Biomedical subjects
Publications and source records attributed to H Jira.
Urachal remnants are not exceptional and are symptomatics if complicated. Ultrasound and CT scan identify most diseases entities originating from urachal remnant. Treatment consists on total exeresis because there is a risk of malignant degeneration. The authors report a case of urachal remnant and analysis the anatomopathologic, diagnosis and therapeutic features of urachal remnants in a review of the literature.
Extra-corporeal Shock Wave Lithotripsy (ESWL) is widely used to treat urinary calculi. With increasing numbers of ESWL, more patients prone to infectious complications. A 62-year-old man presented with cerebral abscess following ESWL. The authors discuss presenting conditions, risk factors and preventive measures.
The authors present modified Denis's technique for hemostasis in 20 suprapubic prostatectomy. The technique is based on the separation between the bladder and the prostatic fossa with a temporary purse-string suture around the bladder neck. The vacuum of the prostatic fossa leads to the retraction and hemostatis. This technique is very effective on intra and post operative hemorrhage, so economy of irrigating fluid; then easier post operative care.
Adenocarcinoma of urethra is a rare tumour, which occurs more often in female than in male. The localizations on bulbomenbranous urethra, most frequent, have worse prognostic than those of penile urethra. Because of scarcity of these tumours there is not therapeutic consensus. The treatment is based on the tripod surgery, more or less mutilating, chemotherapy and radiotherapy associated or managed in a separate way. We report the case of a young patient with adenocarcinoma of the posterior urethra treated by a protocol of radio-chemotherapy.
The authors report 2 cases of prostatic tuberculosis. The patients are 59 and 62-years-old respectively. They presented obstructive and irritative symptoms of the lower urinary tract. The prostatic finding and PSA were abnormals. The prostatic biopsy was negative. The diagnosis of prostatic tuberculosis was made by histologic analysis after transuretral resection of prostate. The treatment is based on chemotherapy anti-tuberculosis.
The authors describe a case of enterovesical fistulas in a patient with Crohn's disease that presented exclusively as urinary symptoms manifesting as bladder tumor. Ultrasound examination showed a normal upper urinary tract and a bladder tumor. Cystoscopy examination revealed a bladder tumor at the retrotrigonal region without showing the fistula orifice. Transurethral resection of the tumor revealed an inflammatory pseudotumor of the urinary bladder at the results of histological studies. Magnetic resonance imaging showed a normal upper urinary tract but a bladder tumor and a sigmoidovesical fistula. The results of barium contrast studies established the presence of numerous enterovesical fistulas. Partial resection of the ileum, ileostomy, colostomy and suture of the bladder fistulas was performed. Histological diagnosis of the affected ileum was Crohn's disease. The clinical features, natural history and treatment of enterovesical fistula secondary of Crohn's disease were discussed.
Urinary tract involvement in neurofibromatosis type 1 is rare and uncommon entity. The syndrome is transmitted as an autosomal dominant trait and is characterized by cutaneous pigmentation and tumors as neural crest origin. Two cases of kidney involvement by Von rechlinghausen's disease with in one case a consequent hydronephrosis with arterial hypertension and in the second a nephrocalcinos without hyperparathyroidism are present. The literature of urogenital and nephrologic neurofibromatosis is reviewed. The authors suggest that the patient with neurofibromatosis be screened annually with medical history, physical examination, urinalysis and serum chemistry for tumors that affect the urinary particularly in children.
The authors report a series of 13 horseshoe kidneys observed over a 22-year period. All patients are men with a mean age of 39 years (20-65 years). The clinical features were dominated by abdomino-lumbar pain (nine cases). The horseshoe kidney was associated with renal stones in nine cases, uretero-pelvic junction syndrome in five cases and pyonephrosis in one case. The specific anatomic and surgical features of this rare malformation are emphasized and the therapeutic features of each uropathy associated with horseshoe kidney are discussed.
We report one case of neuroendocrine tumour of the prostate in a 74 years old patient. The clinical symptomatology was dominated by pollakuria, dysuria. Digital rectal examination showed a bulky prostate, hard and irregular. The rate of PSA was high (23 ng/mL). The endorectal ultrasonography revealed a pelvic heterogeneous mass depending of prostate. The biopsy showed an adenocarcinoma of prostate. The patient underwent a transuretral resection of the prostate (TURP) and pulpectomy. Histology and immunohistochemistry through antibody anti NES and antibody antisynaptophysin of shavings of resection revealed a neuroendocrine tumour of the prostate. Twelve months after, the lung X-ray, abdominal ultrasonography and bone scintigram was normal. The rate of PSA was 2.1 ng/mL.
