Biomedical subjects
Publications and source records attributed to Y Nouini.
Isolated tuberculous epididymitis is a rare entity. Because of the increase of this pathology, tuberculosis should be considered in the differential diagnosis of a scrotal swelling even in the absence of a history of previous tuberculosis. We report a case of isolated tuberculous epididymitis, diagnosed in an early stage, with color Doppler ultrasound findings.
UNLABELLED: We reviewed our experience in managing anterior urethral traumatic rupture. PATIENTS AND METHODS: Between January 1986 and December 1998 a total of 23 consecutive male patients with anterior urethral trauma were studied prospectively, including a clinical and radiographic of the pelvis examination, excretory urography and retrograde urethrography. The average patient age was 29 years (range 19 and 65 years). The mechanism of injury was represented by the blunt perineal trauma in 17 cases and the cavernous body rupture in six cases. Clinical manifestations are dominated by the urethrorragia (19 cases), urinary retention (16 cases), perineal hematoma (14 cases). Radiological imaging have shown a pelvic fracture (six cases), urethral rupture (17 cases) and bladder rupture (three cases). Therapeutic procedure realized in emergency in six patients having a cavernous body lesion and delayed repair in 17 other patients. RESULT: The outcame was favorable in 12 patients and recurrence stenosis has occurred in 11 patients who are corrected by optical urethrotomy (four cases), end-to-end anastomosis (two cases), B. Johanson urethroplasty (three cases) urethroplasty by penile skin (one case), dilations (one case). CONCLUSION: Suprapubic cystostomy with healing control of the partial ruptures, delayed end-to-end anastomosis for total ruptures and immediate reparation of the urethral rupture when associated with a penile fracture are even the best warrant of a correct functional recovery.
The authors present two cases of verrucous carcinomas on Buschke-Lowenstein tumor. The Buschke-Lowenstein tumor is an epithelial sexually transmissible benign tumor of viral origin. Under the influence of oncogenic papillomavirus types 16 and 18 it can become malignant tumor which relations with the verrucous carcinoma, tumor with low grade and essentially local malignancy are still discussed. This evolution follows the alteration by a viral protein of the functions of the tumor suppressor protein P 53. The surgery remains the reference treatment although there is a possibility of frequent recurrences. Radiation therapy and chemotherapy were suggested as adjuvant treatments for the complicated sorts.
In this paper we are relating the medical history of 30 year-old female patient with psychiatric medical background. This patient introduced multiple foreign bodies in her bladder via the urethra. Throughout this observation, we analyse diagnosis and therapeutic aspects of bladder foreign bodies.
The authors report a case of renal endometriosis. The preoperative diagnosis of this pathology is difficult because the clinical aspect and the radiological appearance are non specific. This fact limits the place of the medical treatment and of the conservative surgery nevertheless desirable in this young population.
Between 1986 to 1998, 40 patients, 16 to 52 years old, consulted for trauma of the scrotum. The trauma was closed in 36 cases. The trauma occurred by accident of traffic in 19 cases, an accident of work in seven cases, an accident during sport in seven cases, aggression in six cases and brawl in one case. The clinical symptomatology was dominated by inflammatory big scrotum or haematoma in the tunic. Ultrasound imaging was performed in 20 patients, showed a contusion of the testicle in five cases, haematoma of the scrotum in ten cases and albuginal rupture in two cases. Thirty patients underwent surgical repair. Five patients underwent orchidectomy. Atrophy of the testis occurred in two patients who underwent resection of the pulp and two others who had haematoma of the haematocele.
Wolfram's syndrome is an autosomal recessive neurodegenerative disease. The major manifestations consist of diabetes mellitus and bilateral optic atrophy and are sufficient to establish the diagnosis. Urinary manifestations constitute an integral part of the syndrome, as they are present in up to 62% of cases and represent one of the major causes of morbidity. Three cases allow emphasize the difficulty of treatment, which is essentially symptomatic, and largely guided by the results of the various complementary investigations, especially urodynamic assessment. Although the causes of this syndrome are multifactorial and complex, it appears that the urinary lesions are at least temporarily improved by correction of excessive bladder pressure.
Emphysematous pyelonephritis is rare. It is exceptionally associated with urolithiasis with obstruction of the collecting system. It is generally observed in female diabetic patients. It is caused by gas-producing bacteria. We report a case in which emphysematous pyelonephritis was caused by an acinetobacter, associated with pelvic ureteral junction lithiasis. Drainage and nephrectomy were necessary to overcome this life threatening situation.
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.
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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.