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The Mediterranean Sea has been characterized in recent years by marine litter pollution. Our study aims to quantify waste flows in two watersheds in the northern Mediterranean region of Morocco. For Laou wadi and Martil wadi, floating and bank-accumulated waste was monitored during the autumn 2022 and spring 2023 seasons respectively. The results revealed that for Laou wadi, 384 objects/100 m were collected on the banks with a density of 0.20 objects/m2, and "plastic/polystyrene" constituted the main component of the total debris collected representing 57.19% in number of pieces, followed by "glass/ceramic" with 28.44%. For Martil wadi, 4715 objects/100 m were collected, with a density of 6.74 objects/m2, and "plastic/polystyrene" also constituted the main component of the total debris collected with 94.38%. The debris recorded are mainly associated with waste discharge along the river banks. It is therefore recommended to improve solid waste management and activate environmental control in the two Mediterranean basins studied in order to protect the Mediterranean Sea.

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Quoique rare le carcinome épidermoïde du scrotum a un mauvais pronostic. Les Carcinomes du scrotum induite et - liées au travail sont moins fréquentes en raison d'une meilleure hygiène, vêtements de protection, et la sensibilisation de la cancérogénicité des huiles industrielles. L'épidémie à l'HPV a induit une augmentation de l'incidence. Le traitement de dépend toujours exérèse locale de la lésion primaire. La radiothérapie a peu de bénéfice thérapeutique dans le traitement d'un carcinome épidermoïde du scrotum. La bléomycine peut être utile comme traitement adjuvant pour les maladies ilio-inguinal généralisée avant la tentative exérèse, même si cela n'a pas encore été prouvé. Entre janvier 2011 au 1er janvier 2013, 7 patients atteints de carcinome épidermoïde ont été pris en charge, Trois patients ont présenté une localisation ganglionnaire. Les sept patients ont eu un traitement chirurgical par exérèse large avec reconstruction, Deux patients ont été adressé pour chimiothérapie.2 patients ont présenté une récidive, dont un est décédé.

Congenital anomalies of the large vessels are rare. Left inferior vena cava is the second most common anomaly after duplication. They are a challenge that some Departments of Urology and Vascular Disease face. We report the case of a patient admitted for kidney transplantation in whom left inferior vena cava was detected on radiological evaluation performed in the preoperative period., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (© Khalid Elmortaji et al.)

Disorders of sex differentiation cause a discrepancy between sex itself (phenotype) and genetic sex (genotype) which poses a problem in sex determination. In lower socioeconomic level countries where prenatal diagnosis is often absent and technical equipments are inadequate, medical and surgical management is difficult. The aim of this study is to clarify the role of laparoscopy in the management of sexual ambiguity through observation of 4 cases and review of the literature.

The authors report a case of giant retroperitoneal liposarcoma. The diagnosis was suspected after scanography and magnetic resonance imaging and confirmed by the histological analysis of the extracted piece after surgical treatment. Postoperative evolution was favourable after one year without recurrence or distant metastasis. The authors discuss the pathologic and therapeutic aspects and the prognosis of retroperitoneal liposarcoma.

Objectives: Renal cysts of the sinuses or parapelvic cysts constitute a rare form of renal cyst, usually associated with low back pain. Symptomatic forms may be treated by percutaneous aspiration, but the treatment of these cysts has changed considerably over recent years due to the proximity of the renal hilum. Percutaneous treatment is now contraindicated due to its high complication rate, and open surgery is an invasive technique. Laparoscopy appears to be the most appropriate and most effective solution., Patients and Methods: The authors report five cases of parapelvic renal cysts all presenting with renal colic and diagnosed by ultrasound, and confirmed by CT in three cases. Treatment consisted of retroperitoneal laparoscopy using four trocars allowing cyst resection with no intraoperative complications or conversion., Results: The mean operating time was 55 minutes (range: 40 to 70 minutes). The postoperative course was uneventful and all patients were discharged on postoperative D1 or D2. No recurrence was observed after a mean follow-up of 6 months (range: 3 to 15 months)., Conclusion: Retroperitoneal laparoscopic treatment of parapelvic renal cysts is an effective approach, with a low morbidity and less postoperative pain, a short convalescence period and good cosmetic results.

The inflammatory myofibroblastic tumour of the bladder is a rare benign affection that interests mainly young adults. Its etiopathogeny remains unknown, but its tumoral origin was evocated recently by Griffin (1999), incriminating a chromosomic abnormality involving the ALK gene. We will discuss the etiopathogenic, anatopathological and therapeutical aspects of this lesion for which the diagnosis is histological and the treatment remains conservative with a good prognosis.

