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Biomedical subjects

S Bennani

Publications and source records attributed to S Bennani.

At least 55 records · Page 3Linked to original sources

[Torsion of an undescended testis. Apropos of a case].

The authors report an uncommon case of torsion of an inguinal undescended testis occurring in a 15-year-old child. He consulted seven days later for isolated left inguinal pain. Physical examination showed a left inguinal mass, and only the right testis was palpable within the scrotum. Sonography revealed left inguinal mass with echogenic and heterogeneous contents in keeping with undescended testis. The diagnoses of testis tumor or testis torsion were suggested. Surgical exploration revealed a mass suggesting a testis tumor. Orchidectomy was performed. Histological examination showed that the mass corresponded to a necrotic ischemic testis without tumor cells. In the light of this case, the authors analyse the diagnostic aspects and management of torsion of an undescended testis.

Adolescent↗

[Treatment of cystoceles with urinary stress incontinence].

Thirteen women were operated for cystocele associated with urinary stress incontinence. Cystoceles were grade I in 6 cases, grade II in 6 cases and grade III in 1 case. Five patients underwent retropubic colposuspension according to Burch (3 cases) and M.M.K. (2 cases). Eight patients were treated by RAZ's technique associated with anterior colporaphy in order to reduce the cystocele. In this latter group, only one recurrence was observed and was treated by repeat colporaphy with good results. Colposuspension associated with anterior colporaphy is a reliable method for the treatment of cystocele with urinary stress incontinence, associated with low morbidity and short hospitalization. Its results are probably comparable to those of retropubic colposuspension, at least for a 6 months follow-up.

Adult↗

[Traumatic rupture of the corpus cavernosum].

Traumatic rupture of the corpus cavernosum is relatively frequent in the authors' experience. Based on the study of a series of 80 cases and a review of the literature, the authors analyse the diagnostic and therapeutic aspects and outcome of this disease. The patients in this series had a mean age of 30 years. Meticulous and intimate clinical interview demonstrated that the commonest mechanism is forced manipulation of the erect penis (68%). Clinical examination localized the site of the fracture (proximal: 57%, distal 43%). The fracture was unilateral (78 cases), rarely bilateral (2 cases) and associated with complete rupture of the urethra (1 case). Treatment was surgical in 79 patients. A distal semicircumferential incision was used in the case of bilateral rupture, distal rupture and associated urethral lesion (34 cases). A favourable course was observed in 86% of cases. However, 9 postoperative complications (12.5%) were observed (6 cases of fibrous plaques, 3 cases of chordee of the penis), due either to the extent of the haematoma or to the delay in treatment. Traumatic rupture of the corpus cavernosum is a disease of young adults, which requires early surgical treatment with an approach adapted to the type of lesions.

Adolescent↗

[Epidermoid carcinoma of the bladder. Apropos of 14 cases].

The authors report 14 cases of squamous cell carcinoma of bladder over a period of 20 years. All patients were male, with a mean age of 56 years. A history of urogenital bilharziasis was reported in 2 patients and 10 patients were smokers. Hematuric cystitis was the commonest presenting feature and infiltration of the bladder base was detected on rectal palpation in 10 patients. The patients consulted late in the course, at the stage of upper urinary tract repercussions (11 cases) and computerized tomography showed locoregional extension in 5 cases. 12 total cystoprostatectomies were performed and 2 patients were treated exclusively by radiotherapy. The long-term course was marked by urethral recurrence in 3 patients. The etiopathogenesis, diagnosis, treatment and clinical course of these tumors, which are often aggressive, are reviewed.

Aged↗

[Foreign bodies of the bladder and urethra. Apropos of 2 cases].

The bladder and urethra can be the site of various types of foreign bodies. The authors report two cases of low urinary tract foreign bodies. The first case concerned a young man with psychiatric disorders who introduced a condom into his bladder and the second case was an elderly patient with a history of self-dilation who introduced a safety pin into his urethra. In the light of these two cases, the authors review the diagnostic features and management of bladder and urethral foreign bodies.

Adult↗

[Idiopathic renal arteriovenous fistula].

The authors report a case of idiopathic renal arteriovenous fistula. The diagnosis was established angiographically in a 24 year old man presenting gross hematuria. Embolization of the fistula was performed. Efficiency of this treatment was appreciated clinically and by duplex renal ultrasonography. The characteristics of renal arteriovenous fistulas are reviewed.

Adult↗

[Detubularized U-shaped enterocystoplasty after cystoprostatectomy].

