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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.

The condition known as scrotal elephantiasis is a debilitating rarity where the scrotum undergoes significant swelling, typically arising from chronic obstructive lymphedema. A case is presented of a 60-year-old man who had suffered severe and persistent enlargement of his scrotum for multiple years. This affliction greatly affected both his ability to function effectively and caused detrimental psychosocial consequences.After a clinical evaluation, the patient was diagnosed with scrotal elephantiasis.A comprehensive strategy was adopted, utilizing scrotal volume reduction surgery to yield a significant enhancement in the quality of life following the operation.

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.

We report a case of spontaneous bladder rupture due to bladder carcinoma. A 62-year-old man presented to the emergency department with acute urine retention; two days later, the patient presented with abdominal distension and a large intraperitoneal effusion on CT scan, as well as a breccia in the bladder.Exploratory laparotomy confirmed a definitive diagnosis: bladder rupture due to bladder carcinoma. He underwent radical cystectomy.Surgery is recommended to treat carcinomatous bladder rupture. Rapid diagnosis is essential to optimize patient outcomes. The possibility of spontaneous bladder rupture should not be overlooked as a differential diagnosis in cases of acute abdomen.

Spontaneous renal subcapsular effusion is a rare condition, diagnosis is suspected on ultrasound and confirmed by a computed tomography (CT) scan. Treatment options include mainly percutaneous drainage and surgery. Authors report the case of a young female patient treated at our department of Urology B, university hospital center Ibn Sina, Rabat, MOROCCO. The patient underwent a minimally invasive treatment approach, which yielded excellent results.

Liposarcomas are an uncommon occurrence in the paratesticular region that makes about 20 % of all sarcomas. The clinical appearance is an inguinal lump, which can resemble a hydrocele or hernia. There would be no conventional treatment accessible because it is such a rare disease. We report the case of a 68-year-old man with paratesticular myxoid liposarcoma. Ultrasound and CT-scan came back in favor of a paratesticular tumor. A high inguinal orchidectomy has been done and the diagnostic of myxoid liposarcoma was first evoked by histology and confirmed by molecular biology. At 12 months follow up the patient remains tumor free.

Rarely occurring at birth, crossed renal ectopia is an abnormality in which both kidneys occupy the same side of the body while one ureter - its length based on kidney location - traverses across midline to graft into opposite-side bladder.McDonald and McClellan classified renal ectopia into 4 types.Solitary crossed renal ectopia (SCRE) is an extremely uncommon abnormality of the urinary system. To date, only 35 instances have been documented in published literature. Typically, these cases are detected by chance during patient assessments for related issues such as genitourinary, cardiovascular, hematological or vertebral abnormalities.

Abstract Background Granular cell tumors (GCTs) also called Abrikossoff's tumor are rare tumors of often benign neurogenic origin, mainly located in the craniocervical region, rarely found in the external genitals. We report in this article the case report of a purely cutaneous case of rare clinical presentation at the level of the penis. Case presentation We report the case of a man, aged 54, with no history, consulted for a nodular lesion on the penis evolving for a year. a nodular cutaneous plate, indurated 3 cm in large diameter, painless and mobile in relation to the deep plane. The lymph node areas were free, and the remainder of the skin examination was without abnormalities. Conclusions Granular cell tumors (GCTs) also called Abrikossoff's tumor are rare tumors of often benign neurogenic origin, mainly located in the craniocervical region, rarely found in the external genitalia, the diagnosis is based on anatomopathology study completed by immunohistochemistry, and treatment consists of complete surgical excision of the tumor.

Congenital anterior urethral diverticulum is a rare entity that can occur at any age but exceptionally in adults. Its diagnosis is suspected clinically by obstructive symptoms of the lower urinary tract most often associated with a penoscrotal ball.Its management consists of a diverticulectomy associated or not with a urethroplasty depending on the size of the diverticulum.We discuss through a case report the clinical and therapeutic aspects of this rare entity.

