminale dans notre étude était de 88 %. 12% des patients avaient présenté une récidive de la sténose. Tow patients (8%) ayant une sténose bulbaire avaient rapporté des troubles éjaculatoires. Aucun de nos patients (0%) n’avait présenté ni dysfonction érectile ni incontinence suite à cette intervention.
    Conclusion  
    L’urétroplastie anastomotique termino-terminale permet des taux élevés de reperméabilisation urétrale après une première procédure. Le taux de récidive de la sténose reste faible comparativement aux autres techniques chirurgicales. Les troubles éjaculatoires peuvent être prévenus par une dissection minutieuse et une restitution anatomique des muscles bulbo-caverneux.

    • Content Type Journal Article
    • Category Article Original
    • Pages 66-71
    • DOI 10.1007/s12301-011-0013-3
    • Authors
      • Jalal Eddine El-Ammari, Service d’urologie, Centre Hospitalier Universitaire Hassan II, Fes, Maroc
      • O. El-Yazami, Service d’urologie, Centre Hospitalier Universitaire Hassan II, Fes, Maroc
      • M. El-Fassi, Service d’urologie, Centre Hospitalier Universitaire Hassan II, Fes, Maroc
      • M. Farih, Service d’urologie, Centre Hospitalier Universitaire Hassan II, Fes, Maroc
  • Prophylactic role of Boerhaavia diffusa in ethylene glycol induced calcium oxalate urolithiasis

    Abstract
    Introduction  
    Boerhaavia diffusa Linn. (Family: Nyctaginaceae) is a widely used plant in India and Brazil as a traditional medicine for treatment of urolithiasis and other urinary disorders.
    Objectives  
    The aim of this study was to evaluate the antiurolithic activity of Boerhaavia diffusa root aqueous extract (BDE) as prophylaxis for renal stones.
    Methods  
    In vitro calcium oxalate (CaOx) crystallization inhibitory effect of BDE was determined by measuring change in turbidity at 620nm on addition of sodium oxalate in the synthetic urine. In a rat model of urolithiasis, induced by adding 0.75% ethylene glycol (EG) in drinking water and effect of simultaneous treatment of BDE (100–200 mg/kg) was observed for 28 days.
    Results  
    BDE inhibited CaOx nucleation, aggregation and crystal formation in the synthetic urine in vitro on addition of NaOx. The lithogenic treatment caused polyuria, weight loss, hyperoxaluria and impairment of renal function which was prevented by BDE. Hyperoxaluria and CaOx crystal deposition in the renal tubules caused by EG intake was prevented by BDE treatment.
    Conclusion  
    This study indicates that the antiurolithic activity of Boerhaavia diffusa extract possibly mediated through inhibition of CaOx crystallization, diuresis and hypo-oxaluria may justify its prophylactic use in urolithiasis.

    • Content Type Journal Article
    • Category Original Article
    • Pages 28-36
    • DOI 10.1007/s12301-011-0007-1
    • Authors
      • Surendra K. Pareta, Department of Pharmaceutical Sciences, Birla Institute of Technology, Mesra, Ranchi 835215, India
      • K. C. Patra, S.L.T. Institute of Pharmaceutical Sciences, Guru Ghasidas University, Bilapur, 495009 India
      • P. M. Mazumder, Department of Pharmaceutical Sciences, Birla Institute of Technology, Mesra, Ranchi 835215, India
      • D. Sasmal, Department of Pharmaceutical Sciences, Birla Institute of Technology, Mesra, Ranchi 835215, India
  • Rectus fascia sling for the treatment of total urethral incontinence in males

    Abstract
    Objectives  
    Urinary incontinence in patients with neurological disease is a major health problem. A modified rectus fascial sling has been assessed in incontinent male patients.
    Patients and Methods  
    Fourteen adult male patients with total incontinence due to neurogenic or post-traumatic and etiology were included in this study. A rectangular rectus sheath flap was harvested and defatted.The flap was placed around the bulbar urethra and sutures were passed both in front of and behindthe pubic bone. Both sutures on each side were tied to each other over the pubic bone.
    Results  
    Of the 14 patients, 9 (64.3%) were completely dry, 3 (21.4%) reported improved continence, while 2 (14.3 %) were a failure. In total, 71.4% of the patients showed significant improvement using the Incontinence Quality of Life (IQoL) questionnaire. A significant decrease in the number of pads used per day of 61.3 % (p <0.05) was found and the mean abdominal leak point pressure significantly improved by 43.7 cm H2O (p <0.05).
    Conclusion  
    The technique is simple, safe and effective. It allows compression of the urethra against a bony structure, thus causing adequate and maintained closure of the bulbar urethra. It offers a comparable success rate to other sling techniques.

    • Content Type Journal Article
    • Category Original Article
    • Pages 43-47
    • DOI 10.1007/s12301-011-0009-z
    • Authors
      • M. Shoukry, Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
      • Mohamed E. Hassouna, Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
      • A. Abd El-Kerim, Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
      • S. El-Salmy, Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
  • Predicting the fragility of renal calculi in response to shock wave lithotripsy through their radiographic appearance

    Abstract
    Objectives  
    To evaluate the radiological characteristics of renal stones on plain X-ray film of the kidneys, ureters and bladder (KUB) area as predictors of stone fragility during shock wave lithotripsy (SWL).
    Patients and Methods  
    This prospective study included 336 patients who had a single renal pelvic stone ≤20 mm and were managed by SWL at 3 different centers. The patients were classified according to the radiological appearance of the stone on KUB film in terms of homogeneity, smoothness of the outline, and radiodensity in comparison to the last rib. The primary endpoint was the stone-free rate (SFR) within 3 months post-SWL. Multivariate regression analysis was used to compare the results.
    Results  
    The overall SFR was 71.43%. SFR was significantly higher in heterogeneous compared with homogenous stones (86% vs. 53%; p<0.01) and in rough compared with smooth surface calculi (77% vs. 61%, p<0.01). SFRs for stones with density less than, similar to or higher than that of the last rib were 82%, 69% and 56%, respectively (p<0.01). Multivariate analysis showed a positive proportional relationship between stone fragility (SWL outcome) and one or more favorable radiological criteria.
    Conclusion  
    The radiological characteristics of renal calculi could predict their fragility after SWL. Stones which were heterogeneous, rough, or less dense than the last rib on KUB film were more likely to disintegrate during SWL.

    • Content Type Journal Article
    • Category Original Article
    • Pages 37-42
    • DOI 10.1007/s12301-011-0008-0
    • Authors
      • Mohamed Ali Elkoushy, Department of Urology, Suez Canal University, Ismailia, Egypt
      • M. Nady, Department of Urology, Al-Azhar University, Assiut, Egypt
      • A. Abdel Hafez, Department of Urology, Sohag University, Sohag, Egypt
      • E. Salah, Department of Urology, Al-Azhar University, Assiut, Egypt
  • Prise en Charge du Priapisme Chez L’enfant, au Chu de Treichville

    Resume
    Objectif  
    Le but de cette étude est d’évaluer la prise en charge du priapisme dans notre service en vue de proposer une conduite á tenir á partir d’une revue de la littérature.
    Patients et méthodes  
    Il s’agit d’une étude rétrospective portant sur 7 dossiers de patients suivis pour priapisme dans le service de chirurgie pédiatrique du CHU de Treichville, de Janvier 2006 á Octobre 2010. Nous avons analysé: l’âge, les antecedents, le délai de prise en charge, l’étiologie, les aspects cliniques, le traitement, et l’évolution.
    Résultats  
    Il s’agissait de 7 enfants de race noire, de sexe masculin, âgés de 3 ans á 14 ans. Nous avons observé: un priapisme aigu chez 4 enfants (85.71%) drépanocytaires SSFA2, un priapisme intermittent chez 2 enfants hétérozygotes AS et 1 cas de priapisme intermittent idiopathique. Le priapisme aigu a été traité chirurgicalement par shunt caverno-balanique unilatérale sans excision d’albuginée selon le procédé de Falandry. Le priapisme intermittent a été traité par l’administration orale d’étiléfrine. Aprés la chirurgie, nous avons observé 3 bons résultats immédiats (75%) et 1 bon résultat 24 heures aprés. Aucune récidive ni aucun trouble de l’érection n’ont été observés aprés un recul moyen de 14 mois.
    Conclusion  
    Le priapisme est une complication fréquente de la drépanocytose qui doit être recherchée et traitée de façon concomitante. Nous préconisons l’injection intracaverneuse précoce d’étiléfrine suivie, en cas d’échec, par la chirurgie selon la technique de Al-gorhab mod Falandry. Des études doivent être effectuées le résultat á long terme, de cette technique, sur la fonction érectile. L’accent doit être mis sur la sensibilisation a de prévenir la survenue d’une impuissance sexuelle irréversible.