Adrenal myelolipoma is a rare, benign, non-secreting tumour composed of adipose and haematopoietic tissue. The authors report a rare case of giant adrenal myelolipoma in a 53-year-old patient presenting with low back pain and a palpable flank mass on examination. CT scan suggested the diagnosis and surgical resection was indicated in view of the size and symptomatic nature of this mass. Histological examination confirmed the diagnosis. The outcome was favourable without recurrence after a follow-up of one year. The diagnosis of adrenal myelolipoma is based on radiology. Conservative management is generally sufficient for small asymptomatic tumours, but resection is required for large (> 5 cm) and/or symptomatic tumours.

The male urethral diverticulum is a rare affection. The authors report one case of congenital urethral diverticulum. The diagnosis was approved by clinical examination and urethrocystography. Treatment was based by resection of the diverticulum and urethrography. On the basis of this case, the authors discuss the incidence, diagnosis and therapeutic aspects of this disease.

A retrospectively series of six patients with non-specific granulomatous prostatitis is reported. The diagnosis was revealed by the histological examination trans-urethral resection or enucleated prostatique. Only histological examination is able to established the definitive diagnosis. This study and a review of literature permitted us to notice the various epidemiological, clinical, histological of this affection.

The pelviureteral junction upon a horse shoe kidney remains a frequent congenital malformation. The authors report 13 cases collected during a period of 16 years and treated surgically. The review of literature permits to discuss the different therapeutic means.

Buske-Lowenstein tumour (BLT) is a giant condyloma acuminata characterized by a potential for malignant transformation and invasion and recurrence after treatment. It is a rare viral disease, essentially transmitted by sexual intercourse. The objective of this study was to evaluate the epidemiology, clinical features, classification and prognosis of this disease and to outline the treatment modalities. The authors report 3 unusual cases of Buske-Lowenstein tumour involving the scrotum in 2 cases and associated with malignant transformation in 1 case. All three patients (1 woman and two men) presented a history of high-risk sexual behaviour. BLT was confirmed by biopsy and was treated by complete surgical resection. The postoperative course was uneventful without recurrence. Treatment has not been clearly defined and is essentially based on surgery. Sexual education and early treatment of condylomatous lesions can improve the prognosis of this disease. In the light of these cases, the authors emphasize the importance of prevention for all sexually transmissible infections based on sexual education.

The authors report a new case of retroperitoneal ganglioneuroma in an 18-year-old girl presenting with abdominal mass and lumbosciatica. The diagnosis of retroperitoneal tumour was based on computed tomography and magnetic resonance imaging. Treatment consisted of complete resection of the tumour. The postoperative course was favourable with no recurrence after one year of follow-up. The authors discuss the diagnostic, therapeutic and prognostic aspects of this disease.

The authors report a new case of Stauffer syndrome characterized by cholestatic jaundice in a 54-year-old patient with renal tumour. This paraneoplastic syndrome resolved after nephrectomy. The authors discuss the pathophysiological, diagnostic and therapeutic aspects in the light of a review of the literature.

Inflammatory pseudotumours of the kidney are rare and raise a problem of differential diagnosis with renal cancer. The authors discuss the diagnostic difficulties of this disease in the light of two patients, aged 32 years and 60 years, admitted for left low back pain (2 cases), large kidney (1 case) and haematuria (1 case). The combination of renal ultrasound and CT suggested a renal tumour or a renal cyst, and MRI suggested a necrotic tumour. Surgical exploration led to tumour excision in one case and surgical biopsy in the other case due to the unresectable appearance of the tumour. Histological examination revealed an inflammatory mass with no signs of malignancy in the two cases. A favourable course was observed in both cases with a normal kidney on subsequent CT. The preoperative diagnosis of pseudotumour remains difficult, despite progress in medical imaging and often requires surgical exploration. The diagnosis is based on a correlation of radiological and histological findings.

The authors report a case of adrenal tuberculosis discovered during staging of a biopsy-confirmed bladder tumour, in a 70-year-old patient consulting for haematuria. Cystoscopy with biopsy revealed a high-grade papillary urothelial carcinoma invading the detrusor. Staging abdominopelvic computed tomography revealed a necrotic, multilobed right adrenal mass. Histological examination of the adrenalectomy specimen revealed adrenal tuberculosis. Antituberculous therapy was administered for 9 months and comprised streptomycin, isoniazid, rifampicin and pyrazinamide for 2 months, followed by rifampicin and isoniazid for 7 months. In the light of this case and with the increasing incidence of AIDS, the diagnosis of adrenal tuberculosis must be considered in any case of incidentaloma.

