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Les paragangliomes rétropéritonéaux non fonctionnels sont des tumeurs rares. Ils sont souvent asymptomatiques et peuvent atteindre des dimensions importantes. Les auteurs rapportent le cas d'une tumeur rétro péritonéale, découverte au cours d'un examen tomodensitométrique réalisé chez une femme âgée de 49 ans en raison de douleurs abdominales non spécifiques. Les formes malignes, plus fréquentes que les formes bénignes, présentent un envahissement locorégional et métastasent tardivement. Le traitement de ces tumeurs nécessite une exérèse chirurgicale la plus complète possible puisque le pronostic en dépend. Il n'existe par contre pas de consensus sur l'utilité des thérapeutiques complémentaires qui peuvent néanmoins constituer un appoint à titre symptomatique.

Testicular feminization, or the androgen insensitivity syndrome, is a rare disease. Because of various abnormalities of the X chromosome, a male, genetically XY, has some physical characteristics of a woman or a full female phenotype. Indeed the androgen insensitivity syndrome occurs because of a resistance to the actions of the androgen hormones, which in turn switches the development towards the aspect of a woman. We report a case of complete androgen insensitivity syndrome in a 30 years old woman who presented primary amenorrhea. We aim to improve our knowledge of this illness from the data that provides us this study, and a review of the literature.

Les angiomyolipomes épithélioïdes rénaux (AMLeR) sont des tumeurs rares (identifiées chez moins de 0,1 patients pour 1000 habitants) et représentent 8% des angiomyolipomes (AML) opérés. Il a longtemps été considérécomme un hamartome mais plusieurs articles récents font penser qu'il s'agir d'une tumeur dérivant de cellules épithélioïdespérivasculaires. L'angiomyolipome épithélioïde est une forme rare d'angiomyolipome à potentiel malin, composé decellules épithélioïdes posant des problèmes de diagnostic différentiel avec les carcinomes à cellules rénales. L'immunohistochimie,en révélant la positivité des cellules épithélioïdes au marqueur HMB45 est essentielle au diagnostic. Les auteursrapportent l'aspect tomodensitométrique et histologique d'angiomyolipomes épithélioïdes chez deux patientes.

Les tumeurs bénignes du muscle lisse sont fréquentesdans le tractus gastro-intestinal et génito-urinaire, et rares au niveau rétro péritonéal.Leur prévalence parmi les tumeurs rétropéritonéales primitives a été estimée entre de 0,5 à 1,2%. Une situation qui conduit à des erreurs de diagnostic. On rapporte dans cet articledeux cas de léiomyomerétropéritonéal (LRP) retrouvés chez des femmes âgées entre 47et 54 ans. L'imagerie a mis en évidence une masse rétro-péritonéale, ce qui a motivé une exérèse totale de la tumeur. L'examen anatomopathologique de lapièce opératoire a posé le diagnostic de léiomyome rétro-péritonéal. L'évolution sans récidive était bonne.

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Xanthogranulomatous prostatitis is a rare benign inflammatory process of the prostate. Only few cases have been reported in the English literature. Xanthogranulomatous prostatitis is usually an incidental finding after needle biopsy or transurethral resection of the prostate in patients suffering from low urinary tract symptoms. We report the case of a 59-years-old patient diagnosed with prostatic abscess managed by transurethral resection of the prostate. Histopathological examination of resected prostatic tissue revealed abscessed xanthogranulomatous prostatitis with no evidence of malignancy. Xanthogranulomatous prostatitis presenting as a prostatic abscess is a rare finding. To the best of our knowledge our case represents the fourth case of xanthogranulomatous prostatitis presenting as prostatic abscess reported in the English literature so far. [ABSTRACT FROM AUTHOR]

Lymphoepithelioma-like carcinoma of the bladder (LELCB) is a rare variant of urothelial carcinoma first described by Zukerberg in 1991 and confirmed as a variant of urothelial carcinoma by the WHO classification of tumors of the urinary system. LELCB is characterized by a marked infiltration of lymphocytes in the area involved by the tumor which may coexist with the conventional urothelial carcinoma. LELCB are classified according to the percentage of lymphoepithelioma component within the tumor with the prognosis depending on the percentage. We report a new case of pure LELCB occurring in 63-year-old woman presenting with hematuria. Ultrasonography and cystoscopy revealed a large tumor on the left lateral wall of the bladder. Transurethral resection of the bladder tumor (TURBT) was performed. Pathological and immunohistochemical analysis revealed a high-grade muscle-invasive LELCB (G3pT2). The patient underwent an adjuvant systemic chemotherapy with no recurrence after a ten-month follow-up. To our knowledge, this is the second Moroccan case of LELCB reported in the English literature. Although its rare occurrence prognosis and ideal therapeutic management of LELCB have not been clearly established yet, literature findings encourage the adoption of a conservative approach in treatment of LELCB. [ABSTRACT FROM AUTHOR]