Abstract Background Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor that develops from the wall of the IVC and can be confused with many other retroperitoneal tumors. We report the observation of a man with leiomyosarcoma of the vena cava which invades the right kidney. Case presentation 56-year-old man who has seen progress for right back pain for over a year. His thoraco-abdominal-pelvic scanner found a right tumor process measuring 18 × 13 × 18 cm invading the right kidney and the inferior vena cava, heterogeneous in nature, which is enhanced after injection of iodinated contrast product, pushing back the liver and the gall bladder. A border of separation persisted between the mass and the abdominal and thoracic walls. His biological assessment was normal. He underwent an open right nephrectomy with intraoperative bleeding requiring a transfusion of 2 red blood cells. The patient's follow-up period was 8 months without local recurrence or secondary localization. Conclusion The LMS of IVC is a tumor whose management is not yet well codified. Surgery is the only therapeutic means that gives good results, when it is possible. But long-term recurrences remain frequent, which therefore requires prolonged monitoring of these patients.

Abstract Background The aim of this study was to analyze the feasibility and the safety of laparoscopic nephrectomy in the treatment of pathologies of the upper urinary tract through the experience of the Urology B department. Methods We have retrospectively and monocentrally selected patients who underwent laparoscopic nephrectomy from January 2017 to December 2019. The collection was carried out on archived files, based on demographic, clinical and perioperative data. The primary endpoint was the occurrence of complications and secondarily the length of the operation and the length of hospital stay. The statistical analysis was carried out using the SPSS software. Results A total of 68 patients were included in our series. The average age of our patients was 57.8 years. There was a slight female predominance: 39 female patients (57.4%) for 29 male patients (42.6%). Indications for nephrectomy were dominated by renal tumor (33.82%) followed by lithiasis (16.17%) and non-functioning kidney (16.17%) at the same rank. During the study period, 31 (45.6%) simple nephrectomy, 26 (38.2%) total nephrectomy, 1 (1.5%) partial nephrectomy and 10 (14.7%) nephroureterectomy were performed in our department. In our series, the average operating time was 180 min. Estimated blood loss averaged 321.8 ml with extremes of a few milliliter to 1100 ml. Intraoperative complications were reported in 10 (14.7%) patients; conversion was necessary in 6 cases (8.82%). The postoperative follow-up was straightforward in 53 (77.94%) patients with an average hospital stay of 3.6 days. The rate of postoperative complications according to Clavien–Dindo was 22.1%. Histological examination of the nephrectomies carried out in our department revealed mainly chronic non-specific pyelonephritis in 24 (35.3%) patients, followed by renal cell carcinoma in 23 (33.82%) patients and urothelial carcinoma in 9 (13.2%) patients. Conclusion Laparoscopic nephrectomy appears to be an efficient and reliable technique. This technique has led to a significant improvement in operative morbidity, mainly represented by the length of hospital stay, operating time and blood loss.

Abstract Background The testicular epidermoid cyst is an exceptional benign tumor. The presumptive diagnosis is facilitated by the development of medical imaging (echo-Doppler, elastography, contrast-enhanced ultrasound, MRI). The confirmatory diagnosis is histological. Case presentation We report the case report of a 37-year-old man who had a history of repetitive orchitis. He had complained of right scrotal discomfort for 6 months with no associated urinary symptoms. We performed an extemporaneous biopsy given the uncertain diagnosis (Fig. 3), and the histological examination was in favor of a mature teratoma. This prompted us to perform a right orchidectomy. The postoperative was simple. The final histological examination tipped in favor of an epidermoid cyst of the testicle. The patient was seen again at one month, and his clinical examination was normal. Conclusion The testicular epidermal cyst is a rare benign tumor of the testicle. Currently, conservative surgery has become the gold standard thanks to the development of medical imaging to differentiate between the both forms of TEC, and it retains certain limits which lie in the differential diagnosis with the teratoma requiring large multicenter studies to better characterize these two entities.