We reviewed the charts of 58 patients who underwent orthotopic bladder replacement after total cystoprostatectomy for muscle invasive bladder cancer. Mean age was 56 years. As described by Camey, 60 centimetres of small bowel, are isolated, detubularised then folded upon itself to form a U shaped reservoir, which is anastomosed to the urethra. Death occurred in 5%. Urologic complications observed were: urinary leakage (15%), ureteral reflux (6.8%), ureteral stenosis (8.6%) and stones of the neobladder (5.1%). 64.2% of the patients were immediately continent during the day. Nocturnal continence was obtained for 50% immediately and for 80% three months postoperatively. Detubularised and U shaped cystoplasty achieve a low pressure reservoir, with protection of the upper urinary tract, and a diurnal continence. Nocturnal continence is achieved later.

Adult↗

[Uretero-ileoplasty].

There are several therapeutic procedures for stenosis of the ureter. Ileal plasty is indicated in case of extended stenosis or those located in the pelvis when the poor quality of the bladder prevents use of a bladder flap. We report 6 surgical cases from 1977 to 1993, there were 4 women and 2 men, mean age 34 years. There was an inflammatory cause in 4 cases (tuberculosis or bilarziosis), retroperitoneal fibrosis in 1 case and idiopathic stenosis in 1. Radiographically, the stenosis was unilateral in the iliac area (3 cases), unilater in the pelvis (1 case) and bilateral and iliopelvic in 2 cases. Associated lesions included bladder injury with a small sclerotic bladder in 3 cases. Partial unilateral was used in 2 cases, bilateral U ileoplasty in 1 and ileouretero-cecocystoplasty in 3. Results were good in 5 cases with a follow-up from 2 months to 7 years. The patient with bilateral U ileoplasy without an antireflux procedure had massive bilateral reflux with renal failure and urinary infections. Ileoureteroplasty is indicated in case of extensive stenosis of the ureter. Results are good if an effective antireflux system is installed.

Adult↗

[Ureterovaginal fistulas. A report of 17 cases].

OBJECTIVE: Our purpose was to study aetiopathogenic, diagnostic and therapeutic aspects of ureterovaginal fistulas. STUDY DESIGN: A retrospective study concerned 17 ureterovaginal fistulas in 16 patients. The main causes were gyneacological and obstetrical procedures. The diagnosis was based on clinical considerations and intravenous pyelography in all cases. Three vesicovaginal fistulas were associated with iatrogenic ureteral lesions. Various therapeutic methods were used: psoas-bladder hitch procedure (11 cases) and Boari-Küss flap (4 cases). In two patients, fistulae healed by drainage after ureterolysis. RESULTS: Late radiology showed success of the procedure in 14 patients and persistance of ureteral dilatation in 2 cases treated by Boari-Küss procedure. CONCLUSION: Ureterovaginal fistulae are a relatively frequent complication of pelvic surgery. Psoas-bladder hitch is the procedure of choice in such fistulae cure and prevention is the most efficient treatment.

Adult↗

[Internal version and breech extraction of the second twin. A series of 35 cases].

OBJECTIVES: Identify indications and assess results of internal version followed by breech extraction. Evaluate fetal and maternal prognosis. METHODS: A retrospective study of 35 cases of ionternal versions followed by primary breech extraction of the second twin performed between 1 January 1986 and 31 December 1994, were analysed and compared with data in the literature. RESULTS: There were 2 failures requiring cesarean extraction of the second twin. There were no maternal complications other than minor bleeding at deliver in 3 who did not require transfusion. Obstetrical trauma was observed in 3 cases with no sequelae. Five infants were referred to the prematurity unit and 9 to the infant intensive care unit due to consequences of prematurity. In six cases nitroglycerin used as a uterine relaxing agent was associated with spinal analgesia thus avoiding general anesthesia. CONCLUSION: Internal version is the only alternative (together with external version) to cesarean, allowing rapid delivery of the second twin in breech position. Maternal prognosis is excellent and fetal prognosis is good if contraindications are avoided.

Breech Presentation↗

[Cord prolapse. Review of the literature. A series of 50 cases].

OBJECTIVES: Identify the role of cord prolapse in modern obstetrics by estimating the frequency of this obstetrical accident, its conditions, prognosis and treatment and by analyzing factors favoring development of cord prolapse. METHOD: From a retrospective study of 50 observations of cord prolapse occurring in the department of obstetrics from January 1985 to June 1994. Results were compared with those reported in the literature. RESULTS: The frequency of cord prolapse was 0.21% over the 10-year period. Cesarean section was required in 72% of the cases, and obstetrical manoeuvers were used in some of the vaginal deliveries (28%). Neonatal mortality was 20/1000. Predisposing factors were breech presentation, prematurity, twin pregnancy and multiparity. CONCLUSION: Despite much progress in obstetrics, the frequency of cord prolapse has not changed over time. The consequences are not as lethal as in the past, because of progress in diagnosis and neonatal resuscitation. Fetal prognosis remains however severe.