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hemangiomas are benign vascular tumors. They are the prerogative of the liver and skin. And genitourinary localizations are rare and have only been rarely reported in the prostat, bladder, ureter or the perineum. In the light of published cases, urethral hemangiomas are mostly found in males. Few cases of hemangioma in the female urethra were reported. We report a cavernous hemangioma of the urethra in a 61 years old patient who presented bleeding from the urethra and micturition disorders. Physical examination revealed a tumor 3 cm x 2 polyploid arising from the terminal urethra (urethral hemangioma). We performed surgical resection of the tumor, along with bladder drainage. The postoperative course was simple. We update through a review of the literature aspects of the diagnostic and therapeutic care of the urethral hemangioma. [ABSTRACT FROM AUTHOR]

Condom catheters are widely used in the management of male urinary incontinence, bedridden patients, and geriatric population. They are considered to be safe; however they are associated with serious complications in case of an incorrect use. We report a dramatic case of penile strangulation by condom catheter tardily discovered till occurrence of necrosis and gangrene leading to death in an elderly bedridden and diabetic man. Through this case we emphasize the importance of patient education for the correct use of condom catheters and remind care providers to maintain a high level of sensibility to complication generated from long-term use of condom catheters. [ABSTRACT FROM AUTHOR]

Leiomyoma is a benign smooth muscle tumor which is rarely found in urethra. It often appears in females during their reproductive age (from menarche to menopause); the mean age of their appearance is approximately 41 years. Less than 100 cases were reported in the literature.We hereby report a case of a 52-year-old White woman who presented with complaints of dysuria and urinary tract infection. The mass was completely removed by transvaginal excision with a rim of normal tissue. Histopathological studies confirmed the urethral leiomyoma. The patient remained asymptomatic and there was no evidence of recurrence in the followup. [ABSTRACT FROM AUTHOR]

The aim of our study was to report the status of penile cancer sites in the urology department at the University Hospital of Rabat and evaluate long-term results of surgical treatment of this cancer. Patients and Methods: Between 1989 and 2015, 10 patients were treated for penile cancer. 10 cases were retrospectively reviewed and the following data were recorded: mode of revelation, seat, staging, TNM stage, treatment, evolution and survival. The mean age of patients was 58,1 years (48-81 years). All patients had squamous cell carcinoma of the penis. Six patients had a partial amputation of the penis, and three patients underwent total amputation. The median size of the lesion was 4.25 cm (1.5-8 cm). All tumors had a distal seat (gland- Furrow balanopreputial), 8 were localized and non-invasive (PT1 - PT2) and 2 had infiltrated the urethra (PT3). Four patients had lymph node localization. A single bilateral lymphadenectomy was performed and was positive only on one side, with a node <3 cm and no extracapsular extension. Two patients were referred for chemotherapy, a neoadjuvant referred to basic (Bleomycin - Methotrexate, Cisplatin) the other in a palliative goal. Median follow-up was 42 months (6 -72mois). Four patients died, one of which was presented immediately with metastatic mode. Six patients were alive at last node or local recurrence negative. Cancer of the penis seems rare in Morocco. His oncologic and functional outcomes (sexual and urinary) depend on the precocity of the treatment. The surgery of lymph node resection with lymphadenectomy remains the reference treatment. [ABSTRACT FROM AUTHOR]