    • Content Type Journal Article
    • Category Article Original
    • Pages 59-65
    • DOI 10.1007/s12301-011-0012-4
    • Authors
      • K. R. Nandiolo-Anelone, Service de chirurgie pédiatrique du CHU de Treichville, Abidjan, Côte d’Ivoire
      • K. Djè, Service d’urologie du CHU de Bouaké, Bouaké, Côte d’Ivoire
      • S. R. Bankolé, Service de chirurgie pédiatrique du CHU de Treichville, Abidjan, Côte d’Ivoire
      • M. L. Mobiot, Service de chirurgie pédiatrique du CHU de Treichville, Abidjan, Côte d’Ivoire
  • Primary renal leiomyosarcoma: Case report and literature review

    Abstract  
    Primary leimyosarcoma of the kidney is extremely rare. The management is unclear due to the limited literature on the subject. The diagnosis should be considered when imaging shows a relatively hypovascular tumor involving one renal pole, with atypical features on microscopy. We report a renal leiomyosarcoma in a 68 year old man, who underwent right radical nephrectomy. A tumor-free surgical margin is the most important prognostic factor. Although various modalities of adjuvant treatment have been tried, the overall prognosis is poor as the tumor is highly aggressive.

    • Content Type Journal Article
    • Category Case Report
    • Pages 15-17
    • DOI 10.1007/s12301-011-0004-4
    • Authors
      • Gajanan S. Bhat, Department of Urology, Institute of Nephrourology, Bangalore, India
      • G. G. Nelivigi, Department of Urology, Institute of Nephrourology, Bangalore, India
      • M. Shivalingaiah, Department of Urology, Institute of Nephrourology, Bangalore, India
      • C. S. Ratkal, Department of Urology, Institute of Nephrourology, Bangalore, India
  • Localisation Intravésicale d’une Broche d’ostéosynthèse (A Propos D’un Cas)

    Resume  
    La variété de corps étrangers introduits dans l’appareil génitourinaire défie l’imagination et peut confronter l’urologue aux difficultés de leur extraction. Si leur présence relève souvent d’une pratique douteuse d’origine psychiatrique, il faut noter la possibilité d’une migration à partir des espaces perivésicaux lors d’une chirurgie de voisinage ainsi qu’une introduction accidentelle durant une intervention transvésicale.
    Les symptômes du bas appareil urinaire, non spécifiques, sont les circonstances fortuites de découverte de corps étrangers intravésicaux. Bien que le pronostic vital ne soit pas engagé, l’extraction chirurgicale ou endoscopique s’avère nécessaire du fait de l’inflammation sévère associée aux dommages vésicaux secondaires à ce corps étranger.
    Nous rapportons le cas d’un jeune patient admis aux urgences chez qui on trouve une broche d’ostéosynthèse compliquée d’une lithiase située dans la vessie.

    • Content Type Journal Article
    • Category Cas Clinique
    • Pages 24-27
    • DOI 10.1007/s12301-011-0006-2
    • Authors
      • Mohamed Makhloufi, Clinique urologique « B », CHU Ibn Sina, Rabat, Maroc
      • M. Lahyani, Clinique urologique « B », CHU Ibn Sina, Rabat, Maroc
      • T. Karmouni, Clinique urologique « B », CHU Ibn Sina, Rabat, Maroc
      • K. El Khader, Clinique urologique « B », CHU Ibn Sina, Rabat, Maroc
      • A. Koutani, Clinique urologique « B », CHU Ibn Sina, Rabat, Maroc
      • A. Ibnattya, Clinique urologique « B », CHU Ibn Sina, Rabat, Maroc
      • M. Hachimi, Clinique urologique « B », CHU Ibn Sina, Rabat, Maroc
  • Semiquantitative smoothelin expression in detection of muscle invasion in transurethral resection and cystectomy specimens in cases of urinary bladder carcinoma

    Abstract
    Objectives  
    To examine the usefulness of smoothelin — a new immunohistochemical (IHC) marker that is expressed predominantly in visceral smooth muscle — in recognizing muscularis propria (MP) in transurethral resection (TUR) and matched cystectomy specimens and to compare the pattern of its expression in muscularis mucosae (MM) and MP in radical cystectomy specimens.
    Methods  
    IHC staining for smoothelin was performed in 49 cases of urothelial carcinoma removed by radical cystectomy (16 had undergone TUR before the cystectomy).
    Results  
    In cystectomy specimens, smoothelin staining in the MP was strong (+3), moderate (+2) and weak (+1) in 49%, 44.9% and 6.1% of cases, respectively, whereas smoothelin positivity in the MM was absent and weak in 77.6% and 22.4% of cases, respectively. In TUR specimens, smoothelin immunoreactivity was moderate to strong in 68.8% and weak in 6.3% of cases and all of them proved to have MP invasion in cystectomy specimens.
    Conclusion  
    Smoothelin is a useful marker for the detection of MP in TUR specimens. Moderate to strong smoothelin staining of the muscles included in TUR specimens and split by the tumor is a sign of MP invasion. It may be useful in cancer staging and treatment decision making.

    • Content Type Journal Article
    • Category Original Article
    • Pages 6-10
    • DOI 10.1007/s12301-011-0002-6
    • Authors
      • A. Refaiy, Department of Pathology, Faculties of Medicine, Assiut, Egypt
      • E. Muhammad, Department of Pathology, Faculties of Medicine, Sohag Universities, Sohag, Egypt
      • Ehab O. ElGanainy, Department of Urology, Faculties of Medicine, Assiut, Egypt
  • Rolled vaginal wall flap for the treatment of stress urinary incontinence

    Abstract
    Objectives  
    Anterior vaginal wall slings (AVWS) have been used for decades in the treatment of female stress urinary incontinence (SUI). The main drawback of using the vaginal wall as a sling is its tendency to weaken and stretch over the course of years. The use of synthetic tapes for the treatment of SUI is effective but costly. For patients who cannot afford synthetic tapes, we describe the preliminary results of a modi and III.
    Patients and Methods  
    In this series, a modification of the AVWS was applied in 35 female patients with SUI. A fortified and rolled urethra. The vaginal mucosal surface of the across it. The flap is then rolled on itself with a running 2/0 vicryl suture. Two sutures attached to both ends are passed retropubically to the anterior abdominal wall and tied over the rectus sheath.
    Results  
    All 35 female patients had type II/III SUI. After a median follow up of 43 months, 91% of the patients were dry or used 0–1 pad per day. Only one patient suffered from transient retention for one week post-operatively.
    Conclusion  
    This is a simple method to reinforce vaginal wall effective option for the treatment of SUI in patients who can not afford synthetic tapes. Long-term follow up is required to evaluate the durability of the procedure.

    • Content Type Journal Article
    • Category Original Article
    • Pages 1-5
    • DOI 10.1007/s12301-011-0001-7
    • Authors
      • M. Shoukry, Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
      • Mohamed E. Hassouna, Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
      • A. AbdEl-Kerim, Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
      • S. El-Salmy, Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
  • Retrospective analysis of Mathieu’s urethroplasty for anterior hypospadias repair in circumcised children: A single center experience

    Abstract
    Introduction  
    Mathieu’s technique (peri-meatal based flap) makes use of the urethral plate in the repair of anterior hypospadias, thereby creating an almost natural neo-urethra. In a circumcised baby or after previous unsuccessful repair, Mathieu’s flap may be one of the few options left to repair anterior hypospadias.
    Objectives  
    To evaluate the result of Mathieu’s flap repair for anterior hypospadias in a resource poor setting.
    Materials and Method  
    This is a retrospective review of post-circumcision anterior hypospadias managed by Mathieu’s flap repair between January 1996 and December 2006 in the paediatric surgical unit of the Obafemi Awolowo University Teaching Hospital, a tertiary hospital in the South Western Nigeria.
    Results  
    Mathieu’s flap repair was performed in 16 patients with isolated anterior hypospadias; 15 (93.8%) were circumcised before presentation. The complications were urethrocutaneous fistula in 3 (18.8%), wound infection in 2 (12.5%) and flap necrosis in 1 patient (6.3%). Final outcome was satisfactory in all patients.
    Conclusion  
    Mathieu’s flap remains a viable option in the repair of anterior hypospadias even after circumcision.

