Biomedical subjects

Mohamed Chebil

Publications and source records attributed to Mohamed Chebil.

11 recordsLinked to original sources

PubMed2006

Prognostic factors of recurrence after vesicovaginal fistula repair.

PURPOSE: We evaluate the prognostic factors of recurrence in patients after the surgical repair of vesicovaginal fistula. MATERIALS AND METHODS: From 1985 to 2002, 73 women with vesicovaginal fistula underwent late (> 3 months) surgical repair. A multivariate analysis of the data was performed with the EPI-INFO software. All P-values were two-sided, with odds ratio and 95% confidence intervals. RESULTS: A total number of 73 patients underwent 97 procedures with a mean rate of 1.38 procedures/patient. The overall surgical success rate was 86.7%. Multivariate analysis demonstrated that recurrence was statistically significant for multiple fistulas (single vs two or more), fistula size (>10 mm), fistula type (Type I vs Type II), fistula etiology (obstetrical vs non-obstetrical) and the presence of urinary tract infection before the repair. Recurrence risk was fivefold higher for both the size and the type of the fistula, threefold higher for obstetrical etiology and 4.5-fold higher for multiple fistula. The interposition of flaps was a protective factor for recurrent cases. The surgical approach was not a significant prognostic factor of recurrence. CONCLUSION: Successful closure of a vesicovaginal fistula requires an accurate and a timely repair using procedures that exploit basic surgical principles. Multiple fistula, size and type of the fistula, and obstetrical etiology were the recurrence risk factors. We recommend in all patients with multiple risk factors for recurrence, the interposition of flaps.

Adult↗

PubMed2006

[Imaging of renal hydatid cyst based on a series of 41 cases].

OBJECTIVES: The authors present the various imaging features of renal hydatid cyst and define the place of the various imaging modalities. MATERIAL AND METHODS: This retrospective study was based on 41 cases of renal hydatid cyst treated between 1989 and 2003, including 19 men and 22 women with a mean age of 32 years. KUB x-ray was performed in every case, ultrasound was performed in 39 cases, computed tomography (CT) was performed in 13 cases and MRI was performed in 3 cases. RESULTS: The preoperative diagnosis of renal hydatid cyst was established in 39 cases (95%), based on ultrasound in 31 cases (75%), CT in 5 cases (12%) and MRI in 3 cases (7%). The diagnosis was confirmed histologically in 41 cases. CONCLUSION: The diagnosis of renal hydatid cyst is often simple in hydatid endemic countries and is based on a combination of KUB-ultrasound. CT constitutes the second-line examination, which should be reserved for complicated cysts. MRI is the modality of choice in the case of atypical forms ensuring the differential diagnosis with serous cyst and cystic renal cancer

Adolescent↗

PubMed2006

[Prostatic stromal sarcoma].

Prostatic sarcoma is a very rare tumour arising from the specialized stroma of the prostatic parenchyma. The clinical and histological features and biological behaviour of this entity are poorly elucidated at the present time. The authors report a case of prostatic stromal sarcoma in a 47-year-old man presenting with complete bladder retention. The initial diagnosis was that of benign prostatic hyperplasia and the patient was treated by suprapubic prostatectomy with no other complementary treatment. Histological examination demonstrated primary neuroectodermal tumour (PNET). The patient was subsequently lost to follow-up and was only reviewed 22 months later in a context of haematuria. Digital rectal examination revealed a large, soft prostate with an estimated weight of 83 grams on ultrasound. Transurethral resection was performed and histological examination of the resection material and review of the slides of the primary tumour showed identical microscopic and immunohistochemical features, corresponding to stromal sarcoma. The patient was treated by local and regional radiotherapy (60 Grays). With a follow-up of 36 months, he presents urinary symptoms with no signs of local extension or metastasis.

Humans↗

PubMed2006

[Surgical treatment of post-traumatic complete urethral rupture: deferred urgent urethral suture or delayed repair?].

OBJECTIVE: To compare the results of deferred urgent surgical treatment and delayed repair in post-traumatic complete urethral rupture. PATIENTS AND METHOD: Between 1986 and 2003, sixty patients were operated for complete rupture of the posterior urethra. In the absence of any serious visceral or skeletal lesions, 32 patients were operated within five to ten days (Group I). In 28 cases (Group II), patients were operated 8 months after the injury via a perineo-transsymphyseal approach. RESULTS: The mean age of these patients was 28 years (range: 18 to 53 years). With a minimum follow-up of 2 years (range: 2-14 years), the urine stream was considered to be satisfactory in 90% of patients of group I and in 100% of cases of group II. Continence was perfect in 91% of patients in the two groups. Erectile dysfunction was observed in 22% of cases of Group I versus 28.5% of cases of Group II. CONCLUSION: Deferred urgent end-to-end urethral suture and delayed urethroplasty give globally comparable results. Deferred urgent end-to-end urethral suture must be performed whenever possible. The perineo-transsymphyseal approach must be reserved to the treatment of large stenoses in multi-operated or delayed repair patients.

Adolescent↗

PubMed2005

[Primary transitional cell carcinoma of the bulbar urethra].

The authors report a case of low-grade primary papillary transitional cell carcinoma of the bulbar urethra in a 61-year-old man treated by endoscopic resection with a favourable outcome and no recurrence with a follow-up of 11 years.

Carcinoma, Transitional Cell↗

PubMed2005

[Ureterocalicostomy: last resort in the treatment of certain forms of ureteropelvic junction stenosis. Report of 5 cases].