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pelvic organ prolapse (POP) significantly impairs women's quality of life. The literature reports that nearly one in five women will require surgery in their lifetime, and nearly 40.6% involve anterior wall repair, specifically cystocele. Several techniques and surgical approaches have been used for cystocele management. These were performed by transvaginal and/or transabdominal approach and involved the use of native tissue or prosthesis. Nevertheless, since the transvaginal mesh ban recommended by the FDA and learned societies, autologous tissue repair has become the cornerstone of all vaginal prolapse surgery. We hereby present the case of a 71-year-old widow who had undergone three vaginal deliveries. The patient reported that she no longer had sexual intercourse. The preoperative functional signs observed included: stress urinary incontinence, urinary urgency, dysuria and disabling vaginal ball feeling. The management strategy chosen in consultation with the patient was a repair using autologous material via the vaginal route. The vaginal strips were passed through trans-obturator and retro pubic route allowed support of the bladder. This technique using autologous material was easy, fast and inexpensive. It was developed on the basis of the TVT and TOT techniques and stood out for its tolerance and long-lasting functional effectiveness. It avoids all the complications due to polypropylene trans-vaginal prostheses that led to the banning of trans-vaginal mesh. • Since the transvaginal mesh ban autologous tissue repair has become the cornerstone of all vaginal prolapse surgery. • Autologous tissue repair is easy, fast and inexpensive and postoperative fibrosis provides sufficient support for quality anchorage. • Techniques using autologous material on the basis of TVT and TOT techniques seems to have a high tolerance and long-lasting functional effectiveness. [ABSTRACT FROM AUTHOR]

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To evaluate the prevalence of urinary colonisation in patients with JJ catheters and to define the risk factors associated with these colonisations, as urinary colonisation in patients with JJ catheters plays a key role in the physiopathology of urinary tract infections. This was a monocentric prospective study between January 2013 and April 2017. In all, 145 JJ ureteric catheters in 120 patients, 25 of which had bilateral probes, were examined. The bacteriological profile of the urine of our patients was followed by the completion of an initial cytobacteriological examination of urine and another at the time of removal of the JJ catheter. The comparison of the means was performed using the Student's test and the Mann–Whitney test for continuous variables and by the chi-square test and Fisher's test for qualitative variables. The threshold for statistical significance was set at P < 0.05. The rate of colonised JJ probes was 35.8% (43/145). The urinary colonisation rate was 31.7%. The rate of urinary colonisation in patients with colonised probes was 71.1%, compared to 9.1% for non-colonised probes. Of the identified pathogens, Escherichia coli was found in 38.1% of the colonised probes; Klebsiella pneumoniae was second (19.1%), followed by Enterococcus faecalis (16.6%). The same bacteria isolated in the JJ probes were found in the urine. Diabetes mellitus (P = 0.001), emergency JJ placement (P = 0.02), and JJ implantation time (P = 0.01), were risk factors for urinary colonisation in patients with JJ probes. The prevalence of urinary colonisation in patients with JJ catheters was 31.7%. Diabetes mellitus, prolonged JJ implantation, and emergency JJ placement were associated with a higher risk of urinary colonisation. [ABSTRACT FROM AUTHOR]

To evaluate the impact of the implementation of an enhanced recovery after surgery (ERAS) protocol on functional results after radical cystectomy (RC) for bladder cancer, as RC is a major surgery with significant morbidity and mortality risks. We conducted a monocentric prospective study from March 2017 to April 2018. Patients who underwent RC for bladder cancer at our institute after introduction of the ERAS protocol were compared with a control group of patients who previously underwent surgery with a standard protocol (control group). Primary endpoints evaluated were: length of hospital stay, rates of complications, gas recovery time, and first defaecation. The comparison of the means was performed using the Student's test for quantitative variables, and the Pearson chi-square test and the Fisher's test for the qualitative variables; statistical significance was considered at a P < 0.05. We studied 45 consecutive patients, 17 operated upon with the traditional protocol and 27 according to the ERAS protocol. The mean hospital stay was 9.4 vs 11.7 days, in favour of the ERAS group (P = 0.05). The gas recovery time was longer in the control group, at 69.8 vs 36.4 h (P < 0.001). The delay of the first defaecation was less in the ERAS group, at 126.6 vs 64.6 h (P < 0.001). The general postoperative complication rate was 31% in the control group and 24.4% in the ERAS group. The rate of gastrointestinal complications was higher in the control group, at 8.8% vs 2.2%. Despite the heterogeneity in ERAS protocols, which are different from one centre to another, its application significantly reduced the length of hospital stay and tended to reduce the rate of general and gastrointestinal complications, and the time to gas recovery and first defaecation. [ABSTRACT FROM AUTHOR]