    • Content Type Journal Article
    • Category Original Article
    • Pages 11-14
    • DOI 10.1007/s12301-011-0003-5
    • Authors
      • A. A. Salako, Department of Surgery and Community Health, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
      • A. O. Olajide, Department of Surgery and Community Health, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
      • A. O. Sowande, Department of Surgery and Community Health, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
      • F. O. Olajide, Department of Surgery and Community Health, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
  • Séminome Spermatocytaire: à Propos d’un Cas et Revue de La Littérature Spermatocytic Seminoma

    Resume  
    Le séminome spermatocytaire est une tumeur rare, représentant moins de 2% des cancers du testicule, survenant essentiellement chez le sujet âgé. Nous rapportons une nouvelle observation d’un patient âgé de 48 ans. La tumeur se présentait comme une prolifération de cellules en nappes compactes, avec 3 types cellulaires, des cellules de petite taille, des cellules intermédiaires et des grandes cellules. Il n’a été retrouvé ni contingent sarcomateux, ni séminome classique. L’analyse en immun histochimie n’a retrouvé aucune expression des cellules tumorales pour les anticorps classiques testés, notamment l’Ac anti PLAP et les marqueurs lymphoïdes. Le séminome spermatocytaire doit être reconnu, car son évolution est très favorable et ne nécessite qu’une simple orchidectomie, en l’absence d’un exceptionnel contingent sarcomateux ou de métastase où une chimiothérapie s’impose.

    • Content Type Journal Article
    • Category Cas Clinique
    • Pages 18-23
    • DOI 10.1007/s12301-011-0005-3
    • Authors
      • Benatiya Andaloussi Marwane, Service d’Urologie «A» CHU Ibn Sina, Institut National d’oncologie, Rabat, Maroc
      • G. Rais, Service d’oncologie médicale, Institut National d’oncologie, Rabat, Maroc
      • S. Raissouni, Service d’oncologie médicale, Institut National d’oncologie, Rabat, Maroc
      • A. Barki, Service d’Urologie «A» CHU Ibn Sina, Institut National d’oncologie, Rabat, Maroc
      • El sayegh, Service d’Urologie «A» CHU Ibn Sina, Institut National d’oncologie, Rabat, Maroc
      • A. Iken, Service d’Urologie «A» CHU Ibn Sina, Institut National d’oncologie, Rabat, Maroc
      • Y. Nouini, Service d’Urologie «A» CHU Ibn Sina, Institut National d’oncologie, Rabat, Maroc
      • A. Lachkar, Service d’Urologie «A» CHU Ibn Sina, Institut National d’oncologie, Rabat, Maroc
      • L. Benslimane, Service d’Urologie «A» CHU Ibn Sina, Institut National d’oncologie, Rabat, Maroc
      • H. Mrabti, Service d’Urologie «A» CHU Ibn Sina, Institut National d’oncologie, Rabat, Maroc
      • H. Errihani, Service d’oncologie médicale, Institut National d’oncologie, Rabat, Maroc
      • M. Faik, Service d’Urologie «A» CHU Ibn Sina, Institut National d’oncologie, Rabat, Maroc
  • Penile fracture from entrapment of an erect penis in the African bamboo bed: A case report

    Abstract  
    Penile fracture is an uncommon urological emergency where the tunica albuginea ruptures as a result of blunt trauma to the erect penis. An 18 year old rural patient presented with penile fracture, presumably from entrapment of his penis in the African bamboo bed during nocturnal penile tumescence. He was managed surgically and retained normal erections on follow-up. Using the African bamboo bed without a mattress may lead to penile entrapment and fracture. Key Words: Penis, fracture, African, bamboo, bed without a mattress may lead to penile entrapment and fracture.

    • Content Type Journal Article
    • Category Case Report
    • Pages 24-26
    • DOI 10.1007/s12301-010-0006-7
    • Authors
      • Obi Anselm, Urology Unit, Surgery Department, Federal Medical Centre, Abakaliki, Ebonyi State, Nigeria
      • O. Okechukwu, Urology Unit, Surgery Department, Federal Medical Centre, Abakaliki, Ebonyi State, Nigeria
  • Five years experience of ureterovaginal fistulae following obstetric or gynecological intervention in Ethiopia

    Abstract
    Objectives  
    To study the etiology, presentation and outcome of women presenting to the Addis Ababa Fistula Hospital with an ureterovaginal fistula.
    Patients and Methods  
    Women presenting with ureterovaginal fistulae following obstetric or gynecological intervention. The operating register from June 2004 to July 2009 was studied to identify women who had undergone ureteric re-implantation. Patient files were reviewed and only women with fistulae resulting from iatrogenic injury were included.
    Results  
    Ureterovaginal fistulae were found in 89 women, 64 after Caesarean section, of which 43 were for a stillborn baby, 12 women have uterine rupture, 6 with instrumental delivery and only 7 with abdominal hysterectomy. The left ureter was most frequently injured (54). The number of patients seen has doubled over the past two years. Using one of four methods of repair, 88 women were continent at discharge from hospital. One died from a suspected pulmonary embolism.
    Conclusion  
    The incidence of iatrogenic ureteric injury is increasing in Ethiopia and most result from Caesarean section. The reasons should be studied. Using a variety of repair techniques, all patients can be cured. However, surgeons undertaking this surgery should have a wide range of urological training.

    • Content Type Journal Article
    • Category Original Article
    • Pages 17-19
    • DOI 10.1007/s12301-010-0004-9
    • Authors
      • Gordon Williams, Addis Ababa Fistula Hospital, Addis Ababa, Ethiopia
      • S. Broughton, Addis Ababa Fistula Hospital, Addis Ababa, Ethiopia
      • H. Worku, Addis Ababa Fistula Hospital, Addis Ababa, Ethiopia
      • H. Tekle, Addis Ababa Fistula Hospital, Addis Ababa, Ethiopia
  • Le kyste hydatique du rein fistulisé dans les voies urinaires, prise en charge diagnostique et thérapeutique A propos de 14 cas

    Resume
    Objectif  
    l’hydatidose est une pathologie fréquente au Maroc et constitue un problème majeur de santé publique. La localisation rénale de cette parasitose est rare. Les formes s’accompagnant de plus d’une fistulisation dans les voies excrétrices présentent des particularités diagnostiques et thérapeutiques qui seront décrites dans cet article.
    Patients et méthodes  
    14 patients présentant un kyste hydatique du rein fistulisé dans la voie excrétrice urinaire ont été inclus dans l’étude de 2002 à 2008. Les variables étudiées ont été: l’âge moyen, les antécédents, la symptomatologie clinique, l’imagerie, le traitement et l’évolution.
    Résultats  
    L’âge moyen était de 38 ans (21–54). La douleur lombaire a été retrouvée chez tous les patients et l’hydaturie chez 8 patients. L’échographie réalisée chez tous les patients a montré 6 cas de kyste hydatique de type III et 8 cas de type IV selon la classification de GHARBI. L’uroscanner a confirmé la nature hydatique de la masse et deux cas de rein non fonctionnel. L’hydaturie et la dilatation des cavités excrétrices ont été les principaux éléments orientant vers le diagnostic. Le traitement a consisté en une résection du dôme saillant et la fermeture de la fistule chez 12 patients; huit d’entre eux ont eu une néphrostomie per-opératoire après cure de la fistule et deux patients une montée de sonde urétérale double crosse en pré-opératoire, les deux autres n’ont pas été drainés. Les deux patients restant ont eu une néphrectomie. Les suites ont été marquées par une fistule stercorale colique chez un patient et deux cas d’infection de paroi.
    Conclusion  
    Tout kyste hydatique du rein doit avoir un bilan d’imagerie comportant un uroscanner avec des clichés tardifs à la recherche d’une fistulisation dans la voie excrétrice urinaire. Il est conseillé de mettre en place une sonde urétérale en préopératoire à visée diagnostique et thérapeutique.