Renal cancer is rare in pregnant women. Through a study of two cases, the authors underline diagnostic, therapeutic and pathogenic aspects of this association. Two female patients, 26 and 34 years old, were admitted for renal tumor, discovered respectively at the first and the second trimester of pregnancy. Investigation's exams for tumor extension were negative. They were based on ultrasound exam (2 cases), CT scan (1 case) and chest X ray (2 cases). The histological examination concluded to a bright cell carcinoma. In the former case, evolution was marked by spontaneous abortion at the fifth post-operative day, and the absence of metastasis after 16 months. In the second case, the evolution was worse because of metastasis occurrence four months after normal delivery. Pregnancy represents a privileged period for the discovery of renal tumor. Exams of tumor extension must consider pregnancy age. The treatment is similar to that of usual renal cancer and is associated to a simultaneous supervision of the pregnancy.

The incidence of urogenital tuberculosis is still frequent and constitutes a current public health problem in Morocco, a country in which tuberculosis is endemic. The clinical presentation of this form of the disease may be misleading. The pseudotumoral type of renal tuberculosis is extremely uncommon, and in this study this disease has been described in a young patient. The radiological findings suggested the possibility of this lesion being renal cancer. The preliminary diagnosis was corrected and a definitive diagnosis of pseudotumor was made following pathological examination of the surgically-removed kidney.

Prostatic abscess is a rare disease. In the light of two cases, the authors discuss the diagnostic and therapeutic aspects of this disease. Two patients, aged 17 and 55 years, presented nonspecific clinical features. Medical imaging (US, CT) established the diagnosis by showing a loculated cystic prostatic mass. Treatment consisted of transurethral drainage and antibiotics with a favourable course in both cases. Prostatic abscess is a rare disease for which the diagnosis has been facilitated by progress in medical imaging. The treatment of choice remains transurethral endoscopic drainage.

Objectives: To compare the therapeutic results of deferred urgent surgical treatment and late treatment of traumatic ruptures of the posterior urethra., Material and Method: 35 patients with a mean age of 25 years (range: 7 to 79 years) were operated for trauma of the posterior urethra. In most cases, trauma was secondary to a road accident, associated with fracture of the pelvis. When rupture of the posterior urethra was diagnosed, the subsequent management depended on the patient's general condition and associated lesions. In the absence of serious skeletal or visceral lesions, the patient was operated within 3 weeks following trauma, after radiological assessment. This approach was applied in 16 patients (Group I). The other 19 patients (Group II) were only operated at the sixth month, after stabilization of all traumatic lesions., Results: Results were assessed in terms of the quality of the urinary stream, urinary continence and sexual impotence. The stream was considered to be good in 93.75% of cases (Group I) and 78.8% of cases (Group II). Continence was perfect in 100% of cases (Group I), versus 89.4% (Group II) and sexual impotence was observed in 18.7% (Group I) versus 5.3% (Group II)., Conclusion: Trauma of the posterior urethra, without any serious associated lesions, can be operated as a deferred emergency with excellent results in terms of voiding (80% of good results), but with a higher frequency of sexual impotence. In patients with serious associated lesions, the therapeutic management of the urethral trauma is performed after an interval of 3 to 6 months, at the stage of urethral stricture. In this case, surgery consists of resection of the fibrous callus, followed by urethral anastomosis. The results of this operation are good, at the cost of repeated stricture, treated endoscopically, but with a lower incidence of sexual impotence.

Bladder tumours classically affect the elderly, but can also occur in young adults. The authors studied the prognosis of these tumours in patients under the age of 40. In their experience, these tumours represent 3.27% of all bladder tumours. 26 patients with a mean age of 34 years (20-40 years), 8 under the age of 30, were studied. There was a marked male predominance (23 males, 3 females). The tumour was a transitional cell carcinoma in 25 cases and a squamous cell carcinoma in 1 case. It was superficial in 11 cases and invasive in 15 cases. Transurethral resection and cystectomy were performed in 9 cases of superficial tumours and 11 cases of invasive tumours, respectively. In the group of superficial tumours, a favourable course was observed in 7 cases, with 3 cases of recurrence and 1 case of progression. In the group of invasive tumours, a favourable course was observed in 6 cases, recurrence was observed in 2 cases and 5 patients died. Superficial tumours therefore have a better prognosis in subjects under the age of 30. Invasive tumours are more frequent and often advanced, suggesting a marked potential for progression. Their prognosis depends on tumour stage, and is not correlated with age.

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.

The authors report a rare case of hydatid cyst of the psoas muscle in a 28-year-old woman, operated for vertebrospinal hydatid cyst. The patient presented with a left iliac fossa mass. Ultrasonography and computed tomography contributed to the preoperative diagnosis, despite negative hydatid serology. A retroperitoneal approach by left lumbotomy with partial pericystectomy was performed. In the light of this case, the authors discuss the diagnostic and therapeutic problems raised by hydatid cyst of the psoas muscle.

