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A Lachkar

Publications and source records attributed to A Lachkar.

50 records · Page 3Linked to original sources
PubMed1998

[Uretero-vaginal fistulas. 45 cases].

The authors report a series of 45 cases of ureterovaginal fistula (UVF) observed over a 25-year period. The patients had a mean age of 34 years (20 to 50 years). 32 UVF (71%) were secondary to obstetric procedures and operations and 13 UVF (29%) were due to hysterectomy for gynaecological diseases. The clinical features were dominated by urine leak via the vagina with persistent micturition (68.8%) and low back pain (40%). UVF was associated with vesicovaginal fistula in 11 patients and acute renal failure was observed in 4 patients. IVU confirmed the diagnosis in 36 patients (87%) and revealed 23 cases of uretero-hydronephrosis and 4 silent kidneys. Retrograde ureteropyelography, performed in 4 cases, confirmed the diagnosis of UVF. The lesion was situated on the right side in 26 patients and was bilateral in the other 3 patients. The commonest lesion was section (48.8%). Treatment consisted of ureterovesical reimplantation (27 cases), Boari-Küss bladder flap of (3 cases), psoas bladder (5 cases), nephrectomy (2 cases), end-to-end anastomosis (2 cases), appendico-ureteroplasty (2 cases), double J stent (2 cases) and ileoureteroplasty (1 case). The course was favourable in 35 patients (77%).

Adult↗
PubMed1998

[Rupture of the corpora cavernous. 50 cases].

The authors report a series of 50 cases of rupture of the corpora cavernosa observed over a 20-year period. The patients had a mean age of 27 years (16-55 years). The commonest mechanism was sudden and forced manipulation of the erect penis (31 cases). The diagnosis is simple in view of the stereotyped clinical features, dominated by penile pain (48 cases), penile haematoma (36 cases) and crackling (25 cases). All patients were treated surgically, with evacuation of the haematoma and suture of the tunica albuginea (48 cases), suture of the corpora cavernosa and corpus spongiosum (1 case), and fascia lata corporoplasty (1 case). A favourable course was observed in 30 cases, while 11 patients presented painful erection, and 9 patients developed induration and deviation of the penis.

Adolescent↗
PubMed1998

[Spontaneous rupture of bladder diverticulum. Apropos of a case].

We report a case of spontaneous rupture of a bladder diverticulum. A 65-year-old man presented with urinary retention and serious infection. At clinical examination, the patient had a distended abdomen, tenderness of the left flank and left lumbar region and benign prostatic hyperplasia. Urinary catheterisation yielded bloody and purulent urine. CT scan showed a paravesical collection extending to the left lumbar region. Blood count showed anaemia and leukocytosis. Emergency surgical exploration found a large infected bladder diverticulum with necrosis and perforation of the wall. Treatment consisted of resection of the necrotic tissue and suture of the diverticulum neck. Convalescence was uneventful.

Aged↗
PubMed1998

[Urethral diverticula in women. Apropos of 15 cases].

Urethral diverticulum is a rare disease, arising in the urethrovaginal septum and communicating with the urethra through an orifice. Characterised by clinical polymorphism, it is diagnosed by urethrocystography and transvaginal ultrasound. We report a series of 15 cases of urethral diverticulum over a 10-year period. The mean age of the patients was post-voiding was 36 years (range 24-50). The symptoms were recurrent urinary tract infections (66%), post-voiding urethral leakage (22%), vaginal pain (22%). Clinical examination found a vaginal mass in all patients. Retrograde urethrocystography showed the diverticulum in every cases, while IVP confirmed the diagnosis in only 62% of cases. Treatment is surgical and consists of removing the diverticulum via a vaginal approach. Short and long-term course is favourable. All patients were asymptomatic and the follow-up urethrocystography showed no diverticular recurrence.

Adult↗
PubMed1997

[Kidney injuries. Apropos of 30 cases].

Renal trauma remains a topical subject due to its high incidence and the fact that it still raises therapeutic problems. The features of this disease were reviewed by means of a retrospective study of 30 cases of renal trauma observed over a 10-year period. The patients consisted of 27 males (90%) and 3 females (10%), with a mean age of 27 years (range: 20 to 60 years). The aetiology was largely dominated by road accidents (53%), falls (26%) and assaults (16%). Trauma was unilateral, predominantly affecting the left side (60%). The clinical features were dominated by haematuria (93%) and low back pain (90%). Trauma was associated with skeletal or visceral lesions in 46.6% of patients. Assessment of the lesions was based on IVU, ultrasonography and CT. Eight patients (26.6%) presented with moderate or minimal trauma (Chatelain stage 1 and 2) and were treated medically. Twenty-two patients (73%) were operated: 6 of them underwent total nephrectomy and 16 were treated conservatively. Seven of the operated patients subsequently developed complications.

Accidental Falls↗
PubMed1997

[Ureter injuries. Apropos of 42 cases].