Hemospermia or hematospermia is a common benign condition, but its prevalence remains unknown and can result from several causes. The aetiology is idiopathic in about 30-70% of the cases. The hemospermia is first of inflammatory origin, in the young patients, where it is due to uretroprostatitis or orchi-epididymitis, but in the older, it is due to a benign of malignant prostatic tumors. Transrectal ultrasonography and magnetic resonance imaging can afforded the opportunity to best investigate the patients with hemospermia. Hemospermia is not an uncommon problem and in most instances has little clinical significance other than evoking much anxiety for the patient. In view of the literature, the authors discus the diagnostic and therapeutic approach of hemospermia through a series of seven cases.
UNLABELLED: Detrusor-sphincter dyssynergia is responsible for major impairment and is factor for social and professional activity repercussions. METHODS: We have studied the clinical and urodynamic finding in four patients (two men and two women) with detrusor-sphincter dyssynergia. Mean age is 36 years (26-44 years). Dyssynergia was secondary to tuberculosis meningitis in one case, surgery for rectal adenocarcinoma in one case, tight vertebral canal in one case and in one case the cause is indeterminate. The detrusor-sphincter dyssynergia were treated by autocatheterism in two cases, antibiotherapy antituberculosis associated with an anticholinergic drugs in one case and by alpha-blockers agent in another. RESULTS: Quasi-complete salvage of the motor deficit and the dysfonctional voiding in a patient treated by antibiotherapy antituberculosis associated with an anticholinergic drugs. As well, maid evolution in patient treated by alpha-blockers agent and who practice self catheterization. CONCLUSION: Optimal treatment is unknown, and the existence of several cures indicated the limit of all therapeutic methods.
A variety of neoplasms derived from mesechymal elements may arise on the tunica dartos, the tunica albuginea or, more rarely, within the testis or the epididymis. The authors report a case of leiomyoma of the scrotum in a 33-year-old man. This rare and benign tumour is localized in the tunica dartos in 8% of cases. The positive diagnosis is based on histological examination after conservative treatment by local excision which gives excellent results.
The authors report six cases of retroperitoneal fibrosis. The mean age is 32 years. Two patients were treated by corticosteroid and ureteric stents with a good outcome; they have normal kidney function. Four patients underwent ureterolysis by wrapping the ureters in omentum. The mean follow-up is 60 months. In the light of theses six cases and review of the literature, the clinical, diagnosis and therapeutic aspects are discussed.
Supernumerary kidney is a rare poorly documented anomaly. It's generally discovered in stage of complications. Preoperative diagnosis is difficult. The authors report a case of hydronephrotic supernumerary kidney, diagnosed preoperatively, in a 45 years old patient with a review of the literature.
The diseases ectopic kidney is a rare malformation. It can be associated with other urological or nonurological malformation. We report 11 cases observed between 1980 and 1998. They were five females and six males with a mean age of 28 years. The clinical symptomatology was dominated by pain and urinary symptoms. Diagnosis was based on the IVP data and ultrasonography. Renal stone and hynronephrosis were each associated in five cases and one patient had renal stone associated with hydronephrosis. The treatment consisted on a iliopelvic approach and extraction of the stone and or pyeloplasty. In three cases a nephrectomy was realised for muet kidney or pyonephrosis. The outcome was good in ten cases and one patient had a pyelo-ureteral secondary stenosis managed by endoscopy.
Psoas abscess are rare. Primitives or secondary their clinical diagnosis is difficult. Imagery and especially computed tomography is fundamental. Treatment associates antibiotherapy and drainage. This drainage can be percutaneous or surgical (open surgery). The authors analyze in a retrospective way 12 cases of abscess of the psoas.
Ovarian vein syndrome corresponds to ureteral compression by a dilated ovarian vein. The pathogeny of this syndrome is discussed. It seems to be multifactorial, comprising an anatomical and hormonal factors. Ovarian vein syndrome is classically described on the right side. Patients present with lumbar pain or renal colic. Diagnosis is mainly urographic. The surgery constitutes radical treatment of the entity. However, this disorder can be successfully treated laparoscopically. Transcatheter embolisation provides excellent result which may replace or complement the traditional surgical approaches of this disease. On the basis of one case and other recent series, the authors review its different aspects, including some considerations on this rarely reorganized and poorly understood disease.
Cystic tumors of the adrenal gland are uncommon, but are being increasingly more frequently diagnosed during routine radiological evaluation. The management of these "incidentalomas" remains to be defined. Adrenal cysts have been traditionally managed by excision or aspiration to rule out malignancy. Actually, for some authors, in the cases of incidentally found cysts, if the suspicion of malignancy is low, and the lesion is non-functional, observation of the patients with regular follow-up may be an alternative. We report a case of a non-aspirated incidental adrenal cyst with a follow-up of four years.