This paper presents the results of a series of 10 continent urinary valves performed in the urology department of Ibnou-Rochd hospital in Casablanca according to an original technique between 1991 and 1993. These 10 patients (6 men and 4 women) suffered from various diseases of the lower urinary tract: 4 bladder tumrous, 3 complex vesicovaginal fistulae, two of which were associated with a rectovaginal fistula, one bladder exstrophy, one neurogenic bladder and one extensive urethral stricture. The authors describe the surgical technique and the postoperative course. A detubularized ileal graft was used to create a monoblock valve-reservoir. An effective antireflux system protects the upper urinary tract and continence is ensured by a robust hydraulic valve whose flexibility and patency allow very easy self-catheterization. The physical and urodynamic characteristics of this new diversion make it a solid, perfectly continent solution providing undeniable comfort for the patient. Although based on a limited series, these results illustrate the advantages of this new continent detubularized ileal graft diversion.

Isolated retrovesical location of hydatid cyst is a very uncommon condition. Clinical patterns appear after a long course of the cyst. They are represented by hypogastric mass associated with compressive manifestations. Ultrasonography is essential for diagnosis and identification of other sites. When diagnosis is unclear, then CT scan plays a role. Cystectomy and pericystic resection, as extensive as possible, is the adequate treatment that gives successful results in most cases.

Perineo-scrotal gangrene is a necrotizing infection of the tissues of the perineum and scrotum. It accounts for 0.6% of our hospitalizations. The commonest etiology is urologic (86% of our cases). A proctologic origin was found in 6%, while the condition appeared to be primary in 8%. Concomitant diseases were found in 37% with diabetes the commonest. The diagnosis is clinically evident. The majority of patients are seen late (5 to 10 days) and the necrotizing process spreads rapidly. This is a multidisciplinary emergency, requiring intensive care, antibiotics, surgical excision of all necrotic tissues and possible urinary and/or fecal diversion. Extensive skin loss requires surgical cutaneous reconstruction procedures. The prognosis is severe, with a 12% mortality rate in our series.

Over a 15 year period (1977-1992), the authors have collected 19 cases of vesico-uterine fistulas. These vesico-uterine fistulas rank in third place of genito-urinary fistulas and occur in young patients (mean age is 30 years). Obstetrical etiology is recognised in .95% of cases (cesarean section and dystocic delivery). Leak of urine is present in 95% of cases, and is isolated in 47% or associated with intermittent hematuria in 48%. Diagnosis of this affection is based upon clinical examination with methylene blue test. Communication between bladder and uterus is proved by the issue of methylene blue through the uterus cervix. This communication may be confirmed by opacification (urography and hysterography). Perfect continence is obtained by surgical treatment. Fertility of these patients is often affected.

After reviewing the technique of the endoscopic suspension of the vesical neck, the authors report their experience about the use of paravaginal tissue from either side of the bladder neck to treat female stress incontinence. The authors operated upon 20 female patients with clinically demonstrable stress incontinence of mine between January 1985 and June 1989. With periods of follow up of 6 to 53 months, the results are good in 91% of cases. The characteristics of this procedure are emphasised. It is quick, simple, allowing an easy access even though for multi-operated and fat patients, with possibility of simultaneous treatment of an associated cystocele or rectocele. The post-operative morbidity and the tissular lesions are minimal. Thus, the post-operative hospital stay could be reduced and an eventual second intervention easy. The simplicity of this procedure and the good functional results make the authors indicate it in all urinary stress incontinence.

This work concerns twenty eight cases of urinary stress incontinence treated between 1977 and 1987. The high incidence of previous perineal operations and multiparity are noted. The diagnosis has been established clinically in all cases. Different types of surgery for urinary stress incontinence have been used: endoscopic bladder neck suspension in 17 cases, and retropubic colpopexy in 9 cases. The results are good in respectively 88% and 78%. Correct diagnosis and operative indication are the main elements of treatment of urinary stress incontinence. Each procedure permitting reposition of the bladder neck and proximal urethra in abdominal manometric enclosure amends the urinary stress incontinence. This endoscopic bladder neck suspension procedure is indicated. Otherwise, this procedure is quick, simple, allowing an easy access even though for multi-operated and fat patients. The failure's factors are analysed.

Rapid progress in acute lymphoblastic leukemia treatment in childhood has allowed five years survival rates at least for 50% vs 30% of standard risk (60-70%) and high risk (30-40%) patients. Analyzing our material from University Hospital Pediatric Department (Oran, Algeria) was leading to such conclusions as: First: excess of higher risk acute lymphoblastic leukemias; Second: excess of bad prognosis enzymatic/cytologic markers; Third: post therapeutic 5 years survival probability compares with lowest figures found in literature. Bearing in mind higher risk clinical material and poorer resources of hospital facilities, medical manpower and nursing in such an underdeveloped country as Algeria, therapeutic results seemed reasonably promising.