    • Content Type Journal Article
    • Category Article Original
    • Pages 27-32
    • DOI 10.1007/s12301-010-0007-6
    • Authors
      • Mellas Soufiane, Service d’Urologie, CHU Hassan II, Fès, Maroc
      • Ahssaini Mustapha, Service d’Urologie, CHU Hassan II, Fès, Maroc
      • Ahallal Youness, Service d’Urologie, CHU Hassan II, Fès, Maroc
      • Tazi Mohamed Fadl, Service d’Urologie, CHU Hassan II, Fès, Maroc
      • fassi Mohamed El Jamal, Service d’Urologie, CHU Hassan II, Fès, Maroc
      • Farih Moulay Hassan, Service d’Urologie, CHU Hassan II, Fès, Maroc
  • Tension-free vaginal tape versus transobturator tape for treatment of female stress urinary incontinence

    Abstract
    Objectives  
    The transobturator tape (TOT) is based on a similar principle as the tension-free vaginal tape (TVT), but introduced through the obturator foramen. The aim of this study was to compare these slings as surgical procedures for the treatment of stress urinary incontinence (SUI) in women.
    Patients and Methods  
    This is a retrospective case-control study including female patients with SUI, either due to urethral hypermobility or intrinsic sphincter deficiency. Thirty patients were treated with TVT (group 1) and 30 were treated with TOT (group 2). The parameters studied were: pre-operative clinical data, operative data and surgical outcome.
    Results  
    The post-operative complications in group 1 consisted of bladder perforation in one patient (3.3%), urinary retention in 3 (10%) and de novo urgency in 3 (10%). The post-operative complications in group 2 consisted of vaginal exposure in 2 patients (6.7%), de novo urgency in 2 (6.7%) and transient urinary retention in one (3.3%). In the TVT group, objective cure was achieved in 27/30 patients (90%), while 3 patients (10%) reported subjective cure; failure was not encountered. In the TOT group, objective cure was achieved in 24/30 patients (80%) and subjective cure in 4 patients (13.3%); and it failed in 2 patients (6.7%).
    Conclusion  
    TVT and TOT are effective procedures for the treatment of female SUI, with comparable results regarding operative time, hospital stay and the risk of complications.

    • Content Type Journal Article
    • Category Original Article
    • Pages 12-16
    • DOI 10.1007/s12301-010-0003-x
    • Authors
      • Ahmed M. El-Nashar, Urology Department, Suez Canal University, Ismailia, Egypt
      • A. H. Metwally, Urology Department, Suez Canal University, Ismailia, Egypt
      • H. A. Abdelwahab, Urology Department, Suez Canal University, Ismailia, Egypt
      • S. S. Fawaz, Family Medicine Department, Ministry of Health, Cairo, Egypt
  • Urinary retention in women: Causes and management

    Abstract
    Objectives  
    Urinary retention in women is uncommon and there are numerous etiological factors. Most reported studies are from Europe and North America, with few studies from developing countries. The aim of this study was to review the etiology of urinary retention in women referred to our institution, a public sector hospital serving a largely indigent population.
    Patients and Methods  
    We reviewed the clinical records of all patients admitted with urinary retention to the Urology wards in our hospital during the period September 1998 to June 2007. In total there were 589 patients with urinary retention, 558 (94.7%) men and 31 (5.3%) women.
    Results  
    The average age of the 31 women was 51.9 years (range 20 to 88 years). The underlying pathology was cervical carcinoma (4 patients), urethral carcinoma (4), transitional cell carcinoma of the bladder (3), eosinophilic cystitis (3), hematuria due to miscellaneous causes (3), antiincontinence surgery (2), cerebral palsy (2), multiple sclerosis (1 patient), diabetes mellitus (1), hypotonic detrusor (1), bladder stone (1), vaginal leiomyoma (1), cyclophosphamide cystitis (1), constipation (1), postpartum (1), blocked indwelling catheter and idiopathic (1). Renal dysfunction was present in 17 (55%) of the patients.
    Conclusion  
    The most common causes of urinary retention in women in this study were malignancy in 11 patients (36%) and neuropathic bladder dysfunction in 5 (16%). Eosinophilic cystitis, normally a rare condition, was diagnosed in 3 women (10%). The high incidence of malignancy in this study differs from other reported series, in which neuropathic bladder dysfunction was the most common cause of urinary retention in women.

    • Content Type Journal Article
    • Category Original Article
    • Pages 7-11
    • DOI 10.1007/s12301-010-0002-y
    • Authors
      • C. L. E. van der Walt, Urology Department, University of Stellenbosch and Tygerberg Hospital, Western Cape, South Africa
      • S. P. Jansen van Vuuren, Urology Department, University of Stellenbosch and Tygerberg Hospital, Western Cape, South Africa
      • C. F. Heyns, Urology Department, University of Stellenbosch and Tygerberg Hospital, Western Cape, South Africa
  • Tissue engineering in vesical reconstruction

    Abstract
    Objectives  
    This review summarizes the basic principles of tissue engineering (TE) and describes the possible future clinical application in bladder reconstruction.
    Material and Methods  
    This review is based on an electronic search of the PubMed database and recently published presentations between November 2008 and May 2009 about basic research on TE and vesical reconstruction.
    Results  
    Few articles (about 30) described bladder reconstruction utilizing TE approaches, most being reviews, with 8 experimental animals studies, and only one study in human subjects.
    Conclusion  
    Despite the fact that TE is a recently developed field and remains largely experimental, it promises to influence urological treatment in the near future. One can predict that some form of engineered urothelial tissue will enter the clinical domain within the next 5 to 10 years.

    • Content Type Journal Article
    • Category Review Article
    • Pages 1-6
    • DOI 10.1007/s12301-010-0001-z
    • Authors
      • Gamal Abdel Malek Morsi, Urology Department, Al-Azhar University, Assiut, Egypt
  • Renal artery aneurysm presenting with hematuria

    Abstract  
    Renal artery aneurysm is a relatively uncommon form of renovascular disease. Early diagnosis by appropriate imaging is essential in order to avoid emergency nephrectomy for rupture. We report a 78 year old man who presented with gross hematuria. Doppler ultrasound and CT showed aneurysm of the right renal artery. Because of hemodynamic instability, right nephrectomy was performed with a good outcome.

    • Content Type Journal Article
    • Category Case Report
    • Pages 20-23
    • DOI 10.1007/s12301-010-0005-8
    • Authors
      • Abdelmounaim Qarro, Urological Clinic, Military Hospital Mohamed the Fifth, Rabat, Morocco
      • M. Ghadouane, Urological Clinic, Military Hospital Mohamed the Fifth, Rabat, Morocco
      • Y. Elharrech, Urological Clinic, Military Hospital Mohamed the Fifth, Rabat, Morocco
      • R. Zaini, Urological Clinic, Military Hospital Mohamed the Fifth, Rabat, Morocco
      • A. Ameur, Urological Clinic, Military Hospital Mohamed the Fifth, Rabat, Morocco
      • M. Abbar, Urological Clinic, Military Hospital Mohamed the Fifth, Rabat, Morocco
  • Mucoid cyst of the penile skin: A rare entity

    Abstract  
    A 9-year old male patient was admitted to our clinic for circumcision. Physical examination revealed a mass in the prepuce. After excision of the mass, histopathological examination was consistent with a mucoid cyst of the penile skin, which has been rarely reported. Pathologists and clinicians dealing with genitourinary system pathology should be familiar with this rarely encountered entity.

