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The authors report two cases of endoscopic treatment of vesico-ureteral reflux by submeatic injection of autologous fat. We describe the technique of prelevement and injection. The immediate results confirm the efficacity of this procedure. The long-term follow-up will allow us to adopt it and to give it some modifications.

Resume Buts – preciser les particularites cliniques et therapeutiques des fistules vesicovaginales complexes. Materiel et methodes – 55 cas de fistules vesicovaginales complexes sont rapportes. Apres le diagnostic clinique, toutes les patientes ont eu une urographie intraveineuse (UIV). Les fistules ont ete classees selon la classification de Benchekroun. Resultats – l'âge moyen etait de 34 ans (17–70 ans). Le diagnostic a ete clinique chez toutes les patientes. Treize patientes avaient des anomalies a l'UIV. Le traitement s'est fait par voie vaginale chez 45 patientes, par voie abdominale chez trois patientes et par voie mixte chez deux patientes. Quatre patientes ont eu une derivation urinaire et une a refuse tout traitement. Parmi les 50 fistules traitees, la continence a ete retablie chez 44 (88 %) patientes dont 26 (52 %) apres une seule intervention, 15 (30 %) apres deux interventions et trois (6 %) apres trois interventions. Conclusion – les FVV complexes comme toutes les FVV sont diagnostiquees cliniquement. L'UIV est indispensable pour rechercher une lesion ureterale associee. Le traitement est chirurgical et necessite souvent l'interposition de tissus bien vascularises.

We describe a cheap and simply technique of percutaneous nephrostomy which can be used anywhere. It consists, under local anesthesia, of insertion of a drain into renal cavity using only a needle, a sheat and dilatator. With this technique, we placed 81 PCN with 97% of success, without complication.

Inflammatory pseudotumors are uncommon benign tumors of unknown etiology which may develop at several anatomical sites, e.g., the airways and gastrointestinal tissues, soft tissues, the orbit, the spleen, or the lymph nodes. The renal site is extremely rare, and presents the problem of differential diagnosis as the clinical and radiological aspects of this tumor are similar to those of an adenoma or an angiomyolipoma, and suggest the presence of a carcinoma, in particular a cystic renal carcinoma which is also a rare form of tumor. There is therefore a risk that this benign lesion could be misdiagnosed. Due to the good prognosis associated with this type of tumor, in cases where the definitive diagnosis has been established no surgical procedure is necessary. However, the difficulty in making this diagnosis preoperatively means that in general the organ has to be surgically removed so that a histological analysis can be made and the negative or positive findings confirmed. In the present study, the case of an inflammatory pseudotumor of the kidney has been described. In this instance, radical nephrectomy of the left kidney was carried out as the disease was presumed to be renal cell adenocarcinoma. However, the histopathological analysis was negative as regards malignancy, and indicated the presence of an inflammatory pseudotumor. This article raises the question of the problem in establishing a preoperative definitive diagnosis, as a correct diagnosis is often only confirmed following nephrectomy (in cases where the contralateral kidney is healthy).

Resume L'exstrophie vesicale est une pathologie malformative dont l'incidence est estimee a 3,3/100 000 naissances. Elle est habituellement prise en charge dans les premieres heures de la vie. Les auteurs rapportent trois cas d'exstrophie vesicale traites a l'âge adulte par une derivation externe continente type vessie ileocaecale de Benchekroun (VICC). Apres une revue de la litterature sur la prise en charge actuelle de l'exstrophie vesicale, ils precisent les particularites cliniques et therapeutiques de l'exstrophie chez l'adulte.

Resume Nous rapportons un cas de liposarcome retroperitoneal traite par la chirurgie et la radiotherapie. A travers une revue de la litterature nous discutons les aspects diagnostiques et therapeutiques.