INTRODUCTION: Iatrogenic stenoses of the ureteropelvic junction are now essentially treated by endoscopic techniques. However, conventional surgery is sometimes required to treat severe or extensive stenosis. The authors report the use of ureterocalicostomy to treat 5 patients with complex lesions. MATERIAL AND METHODS: Between 2001 and 2003, the authors treated five patients with iatrogenic stenosis of the ureteropelvic junction. Two of these patients had a history of percutaneous nephrolithotomy and the other three had undergone conventional pyelotomy, complicated by pyelocaliceal avulsion in one case. The diagnosis was confirmed by double anterograde and retrograde opacification in four patients and intravenous urography in one patient. It was decided to perform ureterocalicostomy due to the extent of the lesions. Inferior ureterocalicostomy was performed after lower pole nephrectomy in all cases. RESULTS: The mean follow-up was 21 months (range: 20 to 27 months). Three patients had an uneventful postoperative course and satisfactory radiological follow-up. One patient rapidly developed stenosis that was treated successfully by endoscopy and another patient obtained a poor result requiring nephrectomy. CONCLUSION: Ureterocalicostomy requires laborious surgical dissection and meticulous ureterocaliceal anastomosis, but it is a useful technique in some cases of severe and extensive iatrogenic stenosis of the ureteropelvic junction.

Adult↗

PubMed2003

[Treatment of ureteral stones by ESWL. Indications and results in 201 cases].

OBJECTIVE: To evaluate the results of treatment of ureteric stones by ESWL as a function of various parameters, size, site and number of stones treated, in order to more precisely define the indications and consequently improve our results. MATERIAL AND METHODS: This study was based on 201 patients treated by ESWL for ureteric stones. The stones were situated in the lumbar ureter in 151 cases (73.6%) and in the pelvic ureter in 50 cases (26.4%). The size of the treated stones was less than 1 cm in 63.6% of cases and between 1 and 2 cm in 36.4% of cases. Treatment was performed by a Chinese hydroelectric lithotriptor with fluoroscopic and ultrasonographic detection, the ZM III. RESULTS: The results of treatment were not influenced by the site (lumbar or pelvic) of the stone and a good result (fragmentation and complete elimination of the stone) was obtained in 67.6% of cases. However, the difference of the results according to the size of the stone was statistically significant (p < 0.05), with a good result in 75.6% of cases when the stone diameter was less than 1 cm and 55.5% of cases when the stone diameter was greater than 1 cm. CONCLUSION: ESWL remains the first-line treatment for ureteric stones regardless of their site with better results for radiopaque stones less than 1 cm in diameter. An endoscopic procedure (double J stent) can be proposed before ESWL in some cases, such as solitary kidney or large stones, to decrease the complications.

Humans↗

PubMed2003

[Prostatic cancer in the young adult].

Prostatic carcinoma is exceptional in young adults before the age of 30. It is often diagnosed at a late, clinically advanced stage with a poorly differentiated histological type. Treatment is usually palliative and the prognosis is very poor with a mean survival of 6 months. The authors report a new case in a 25-year-old patient with locally advanced poorly differentiated prostatic carcinoma and a Gleason score of 10 treated by endocrine therapy, radiotherapy and chemotherapy with a good clinical and radiological course with a follow-up of two years.

Adenocarcinoma↗

PubMed2002

[Genito-urinary malacoplakia. Report of 10 cases and review of the literature].

The malakoplakia is a rare and benign disease. Its urinary localisation is commonly known. It has no clinical particularity. The diagnosis is histological. The physiopathology is infectious associated with a local macrophage function failure. The treatment associates antibiotic and colinergic drugs. Surgical removal is necessary only when the organ is destroyed. We report 10 cases of urinary malakoplakia with 4 renal localisation's causing pyonephrosis in the majority of cases, 3 prostatic localisation's that were wrongly considered as prostatic adénocarcinoma after a rectal examination and finally 3 testicular localisation's causing a necrotic destruction of the testis. The urinalysis was positive in 4 cases. We did 4 kidney removals, 3 endoscopic prostatic resections and 3 testis removals. The diagnosis was made by the histological examination of the surgical products.

Adolescent↗

PubMed2002

[Intrathoracic kidney due to diaphragmatic hernia: a case report].

The authors report a case of incidental discovery of a right intrathoracic kidney in a 70-year-old man, in July 1994, on intravenous urography performed for assessment of benign prostatic hyperplasia. This intrathoracic ectopic kidney is due to a diaphragmatic hernia and may be either congenital or acquired. It must be distinguished from true ectopic kidney, present during foetal life [4], which requires a high origin of the renal artery from the aorta with elongation of the ureter. Intrathoracic kidney due to diaphragmatic hernia is usually asymptomatic, but may be responsible for severe clinical symptoms with respiratory distress occurring in a newborn infant with this malformation. The diagnosis of intrathoracic kidney must be considered in the presence of a mediastinal mass on chest x-ray and is confirmed by intravenous urography, or even thoracic computed tomography. Apart from its rare complications, this anomaly does not require any specific treatment.

Adenoma↗

PubMed2002

[Impact of the use of double J stents in renal transplantation on incidence of urologic complications and urinary infection].

OBJECTIVE: The authors evaluated the impact of systematic placement of a double J stent on urological complications and postoperative urinary tract infection. MATERIAL AND METHODS: 188 renal transplantations were performed between January 1991 and December 2001. All patients underwent Lich-Grégoire ureterovesical anastomosis. A double J stent was not used in one group (G1) of 110 patients and a double J stent was systematically inserted in another group (G2) of 78 patients and was removed after 3 weeks. Urine culture was performed in all patients. RESULTS: 11 patients of group 1 developed urinary fistula and one patient developed obstruction of the ureterovesical anastomosis. No urological complication was detected in group 2. The postoperative urinary tract infection rate was 47.2% in group 1 versus 48.7% in group 2. CONCLUSION: Systematic double J stenting appears to decrease the incidence of urological complications after renal transplantation without increasing the incidence of postoperative urinary tract infection.

Adult↗