    • Content Type Journal Article
    • Category Case Report
    • Pages 132-133
    • DOI 10.1007/s12301-010-0028-1
    • Authors
      • Tulin Yalta, Department of Pathology, School of Medicine, Trakya University, 22030 Edirne, Turkey
      • G. Kazındır, Department of Pathology, School of Medicine, Trakya University, 22030 Edirne, Turkey
      • F. Oz Puyan, Department of Pathology, School of Medicine, Trakya University, 22030 Edirne, Turkey
      • E. Tastekin, Department of Pathology, School of Medicine, Trakya University, 22030 Edirne, Turkey
      • U. Usta, Department of Pathology, School of Medicine, Trakya University, 22030 Edirne, Turkey
      • T. Ciftci, Department of Pathology, School of Medicine, Trakya University, 22030 Edirne, Turkey
      • A. Kutlu, Department of Pathology, School of Medicine, Trakya University, 22030 Edirne, Turkey
  • Cas clinique leiomyosarcome du rein: A propos d’un cas

    Resume  
    Le léiomyosarcome du rein est une tumeur rare. Les auteurs ont rapporté l’observation d’un homme âgé de 45 ans, chez lequel le diagnostic d’une tumeur rétropéritoénale gauche a été posé lors de l’exploration de douleurs du flanc gauche associées à une altération de l’état général et ce par l’imagerie (Echographie et scanner abdominal). La laparotomie exploratrice avait conclu à une tumeur rénale gauche localement évoluée, une néphrectomie élargie a été réalisée et l’histologie était en faveur d’un léiomyosarcome rénal. Une récidive locale a été diagnostiquée après un recul de 6 mois. Après une nouvelle laparotomie, l’abstention était de mise devant le caractère évolué de la récidive. Le but de cette observation est double. Le premier, est la nécessité de faire un diagnostic précoce, afin d’intervenir sur une tumeur de petite taille, plus accessible à la chirurgie. Le second, est de discuter la place du traitement adjuvant, qui pourrait réduire le risque de récidive précoce.

    • Content Type Journal Article
    • Category Cas Clinique
    • Pages 134-136
    • DOI 10.1007/s12301-010-0029-0
    • Authors
      • Amin Makni, Service de chirurgie générale A, hôpital La Rabta, Tunis, Tunisie
      • W. Rebai, Service de chirurgie générale A, hôpital La Rabta, Tunis, Tunisie
      • F. Chebbi, Service de chirurgie générale A, hôpital La Rabta, Tunis, Tunisie
      • A. Daghfous, Service de chirurgie générale A, hôpital La Rabta, Tunis, Tunisie
      • S. Ayadi, Service de chirurgie générale A, hôpital La Rabta, Tunis, Tunisie
      • Z. Ben Safta, Service de chirurgie générale A, hôpital La Rabta, Tunis, Tunisie
  • Urethral stricture and HIV: Unusual presentations and treatment challenge

    Abstract
    Objective  
    The clinico-pathologic features of urethral stricture in patients with HIV/AIDS are not yet clearly described in the literature. HIV/AIDS has changed the natural course and clinical features of most infectious diseases. We describe some of the features of post-inflammatory strictures associated with HIV Infection and assess the treatment challenges and outcomes of other causes of urethral stricture.
    Patients and Methods  
    Consecutive men with urethral stricture who presented to the University Hospital of Gondar, North-West Ethiopia were enrolled. The HIV status, cause of the stricture, type of treatment and outcome were recorded.
    Results  
    There were 25 post-traumatic and 15 post-gonococcal urethral strictures. All posttraumatic and 5 of the post-gonococcal urethral stricture patients were HIV negative. All 10 HIV positive patients had longer and denser urethral strictures than expected. The time between gonococcal infection and urethral stricture development was 3–5 years in HIV positive patients. The treatment of post-traumatic stricture included progressive perineal anastomotic urethroplasty and a good outcome was seen in more than 95%. However, the surgical treatment of patients with HIV infection was a challenge.
    Conclusion  
    If post-inflammatory urethral stricture occurs in a young man where the time between known gonococcal infection and development of stricture is short (less than 5 years), HIV coinfection is most likely. The stricture in these patients will be longer and denser and not amenable to conventional endoscopic urethrotomy.

    • Content Type Journal Article
    • Category Original Article
    • Pages 124-127
    • DOI 10.1007/s12301-010-0026-3
    • Authors
      • Gashaw Messele Getahun, Department of Surgery, Division of Urology, University of Gondar, Gondar, Ethiopia
      • D. Chane, Department of Surgery, University of Gondar, Gondar, Ethiopia
  • Synchronous primary tumors of the kidney and pancreas: Case report

    Abstract  
    The simultaneous presence of primary carcinomas in the same patient is uncommon and synchronous primary tumors involving the kidney and pancreas are extremely rare. There are a few reports in the English literature of synchronous primary malignancies of the kidney and pancreas. We present a 62-year-old man who had weight loss of 9 kg and epigastric pain. Findings showed a Furhman grade II renal papillary carcinoma confined to the kidney and a synchronous well differentiated pancreatic ductal adenocarcinoma.

    • Content Type Journal Article
    • Category Case Report
    • Pages 128-131
    • DOI 10.1007/s12301-010-0027-2
    • Authors
      • Taher Ould Ismail, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • A. Janane, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • F. Hajji, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • Y. Dekkak, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • S. Bekkali, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • J. Sossa, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • J. Chafiki, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • J. Eloundou, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • Y. Lahrech, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • O. Qamous, Department of Pathology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • A. Qarro, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • H. Jira, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • M. Ghadouane, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • A. Ameur, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • A. Albouzidi, Department of Pathology, Military Hospital for Instruction MEDV, Rabat, Morocco
      • M. Abbar, Department of Urology, Military Hospital for Instruction MEDV, Rabat, Morocco
  • Have we overtreated children with vesicoureteric reflux?

    Abstract  
    Urinary tract infections (UTI) are the most common serious bacterial infections in young children. These UTIs have a high association with vesicoureteric reflux (VUR). The pathophysiology of VUR’s renal sequelae, its investigation and management is presently undergoing a reassessment. This review documents these changes focusing on compelling new data. With regard to the need for and benefit of imaging procedures in children with UTIs we present an algorithm for investigation that is tailored to the African context. The value of continuous antibiotic prophylaxis is questioned and the role of injectable ureteric bulking is discussed with reference to the Swedish Reflux Trial.

    • Content Type Journal Article
    • Category Review Article
    • Pages 103-109
    • DOI 10.1007/s12301-010-0023-6
    • Authors
      • John Lazarus, Departments of Paediatric Urology, Red Cross Children’s Hospital, University of Cape Town, Cape Town, South Africa
  • The relationship between prostate volume, prostate-specific antigen and age in Saudi men with benign prostatic conditions

    Abstract
    Objectives  
    To assess the relationship between prostate volume (PV), prostate specific antigen (PSA) and age in a cohort of Saudi men from the Urology Department, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.
    Methods  
    Medical records of 447 Saudi men aged 20–89 years with benign prostatic conditions seen between January 2003 and June 2009, were reviewed, retrospectively. Cases with PSA >10 ng/ml, proven prostate cancer, previous prostate surgery or those who received 5-alpha reductase inhibitors (5-ARIs) were excluded. The study population was categorized into seven successive age groups (20–89 years). The variables of age, PV and PSA were examined. Using mean PV of the 20–29 years age group and mean PSA of the 40–49 years age group as reference points, percentage differences in mean PV and mean PSA in subsequent age groups were determined. A p-value <0.05 was considered significant. Findings in Saudi patients were compared to other ethnicities.
    Results  
    447 men were enrolled with mean age 64.2 years, mean PV 35.2 cc (range 7–184 cc) and mean PSA 2.2 ng/ml (range 0.18–10 ng/ml). Overall, 62% (277/447) had PV <30 cc and 8.7% (39/447) had PV ≥50 cc. Among individual age groups, most men had PV <30 cc, except the 70–79 years age group where 55.2% (53/96) had PV >30 cc. Percentage differences of PV and PSA in 80–89 years age group (+150% and +70%, respectively) were lower than in the 60–69 and 70–79 years age groups (+187% and +160%; +207.2% and +220% for PV and PSA, respectively). All variables demonstrated significant weak correlations; except PV and PSA which showed a significant positive relationship (p <0.0001; r=0.441).
    Conclusion  
    PV and PSA are significantly and strongly correlated. PV and PSA in Saudi men are closer to Asian than white ethnicities.