Ureteric trauma constitutes a serious disease which can induce renal complications. Ureteric trauma is often iatrogenic, mainly due to gynaecological surgery. The authors report a series of 42 cases of ureteric trauma observed over a 20-year period. These patients consisted of 33 females (78%) and 9 males (21%) with a mean age of 38 years (range: 20 to 65 years). 24 ureteric lesions (57%) were secondary to obstetric procedures and operations, 9(21%) were due to gynaecological operations (hysterectomy), ureteroscopy was responsible in 3 cases, 2 lesions were due to lumbar sympathectomy, one case was secondary to resection of the rectum and 2 cases were secondary to abdominal trauma. The most frequent lesion was ureteric section (21 cases), usually affecting the pelvic ureter. Iatrogenic lesions were associated with iliac vessel ligation (1 case) and vesicovaginal fistulas (8 cases). The clinical features were dominated by vaginal urinary fistula (33 cases) and low back pain (15 cases). The diagnosis was essentially based on IVU, which showed ureterohydronephrosis in 18 cases and a silent kidney in 2 cases. Eight ureteric lesions were diagnosed at operation, 31 after an interval of 3 to 20 days and 2 after an interval of 3 months. Treatment consisted of ureterovesical reimplantation in 17 cases, Boari-Kuss bladder flap in 3 cases, psoas bladder in 6 cases, end-to-end ureterorraphy in 5 cases, ileoureteroplasty in 3 cases, nephrectomy in 2 cases, appendicoplasty in 1 case, double J stent in 2 cases. The course was marked by the development of hydronephrosis (4 cases), ureteric stenosis (2 cases), vesico-ureteric reflux (1 case), urinary fistula (2 case) and lengthening of the ileal graft (1 case).

Abdominal Injuries↗
PubMed1997

[Continent urostomy: sigmoid reservoir and sigmoid hydraulic valve].

We report our experience of continent sigmoidostomy. The technique consisted in urinary diversion with sigmoid pouch and hydraulic valve. Eleven patients underwent this procedure (10 men and 1 women, mean age 48 years, range 20 to 77 years). Indications were bladder tumor in 7 cases, bladder exstrophy in 2 patients, neurogenic bladder in 1 case and 1 bladder with a small capacity secondary to a stricture of traumatic urethra. The pouch was made according to the detubularized model. The sigmoid was opened on its antimesenteric edge, leaving the distal portion of the sigmoid intended to do the sigmoid valve. The posterior edges of the colonic segment opened were alined then secured by a Dexon 3/0 whipping then the anterior adges were secured, as the former after reimplantation of the ureters according to Camey Leduc or Politano Leadbetter's procedure. The post operative follow-up was marked by a fistula of the pouch in one case treated by securing it. All the patients were continent day and night. The purpose of this study was the description of the technique and the results of the continent sigmoïdostomy.

Adult↗
PubMed1997

[Gangrene of the external genital organs. Apropos of 55 cases].

Gangrène of the male external genitalia (GMEG) is characterized by necrotizing cell evolving toward necrotizing of the soft tissues of the male genitalia and possibly death. The cause may be primary infection called Fournier's gangrene (5%) or secondary infection (95%) due to general or local factors. GMEG is a real urinary emergency because of its local and general complications which lead to death in 20% of cases. Precocious and massive antibiotherapy, a surgery to unbridle and possibly reanimation, oxygenotherapy, urinary diversion or colostomy, are required. We have treated 55 men with this affection from january 1988 to may 1996. Mean age was 58 years (range 20 to 85). The prodromial period was about 12 days. Toxi-infectious shock was noted in 8 patients (14%). Six patients (10%) developed renal acute insufficiency. Lesions were localized to the male external genitalia in 24 cases and stretched to the inguinalis, to the abdomen or to the thorax in 34 patients. The cause was a stricture of urethra in 23 cases (41%) diabetes in 18 cases (32%), anal abscess in 7 cases (13%). No etiology was found in 6 cases (10%). Emergency treatment involved three antibiotics, surgery to unbridle necrotizing tissue in all patients, reanimation in 20 patients (35%), oxygenotherapy in 4 patients (7%), colostomy in 2 cases and urinary drainage in 23 patients (42%). Free skins grafts were necessary in 6 patients (10%), 5 patients (9%) died due to septic shock. On the basis of these observations and a review of the literature, we analyzed the ethiopathogenic, bacteriological and therapeutic aspects of this affection marked by high mortality in spite of therapeutic progress.

Abscess↗
PubMed1997

[Retroperitoneal liposarcoma. Apropos of 2 cases].

We report two cases of retroperitoneal liposarcoma that required multiple surgical excisions for locoregional relapse diagnosed by surveillance based on CT-scan. One patient has had adjuvant radiotherapy. With the literature review, we discuss the pathologic and therapeutic aspects of these lesions.

Female↗
PubMed1997

[Cysts of the prostate. Apropos of 2 cases].

Two prostatic cysts have been diagnosed by us since 1993. The first patient presented with dysurial the second cyst was discovered incidentally. Transrectal ultrasound examination was useful for diagnosis. Treatment was a puncture--aspiration of the cyst in the first case, and abstention in the second one. A review, of the epidemiological, pathological and therapeutic aspects of the prostatic cysts is presented.

Adult↗
PubMed1996

[Herald's lesion with a localization in the bladder. Apropos of a case].

Herald's lesion located in the bladder is an non-specific extrinsic inflammatory lesion. This pseudotumoral neoformation often results from a pathologic process of the pelvis (95%). Recurrent cystitis is the main symptom. The diagnosis is difficult and cystoscopy and biopsy is the basic investigation. Surgical treatment must remove the original lesion with partial or total cystectomy. Epidemiologic, pathologic and therapeutic aspects of this disease are discussed.

Adult↗
PubMed1995

[Xanthogranulomatous pyelonephritis. Apropos of 11 cases].

Xanthogranulomatous pyelonephritis is a rare manifestation of chronic pyelonephritis. 11 cases were treated between 1988 and 1993. Patients age ranged from 17 to 60 years (mean 34 j). A pseudotumoral form was documented in 3 patients and pyonephrosis was found in 8 cases. Urine culture was usually positive for a non specific germ. Imaging technics could differentiate pseudotumoral disease from diffuse disease. Treatment consisted in a nephrectomy.

Adolescent↗