Abstract Background The aim of this study is to evaluate the prevalence of urinary colonization in patients with the JJ stent and to define the predictive factors associated with this colonization. Methods This is a monocentric prospective study (between January 2013 and April 2017), conducted in the department of Urology B of Ibn Sina Hospital in Rabat. One hundred and forty-five double ureteral stents carried by 120 patients, 25 of which had bilateral double ureteral stent, were examined. The bacteriological profile of the urine of our patients was followed by the completion of an initial urine examination and another at the time of the removal of the JJ. The comparison of the means was made by the Student's test and the Mann–Whitney test for continuous variables and by the KHI-2 test and Fisher's test for qualitative variables. The threshold of significance is set at 0.05. Results The rate of colonization of JJ stent was 35.8% (43 out of 120). The urinary colonization rate was 31.7% (38 out of 120). Average time of indwelling of JJ stent was 90 days. On double ureteral stent culture, we identified Escherichia Coli as the most predominant colonizing pathogen (47.3% of probes) followed by Enterococcus faecalis and Klebsiella pneumoniae (18.4% and 15.8%, respectively). 11.5% of colonized patients developed infectious complications (5 out of 43) and have been treated successfully except a patient who died from septic shock. In univariate analysis, diabetes mellitus (p = 0.007, OR = 4.1, CI = 1.46–11.48), urgent establishment of JJ (p = 0.03, OR = 4.61; IC = 1.08–19.6) and time of indwelling of the JJ (p = 0.05, OR = 1.89, CI = 0.95–3.77) were the predictive factors for urinary colonization in patients with JJ. In multivariate analysis, these three factors were statistically associated with this risk: diabetes mellitus (p = 0.005, OR = 0.23, CI = 0.08–0.64), the urgent establishment of JJ (p = 0.05, OR = 0.26, CI = 0, 06–1.04) and time of indwelling of the JJ more than 30 days (p = 0.007, OR = 4.29, CI = 1.49–12.37). Conclusion The prevalence of urinary colonization in patients with the double J stent was 31.7%. Diabetes mellitus, time of indwelling of the JJ more than 30 days and urgent JJ ​​ establishment are associated with a higher risk of these urinary colonizations. Strict monitoring is therefore recommended in patients with these risk factors. These results should be confirmed by multicenter and randomized studies to analyze the development of urinary tract infections in colonized patients.

Background The variant of urothelial carcinoma (UCV) is a rare and aggressive histological entity; its therapeutic management remains debated. Methods Between January 2017 and October 2019, 39 patients were diagnosed retrospectively with urothelial carcinoma with a histological variant. The aim of this study was to analyze the clinico-pathological and therapeutic aspects of these variants to better understand this invasive disease. Results In 39 cases, 36 (92%) were men and 3 (8%) were women; the average age was 62 years; 54% of patients had a ≥ cT3 stage with clinical lymph node involvement in 28% and 23% had distant metastases, 36% of patients were treated with RC and 54% by other therapeutic and 10% refused RC. No patient received neoadjuvant chemotherapy. Lymph node involvement was 28.5%. The two predominant histological types were squamous and micropapillary differentiation between the operating piece and bladder biopsy 28.5%, 30% and 21.5% and 13%, respectively. The overall survival at 20 months was 70 and 40% for RC and the other therapeutic (TURB alone or a TURB with an adjuvant), respectively. There was no significant difference in survival between the two groups (p = 0.27). Conclusion UCVs are heterogeneous groups of tumors which are increasingly identified due to their distinct morphological characteristics with variable clinical prognosis. Therapeutic management is not in favor of cystectomy in our study. However, a prospective study using a larger cohort is still necessary to validate our results.

The purpose of this study is to clarify the associations between the enhancement patterns on contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) and the aggressiveness and prognosis of pancreatic neuroendocrine neoplasms (PanNENs). Patients who underwent CH-EUS and were pathologically diagnosed with PanNEN were included in this study. Patients were divided into three groups according to contrast-enhancement patterns on early-phase and late-phase imaging: “Group A”, vascular rich in both phases; “Group B”, vascular rich and vascular poor in early and late phases, respectively; “Group C”, vascular poor in both phases. Of 39 patients, 25 were assigned to Group A, 7 to Group B, and 7 to Group C. The median overall survival was not reached in Groups A and B and was 335 days in Group C (p < 0.001). The 1-year survival rates were 100% in Group A, 60% in Group B, and 43% in Group C. Patients in Group C showed the shortest overall survival among the three groups. The vascular-poor pattern on late-phase CH-EUS had the highest sensitivity, specificity, and accuracy for aggressive PanNENs among the patterns analyzed on CH-EUS and CECT (84.6%, 91.7%, and 89.2%, respectively). CH-EUS is useful for the diagnosis of and predicting the prognosis of PanNENs.

Cases of rectal foreign bodies (RFB) insertion are frequently encountred in the last years, leading to many complications, while many patients tends to obscure the context. This entity represent a particular form of rectal injuries that can be more lethal with the peritoneal involvement. However, combination of genitourinary injuries to rectal injuries doesn't worsen the prognosis.We report a case of a RFB injury leading to an extraperitoneal rectal injuri with a recto-vesical fistula that was managed effectively conservatively with successive CT Cystogram follow-ups.