    • Content Type Journal Article
    • Category Original Article
    • Pages 117-123
    • DOI 10.1007/s12301-010-0025-4
    • Authors
      • H. A. Mosli, Department of Urology, King Abdul Aziz University Medical City, Jeddah, Saudi Arabia
      • Taha Abo-Almagd Abdel-Meguid, Department of Urology, El-Minia University, El-Minia, Egypt
  • Intravesical gemcitabine for treatment of superficial bladder cancer not responding to Bacillus Calmette-Guérin vaccine

    Abstract
    Objectives  
    Intravesical Bacillus Calmette-Guérin (BCG) vaccine is the mainstay of treatment and prophylaxis in superficial bladder cancer (SBC) as it reduces tumor recurrence and disease progression. About one-third of patients do not respond to BCG. The aim of this study was to determine the efficacy of intravesical gemcitabine in patients with BCG-refractory SBC.
    Methods  
    Twenty three patients with SBC; TaG3, T1G2-G3 or carcinoma in situ (CIS), refractory (after at least 2 courses of intravesical BCG) or intolerant to intravesical BCG therapy were included. Two weeks after complete tumor resection, patients received intravesical gemcitabine twice weekly at a dose of 2.000 mg/100 ml normal saline for 6 consecutive weeks. Two months after the last dose, recurrence-free patients underwent cystoscopy, urinary cytology and 6 random bladder biopsies. Thereafter, patients were evaluated by the same measures every 3 months, as long as there was no recurrence. Patients with complete response (negative cytology and random biopsies) at the first follow-up cystoscopy received a similar maintenance dose once weekly for another 6 weeks.
    Results  
    Twenty one patients completed the study: 15 males and 6 females with a mean age of 48.1 (38–72) years. The follow-up was 15 months (range 2–19 months). Thirteen (61.9%) patients were recurrence-free after a mean of 17 months. Superficial recurrences were detected in 6 (28.6%) patients and progression by stage in 2 patients (9.5%). During follow-up, 8 patients had tumor recurrences and 2 had progression to a higher stage. The median recurrence-free time was 14.7 months (5–19 months). The drug was well tolerated and side-effects were mild in all patients, except two: one had easily controlled hematuria and the other had leucopenia.
    Conclusion  
    In properly selected patients, gemcitabine seems to be a promising option in the management of high-risk BCG-refractory SBC, especially in those who refuse or are unfit for cystectomy. Long-term efficacy and the role of maintenance therapy have to be properly studied.

    • Content Type Journal Article
    • Category Original Article
    • Pages 110-116
    • DOI 10.1007/s12301-010-0024-5
    • Authors
      • Mohamed Ali Elkoushy, Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
  • Endoscopic resection of a prominent median lobe during TURP: a simple technique to avoid sub-trigonal resection

    Endoscopic resection of a prominent median lobe during TURP: a simple technique to avoid sub-trigonal resection

    • Content Type Journal Article
    • Category Point of Technique
    • Pages 93-94
    • DOI 10.1007/s12301-010-0020-9
    • Authors
      • Abd El-Wahid Attia, Department of Urology, Ahmed Maher Teaching Hospital, Cairo, Egypt
      • M. T. Abd Al-Hak, Department of Radiology, AL-Zahraa University Hospital, AL-Azhar University (Girls), Cairo, Egypt
  • Testicular biopsies of azoospermic men at the Lagos State University Teaching Hospital

    Abstract
    Objectives  
    This study was conducted to evaluate the histological findings from testicular biopsies in azoospermic men seen at the Lagos State University Teaching Hospital, Ikeja — Lagos, Nigeria.
    Patients and Methods  
    A retrospective study of testicular biopsies of azoospermic men who presented to our institution from 2005 to 2006 was performed. The patient’s age, type of infertility and histopathological diagnosis were evaluted. All biopsies were preserved in 10% formaldehyde solution.
    Results  
    Of the 51 azoospermic men (mean age 30 years, range 25–46 years) 25 (49.0%) had primary infertility, 11 (21.6%) had secondary infertility and 15 (29.0%) were not specified. Five (9.8%) patients had normal spermatogenesis. Abnormal histological parameters occurred in 46 (90.2%) patients: testicular atrophy in 30 (58.8%), maturation arrest in 14 (27.5%) and hypospermatogenesis in 2 (3.9%) patients.
    Conclusion  
    The presence of normal spermatogenesis in azoospermic men, which would suggest an obstructive lesion, is not common in our practice, in contrast to previous studies from our country. This may indicate a changing pattern in the aetiology of male infertility in our environment. Identification of the possible causes of testicular damage resulting in non-obstructive azoospermia in our environment may help to prevent male infertility.

    • Content Type Journal Article
    • Category Original Article
    • Pages 69-72
    • DOI 10.1007/s12301-010-0016-5
    • Authors
      • S. Odunayo Ikuerowo, Department of Surgery, Lagos State University Teaching Hospital, Ikeja - Lagos, Nigeria
      • M. C. Izegbu
      • A. S. Benebo, Department of Morbid Anatomy and Forensic Medicine, Lagos State University Teaching Hospital, Ikeja - Lagos, Nigeria
      • I. O. Fadeyibi, Department of Surgery, Lagos State University Teaching Hospital, Ikeja - Lagos, Nigeria
      • F. O. Omodele, Department of Surgery, Lagos State University Teaching Hospital, Ikeja - Lagos, Nigeria
  • An interesting neonatal abdominal mass

    Abstract  
    We present the case of a neonate who was born with an antenatal ultrasound diagnosis of a cystic abdominal mass of uncertain origin. The diagnosis of pelviureteric junction obstruction (PUJO) was obscured by difficulty determining the origin of the extremely large cystic abdominal mass. Sonographically, the kidneys appeared relatively normal, creating a diagnostic dilemma — the hydronephrosis was almost exclusively in an extrarenal pelvis. Additionally, contralateral hydronephrosis secondary to the mass effect further confused the diagnosis. We discuss the differential diagnosis of neonatal cystic abdominal masses and review the literature of giant hydronephrosis.

    • Content Type Journal Article
    • Category Case Report
    • Pages 95-98
    • DOI 10.1007/s12301-010-0021-8
    • Authors
      • John Lazarus, Departments of Paediatric Urology, Red Cross Children’s Hospital, University of Cape Town, Cape Town, South Africa
  • Accuracy of ultrasound diagnosis after blunt scrotal trauma (10 years experience)

    Abstract
    Objectives  
    To evaluate the role of ultrasonography (US) and its accuracy, sensitivity and specificity for the diagnosis of testicular rupture after blunt scrotal trauma. Moreover, tunica albuginea breach, testicular hematoma, testis avulsion, epididymal injuries and hematocele are particularly examined.
    Patients and Methods  
    Between 1998 and 2008, 24 patients presented to Suez Canal University Hospital after blunt scrotal trauma and underwent surgical exploration. All patients had an emergency scrotal US examination with the use of a 7.5–10 MHz linear transducer. US findings were compared with the surgical findings to calculate the sensitivity and specificity of US for each type of lesion.
    Results  
    Out of 24 patients, 12 were diagnosed as having testicular rupture and tunica albuginea breach was visualized on US in 6 patients. Sensitivity and specificity of US were 92% and 50% for testicular rupture, 85% and 75% for hematocele, 80% and 79% for testicular hematoma, and 100% and 96% for testicular avulsion, respectively. US diagnosis of epididymal injuries was poor as it failed to detect 3 out of 5 epididymal lesions.
    Conclusion  
    US was highly sensitive in the diagnosis of testis rupture. This can provide information on the integrity of the scrotal contents that can help the physician to determine the optimal treatment.

    • Content Type Journal Article
    • Category Original Article
    • Pages 73-78
    • DOI 10.1007/s12301-010-0017-4
    • Authors
      • Osman A. Abd El Kader, Department of Urology, Suez Canal University Hospital, Ismailia, Egypt
      • A. El Nashar, Department of Urology, Suez Canal University Hospital, Ismailia, Egypt
      • K. Mohy El Den, Department of Urology, Suez Canal University Hospital, Ismailia, Egypt
  • Cystadénome Papillaire de L’épididyme: Un Nouveau Cas

    Resume  
    Le cystadénome papillaire de l’épididyme est une tumeur paratesticulaire bénigne rare. Se présentant comme une masse épididymaire uni ou bilatérale. Son association avec le syndrome de Von Hippel-Lindau est fréquente, en particulier dans les lésions bilatérales. Nous rapportons l’observation d’un patient âgé de 36 ans, qui présentait depuis un an des douleurs scrotales gauches, une grosse bourse chronique, sans fièvre ni signes fonctionnels urinaires. L’examen avait mis en évidence une masse testiculaire dure, irrégulière et indolore sans adénopathies inguinales ni masse abdominale. L’échographie scrotale avait montré une masse testiculaire gauche solide hypoéchogène bien limitée de 3 × 2,5 × 2,2 cm. Les marqueurs tumoraux étaient normaux (βHCG: 2 UI/j, AlphaFoetoProteine: 2,94 UI/l). La masse testiculaire a été explorée à travers une incision inguinale gauche. A la palpation, c’était une tumeur testiculaire dure. Une orchidectomie gauche a été réalisée. L’examen anatomopathologique de la pièce d’exérèse avait conclu à un aspect morphologique et immunohistochimique d’un cystadénome papillaire séreux borderline paratesticulaire sans signe d’invasion. A travers notre observation et les données de la littérature, nous proposons de mieux définir le diagnostic clinique et anatomopathologique ainsi que le traitement de ces tumeurs testiculaires rares.