To report our experience and the feasibility of end-to-end anastomotic urethroplasty, as this is an excellent technique for the management of post-traumatic urethral stricture. We present an end-to-end anastomotic urethroplasty in a 17-year-old patient who had abdominopelvic polytrauma at the point of impact. Upon review, the lesional balance revealed a splenic rupture with haemoperitoneum and complete rupture of the membranous urethra, clearly visible on anterograde and retrograde opacification, and fractures of the pubis and the orthopedically treated ischium. The patient underwent an urgent splenectomy for haemostasis with suturing of a grievous wound. After a period of 3 months urethroplasty was performed. Two tips to gain sufficient length of the urethra: the mobilisation of the anterior urethra and the separation of corpora cavernosa in the median line. Two solutions are possible to better individualise the upstream end: the use of a soft fibroscope light or the Beniquet, as in our patient. The urethral anastomosis was performed mucosa against mucosa, the bladder catheter was removed 1-month postoperatively, with a follow-up of 5 years without recurrence. End-to-end anastomotic urethroplasty is a reliable technique for the treatment of post-traumatic urethral stricture. [ABSTRACT FROM AUTHOR]

To report our experience of laparoscopic ureterolithotomy and its effectiveness, as this technique is an excellent alternative to ureteroscopy in the treatment of large ureteric stones. We present a laparoscopic right lumbar ureterolithotomy in a 55-year-old patient with obstructive pyelonephritis on two lumbar calculi measuring 18 and 20 mm, respectively. Urinary drainage was ensured by percutaneous nephrostomy, which was placed preoperatively and removed 15 days postoperatively; there were no postoperative complications, and a fast learning curve. Excellent results were obtained, with no residual fragments. Laparoscopic ureterolithotomy is an effective and reliable surgical procedure with better results (without residual fragments) compared to ureteroscopy. [ABSTRACT FROM AUTHOR]

To analyse the bacteriological correlation between preoperative cytobacteriological examination of urine (CBEU) and urinary calculi, and to evaluate the impact of chemical nature on the bacteriological stones. This was a prospective single-centre study including 42 patients who underwent urolithiasis surgery between January and April 2018. Bacteriological culture of the removed stones was systematic. Mean comparisons were made by the Pearson chi-square test and Fisher's test for qualitative variables, with statistical significance set at P < 0.05. The average age of our series was 56 years, with a male predominance of 83.3%. Bladder opening was performed in 45.2% of our patients. The rate of urinary colonisation was 33.3% (14/42). The rate of infected stones was 35.7%. Of the identified pathogens, Escherichia coli was found in 40% of the infected stones, followed by Enterococcus faecalis (20%), and Staphylococcus coagulase negative and Pseudomonas aeruginosa (13.3%). There was a significant correlation (P < 0.001) between preoperative CBEU and bacteriological analysis of the stones. The infected stones were principally calcium oxalate monohydrate and struvite (P = 0.03, P = 0.01). There is a significant correlation between the bacteriological culture of urinary stones and preoperative CBEU results. A negative preoperative CBEU can guarantee the sterility of urinary calculi in 89.2% for avoiding postoperative infectious complications after surgical manipulation of these stones. [ABSTRACT FROM AUTHOR]

La fibrose rétropéritonéale (FRP) est une maladie rare, caractérisée par la présence d'un tissu fibro-inflammatoire aberrant qui se forme souvent autour de la portion sous-rénale de l'aorte abdominale et des artères iliaques. Une obstruction urétérale est souvent observée. Récemment, la FPR idiopathique est rapportée parmi les manifestations de la maladie à IgG4. L'imagerie joue un rôle important dans le diagnostic de la FRP. Les glucocorticoïdes sont le traitement de référence, utilisés en monothérapie ou en association avec d'autres agents médicamenteux. En cas d'échec des mesures conservatrices, la chirurgie peut être proposée. Récemment, des techniques minimalement invasives ont été utilisées. [ABSTRACT FROM AUTHOR]

Le syndrome de levée d'obstacle est une polyurie massive faisant suite au traitement d'une insuffisance rénale obstructive. Les mécanismes physiopathologiques sont multiples : un état de surcharge hydrique qui dépend du caractère complet ou incomplet de l'obstacle, des anomalies tubulaires (atteinte de la capacité de dilution et de concentration des urines, diminution de la réabsorption du sodium, fuites de potassium, troubles de l'acidification des urines, insensibilité des cellules tubulaires à l'hormone antidiurétique), ainsi que des facteurs biochimiques et immunologiques sont mis en jeu. La levée d'un obstacle nécessite une surveillance clinique et biologique stricte (diurèse horaire, état hémodynamique, état d'hydratation, créatininémie, urémie, ionogramme sanguin). Le traitement a pour but d'éviter les troubles hémodynamiques et métaboliques graves, et repose sur le principe de la compensation des pertes hydroélectrolytiques. [ABSTRACT FROM AUTHOR]