Adult↗

Involvement of estradiol in a catecholamine inhibitory tone of gonadotropin release in the rainbow trout (Oncorhynchus mykiss).

The present study aimed to examine the inhibitory action of catecholaminergic neurons on the release of gonadotropin II (GtH2) in female rainbow trout at different stages of the reproductive cycle. Estradiol (E2) implants in sexually immature female increased blood E2 levels (from 0.55 to about 9 ng/ml) and pituitary GtH2 contents (from 15 to about 8500 ng/pit), but did not modify blood GtH2 levels or pituitary dopamine (DA) and norepinephrine contents. Subsequent treatment by alpha-methyl-p-tyrosine (MPT) increased blood GtH2 levels (from 0.5 to about 3 ng/ml) and decreased pituitary DA levels, only in E2-implanted fish. MPT also increased blood GtH2 levels of sexually recrudescent (about threefold) and sexually mature (about twofold) fish. In the periovulatory period, there was a highly significant positive correlation between blood E2 levels--which fall up until ovulation--and ability of MPT to increase GtH2 release. GtH2 release in rainbow trout is concluded to be inhibited by a brain-pituitary DA tone and there are relationships between this inhibitory tone and the level of estradiol.

Animals↗

[Multiple bilateral renal hydatidosis. A case report].

The authors report one case of multiple bilateral hydatid cyst of kidney associated to brain and spleen localizations, after intra cardiac rupture. They point out the rarity of the bilateral kidney localization of hydatidosis, explain the dissemination mode, and stress the role of computed tomography for the pre-operative diagnosis. The treatment is above all surgical and adapted to each case. The post-operative results are satisfying. Complementary medical treatment could be useful.

Adult↗

[Retroperitoneal liposarcoma. Two cases].

Concerning two cases of liposarcomas developing in the retroperitoneal space, the characteristics of these rare tumors are reviewed. They are the most frequent mesenchymal tumors. Often, they are uncovered by palpable abdominal mass or when they compress adjoining organs. Computed tomography has proved valuable in the diagnosis of these lesions. Surgical removal is the treatment of choice. Recurrences are frequent and prognosis is poor.

Adult↗

[Obstructive anuria. Thirty cases].

The authors report 30 cases of obstructive anuria during the last fifteen years. The anuria was secondary to lithiasis in 60 per cent, in 26.6 per cent to pelvic cancer and in 13.4 per cent to retroperitoneal fibrosis. The diagnosis was facilitated by ultrasonography. Emergency treatment of obstructive anuria is based on urinary diversion by ureteral stent or by percutaneous nephrostomy under ultrasound control. Later the treatment depend of etiology.

Adult↗

[The therapeutic aspects of urogenital tuberculosis. Apropos of 86 cases].

On the basis of a series of 86 cases of urogenital tuberculosis and a review of literature, a detailed study of the different therapeutic methods of this affection is done. Today, with the tuberculostatic agents, the medical treatment alone is frequently sufficient and ablative surgery is less often mandatory than reconstructive. Different types of short course chemotherapy and the role of associated steroids are reviewed. Finally, the authors stress the indications of ablative surgery and review the different procedures of reconstructive surgery in order to clearly define a logical therapeutic approach.

Adolescent↗

[Perinephritic cellulitis. Apropos of 75 cases].

In spite of the contribution of the new techniques of radiology and the use of new antibiotics, the diagnosis of perinephric abscess remains difficult and late and is at the origin of high morbidity and mortality. 75 cases of perinephric abscess collected during 15 years are reviewed. We studied the etiopathogenic, diagnostic, bacteriologic and therapeutic characteristics of this affection. Urinary signs are found in 26.7% of patients, diabetes in 17% and extra urinary origin is found in 11% of patients. Diagnostic delay is over one month in 75% of patients. Ultrasonography is carried out in 55 patients showing evocative images of perinephric abscess in 96% of cases. Computed tomography seems more performant than ultrasonography. Gram negative bacillus and staphylococcus are the germs which are the most frequently found. Surgical drainage associated to antibiotherapy is realized in all patients with collected perinephric abscess (73 cases). Evolution is often favourable in spite of the expanse of the abscedation. Literature data about pathogenesis, bacteriology, diagnosis and treatment of this affection are discussed.

Abscess↗