    • Content Type Journal Article
    • Category Cas Clinique
    • Pages 99-102
    • DOI 10.1007/s12301-010-0022-7
    • Authors
      • Azeddine Elkiassi, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • A. Sahnoun, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • A. Ouakadi, Service d’Anatomie Pathologique, CHU Ibn Rochd, Casablanca, Maroc
      • A. Elmoussaoui, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • R. Aboutaeib, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • H. Fekak, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • M. Dakir, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • R. Rabii, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • A. Debbagh, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • A. Joual, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • S. Bennani, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
      • S. Azzouzi, Service d’Anatomie Pathologique, CHU Ibn Rochd, Casablanca, Maroc
      • F. Meziane, Service d’Urologie, CHU Ibn Rochd, Casablanca, Maroc
  • Primary plasmacytoma of the testis with no evidence of multiple myeloma: a new case report and literature review

    Abstract  
    Plasmacytomas of the testis are extremely rare tumours, especially when occurring in the absence of a previous or concurrent diagnosis of multiple myeloma. We report a new case of solitary testicular plasmacytoma, with immunohistochemical studies showing monoclonal cytoplasmic production of IgG lambda light chains, in a 51-year-old man who had no evidence of multiple myeloma 3 years after the orchiectomy.

    • Content Type Journal Article
    • Category Case Report
    • Pages 88-92
    • DOI 10.1007/s12301-010-0019-2
    • Authors
      • Mehdi Bouassida, Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia
      • H. Ketata, Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia
      • A. Bahloul, Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia
      • S. Mseddi-Hdiji, Department of Hematology, Habib Bourguiba Hospital, Sfax, Tunisia
      • S. Makni, Department of Histopathology, Habib Bourguiba Hospital, Sfax, Tunisia
      • J. Daoud, Department of Radiothorapy, Habib Bourguiba Hospital, Sfax, Tunisia
      • M. N. Mhiri, Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia
  • Expression of estrogen alpha and beta receptors in prostate cancer and hyperplasia: Immunohistochemical analysis

    Abstract
    Objectives  
    Estrogen receptors are believed to play a significant role in the pathogenesis of prostate carcinoma (PCa). The aim of this study is to evaluate the expression of ER-α and ER-β in human benign and malignant prostatic tissue.
    Patients and Methods  
    The archival materials of 100 prostatic specimens (65 PCa, 35 BPH) were collected from the Department of Pathology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia. Seven PCa cases contained foci of high-grade prostate intraepithelial neoplasia (HGPIN). Immunohistochemistry was used to test the protein expression of ER-α and ER-β utilizing monoclonal mouse antihuman antibodies.
    Results  
    Among the 65 cases of PCa, ER-α was expressed in 3 cases (4.6%) in epithelial cells and 4 cases (6.1%) in stromal cells. ER-α was not expressed in any of the HGPIN foci. Additionally, ER-α was not expressed in either luminal or basal cells in any of the 35 BPH cases. However it was expressed in 4 cases (11.4%) in stromal cells of BPH. In PCa, ER-β was expressed in 61 cases (93.8%) and 35 cases (53.8%) in the epithelial and stromal cells respectively. ER-β was expressed only in 2 cases (28.5%) out of 7 HGPIN foci. It was expressed in 33 cases (94.3%) of epithelial and stromal cells of BPH.
    Conclusion  
    The majority of PCa and BPH exhibited nuclear immunoreactivity for ER-β in both tumor and stromal cells and they are usually negative for ER-α. There is probably partial loss of ER-β in HGPIN. ER-β may have a role in the process of prostatic hyperplasia and malignancy.

    • Content Type Journal Article
    • Category Original article
    • Pages 79-87
    • DOI 10.1007/s12301-010-0018-3
    • Authors
      • Jaudah A. Al-Maghrabi, Department of Pathology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia
      • T. M. Hassan, Department of Pathology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia
      • T. A. Abdel-Meguid, Department of Urology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia
      • H. A. Mosli, Department of Urology, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia
  • Bilateral supernumerary kidneys: Incidental finding in a three-month-old infant

    Abstract  
    Supernumerary kidney (SNK) is a rare congenital anomaly with fewer than 100 cases reported in the English literature. The majority of these were unilateral and only five bilateral cases have been reported. We report an infant with six kidneys, incidentally diagnosed at ultrasonographic imaging after presenting with an anterior lower chest wall abscess. Confirmation of the diagnosis was confirmed by excretory urography. To our knowledge, this is the highest number of SNK reported.

    • Content Type Journal Article
    • Category Case Report
    • Pages 46-48
    • DOI 10.1007/s12301-010-0010-y
    • Authors
      • Abdulkadir A. Yisau, Department of Radiology, Federal Medical Centre, Gombe, Nigeria
      • A. T. Sa’ad, Department of Radiology, Federal Medical Centre, Gombe, Nigeria
      • A. Ahidjo, Department of Radiology, Federal Medical Centre, Gombe, Nigeria
      • A. A. Ajape, Urology Unit, Department of Surgery, Federal Medical Centre, Gombe, Nigeria
  • Cystic lymphangioma of adrenal gland

    Abstract  
    An 18 year old female presented with vaginal bleeding at 2 months of gestation. Ultrasonography revealed a large retroperitoneal cyst. Histopathological examination of the excised cyst showed features suggestive of a cystic adrenal lymphangioma. This case is reported because of its rarity and detection during pregnancy.

    • Content Type Journal Article
    • Category Case Report
    • Pages 58-59
    • DOI 10.1007/s12301-010-0013-8
    • Authors
      • Kiran Yagain, Department of Pathology, Kasturba Medical College, Manipal, India
      • L. Rao, Department of Pathology, Kasturba Medical College, Manipal, India
      • S. Vidhyalakshmi, Department of Pathology, Kasturba Medical College, Manipal, India
      • A. Kudva, Department of Surgery, Kasturba Medical College, Manipal, India
  • Adult squamous cell carcinoma of the scrotum in HIV positive patients in Nigeria

    Abstract  
    Squamous cell carcinoma of the scrotum (SCCS) is rare, particularly in West Africa. It usually affects males older than 60 years. Although it was the first cancer to be linked to environmental factors, the mechanism of action of these risk factors is still not completely understood. We report on 4 men who presented with SCCS at our centre during a 20-month period. Three patients were relatively younger (mean age 43 years) and tested positive for human immunodeficiency virus (HIV) infection. They had no history of exposure to any known risk factor for SCCS. Thus, it seems that SCCS may occur in younger men who have HIV infection.

    • Content Type Journal Article
    • Category Case Report
    • Pages 49-53
    • DOI 10.1007/s12301-010-0011-x
    • Authors
      • K. H. Tijani, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
      • F. O. Adetayo, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
      • A. S. Akanmu, Department of Hematology, Lagos University Teaching Hospital, Lagos, Nigeria
      • C. C. Anunobi, Department of Morbid Anatomy, Lagos University Teaching Hospital, Lagos, Nigeria
      • B. O. Mofikoya, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
      • E. A. Jeje, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
  • Spermatic cord liposarcoma and prostate adenocarcinoma: a synchronous association

    Abstract  
    Spermatic cord liposarcoma is rare, with fewer than a 100 reported cases in the world literature. We report on its presence in an elderly man who presented with a painless scrotal mass. The serum prostate specific antigen (PSA) level was also found to be elevated. Transrectal ultrasound biopsy of the prostate confirmed the presence of adenocarcinoma. This is the first report of prostatic adenocarcinoma in association with spermatic cord liposarcoma in the English literature. The treatment options for spermatic cord liposarcoma are discussed further.

    • Content Type Journal Article
    • Category Case Report
    • Pages 54-57
    • DOI 10.1007/s12301-010-0012-9
    • Authors
      • Ahmed Adam, Department of Urology, Kalafong Hospital, Tshwane, South Africa
      • C. K. Adofo, Department of Urology, Kalafong Hospital, Tshwane, South Africa
      • K. K. Ijane, Department of Urology, Kalafong Hospital, Tshwane, South Africa
      • J. E. Dinkel, Department of Anatomical Pathology, University of Pretoria, Tshwane, South Africa
      • R. A. Feilat, Department of Urology, Kalafong Hospital, Tshwane, South Africa
  • Migration Intravésicale du Dispositif Intra-Utérin à Propos de Cinq Cas

    Resume  
    La migration intravésicale du dispositif intra-utérin (DIU) par perforation utérine est une complication rare. Dans cette étude rétrospective monocentrique, nous présentons notre expérience de 5 cas colligés au sein de notre établissement entre 2004 et 2009. L’âge moyen de nos patientes est de 39 ans (32–48 ans). La symptomatologie clinique révélatrice était dominée par le syndrome irritatif vésical. Le diagnostic a été évoqué sur le couple écho/AUSP, puis confirmé par la cystoscopie. Le traitement a consisté en une lithotritie balistique du calcul avec extraction du stérilet par voie endoscopique chez 4 patientes et extraction chirurgicale chez une seule.

    • Content Type Journal Article
    • Category Article Original
    • Pages 60-64
    • DOI 10.1007/s12301-010-0014-7
    • Authors
      • Ali Barki, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • A. Ait Sakel, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • M. H. Benazzouz, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • A. Mazdar, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • Y. Essatara, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • H. El Sayegh, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • A. Iken, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • Y. Nouini, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • A. Lachker, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • L. Benslimane, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
      • M. Faik, Service d’urologie -A-, CHU Rabat-Salé, Rabat, Maroc
  • Inner preputial flap as tunica albuginea replacement in the management of previously untreated fracture of the penis

    Abstract
    Objectives  
    To assess the efficacy of an inner preputial skin flap as replacement for the tunica albuginea of the corpus cavernosum after excision of fibrous plaque.
    Patients and Methods  
    In this retrospective study we evaluated 5 men who presented with impotence, chordee, painful erection and/or painful coitus after previously undiagnosed or untreated penile fracture. In two patients soft tissue X-rays suggested calcification of the plaque, while ultrasonography revealed extension of fibrosis in four cases. In all patients the plaque was excised and the defect in the tunica albuginea was closed with an inner preputial pedicle skin flap.
    Results  
    The flaps had taken well in all cases at 3 months follow-up and all patients reported having normal sexual intercourse.
    Conclusion  
    Surgical excision is the treatment of choice for management of symptomatic fibrous plaques occurring in undiagnosed, untreated or conservatively managed penile fracture. A defect of more than 1.5 cm after excision of the plaque requires tunica replacement, and an inner preputial flap is a good replacement.

    • Content Type Journal Article
    • Category Original Article
    • Pages 33-38
    • DOI 10.1007/s12301-010-0008-5
    • Authors
      • Amilal Bhat, Department of Urology, Sardar Patel Medical College, Bikaner, Rajasthan, India
      • B. Sharma, Department of Urology, Sardar Patel Medical College, Bikaner, Rajasthan, India
      • M. Dawan, Department of Surgery, Sardar Patel Medical College, Bikaner, Rajasthan, India
      • G. Saxena, Department of Urology, Sardar Patel Medical College, Bikaner, Rajasthan, India
  • Adult patients presenting with undescended testis in awareness-poor region

    Abstract
    Objectives  
    The majority of patients with undescended testis present during childhood with minimal complications owing to straightforward treatment with excellent postoperative outcome. This paper reports the mode of presentation, challenges and outcome of management of adult patients with undescended testis.
    Methods  
    This prospective study included consecutive cases of adult patients managed with undescended testis from January 2004 to December 2008 in Evbuomore, Nigeria.
    Results  
    Eighteen adults with a mean age of 38.3 years (range 19–61) were managed during the period. Ten (55.5%) had bilateral, 5 (27.8%) right and 3 (16.7%) left lesions. Awareness was poor as they presented due to infertility in 8 (44.4%), associated hernia 5 (27.8%), wife/self discovery 4 (22.2%) and accidental discovery by a health worker 1 (5.6%), with 9 men (50%) presenting between 30 and 40 years of age. On inguinal exploration, only 3 (10.7%) patients had viable but significantly reduced testicular volume, 17 (60.7%) were atrophic/fibrotic while in 8 (28.6%) the vas deferens ended blindly in the inguinal canal with no viable testicular tissue. Apart from three patients who had children before presentation, infertility persisted even after treatment despite adequate hormone profiles and satisfactory sexual performance. Counseling of spouses was a major challenge, with 8 couples adopting children and three marriages ending in separation.
    Conclusion  
    Management of adults with undescended testis was challenging due to irreversible complications, psychological effects and poor outcome of treatment which shows the importance of awareness programs that will result in childhood presentation.

    • Content Type Journal Article
    • Category Original Article
    • Pages 39-45
    • DOI 10.1007/s12301-010-0009-4
    • Authors
      • O. D. Osifo, Pediatric Surgery, University of Benin Teaching Hospital, Benin City, Nigeria
      • E. O. Osaigbovo, Urology Units, Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria
  • La Malakoplakie Rétropéritonéale Pseudotumorale

    Resume  
    La malakoplakie est une maladie inflammatoire granulomateuse chronique, qui affecte généralement le tractus génito-urinair e et moins fréquemment les autres sites tels que le rétropéritoine et le tractus gastro- intestinal. L’origine infectieuse associée à un déficit dans la digestion macrophagique des bactéries est la théorie physiopathologique la plus soutenue. Sa définition est anatomopathologique. Les auteurs rapportent un cas de malakoplakie rétropéritonéale pseudotumorale chez un patient sous corticothérapie au long cours admis aux urgences pour une masse douloureuse et fébrile du flanc gauche. Les explorations radiologiques étaient en faveur d’une collection abcédée nécessitant un drainage chirurgical en urgence. L’examen histologique des prélèvements réalisés au niveau de la graisse rétropéritonéale révélait une inflammation granulomateuse faite d’histiocytes dénommés cellules de Von Hansemann, renfermant des granulations pathognomoniques de Michaelis-Gutmann. Le patient a été mis sous traitement médical à base de ciprofloxacine avec bonne évolution clinique et radiologique.

    • Content Type Journal Article
    • Category Cas Clinique
    • Pages 65-68
    • DOI 10.1007/s12301-010-0015-6
    • Authors
      • A. Elktaibi, Service d’Anatomie Pathologique, Hôpital Ibn Sina, Rabat, Maroc
      • A. Barki, Service d’Urologie, Hôpital Ibn Sina, Rabat, Maroc
      • S. Mesmoudi, Service d’Anatomie Pathologique, Hôpital Ibn Sina, Rabat, Maroc
      • N. Harchichi, Service d’Anatomie Pathologique, Hôpital Ibn Sina, Rabat, Maroc
      • A. Jahid, Service d’Anatomie Pathologique, Hôpital Ibn Sina, Rabat, Maroc
      • M. Faik, Service d’Urologie, Hôpital Ibn Sina, Rabat, Maroc
      • Z. Bernoussi, Service d’Anatomie Pathologique, Hôpital Ibn Sina, Rabat, Maroc
      • N. Mahassini, Service d’Anatomie Pathologique, Hôpital Ibn Sina, Rabat, Maroc
  • Congenital bladder diverticulum in a 28-year-old male: A rare cause of urinary retention

    Abstract  
    Congenital vesical diverticulum causing urinary retention in adults is very uncommon. Herein we describe the case of a 28-year-old male patient presenting with retention of urine due to a large diverticulum. The mechanism by which a diverticulum causes retention is discussed along with the features which distinguish a congenital from an acquired vesical diverticulum.

    • Content Type Journal Article
    • Category Case Report
    • Pages 32-34
    • DOI 10.1007/s12301-009-0006-7
    • Authors
      • G. Sharma, Department of Urology, Chitale Clinic and Department of Radiology, Shri Markandey Solapur Sahakari Rugnalaya and Research Center Niyamit, Solapur, Maharashtra India
      • A. Sharma, Department of Urology, Chitale Clinic and Department of Radiology, Shri Markandey Solapur Sahakari Rugnalaya and Research Center Niyamit, Solapur, Maharashtra India
 

 

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