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Biomedical subjects

A Lachkar

Publications and source records attributed to A Lachkar.

At least 19 recordsLinked to original sources
PubMed2003

[Bladder paraganglioma (pheochromocytoma): report of a new case].

The authors report one case of vesical paraganglioma, not suspected in a 50-years-old female patient who presented gross hematuria as only symptom. The patient was not hypertensive. Radiologic and endoscopic investigations revealed a trigonal submucosal tumour. Complete transurethral resection of the tumor was performed with no intraoperative complications. The histopathological diagnosis indicated pheochromocytoma. Blood pressure was stable. There has been no recurrence for 18 months after transurethral resection.

Female↗
PubMed2003

[Vesico-vaginal fistula: report of 1050 cases].

The authors reports their experience of a large series of 1050 cases of vesico-vaginal fistulas recorded during 30 years and analyse their epidemiological, anatomo-clinical, and therapeutic aspects. Patients could be classified as a function of site of fistula into 3 types, according to the Benchekroun's classification: type I ureto-vaginal fistula (30%); type II cervico-vaginal fistula (22%); type III vesico-vaginal fistula (48%). Etiology was mainly obstetrical (93%). An associated lesion was detected in 10.4% of cases (uterine, ureteral and rectal). Treatment was only performed after a minimal period of three months with the following results in obstetrical vesico-vaginal fistulas. Type I fistula, using a low approach and requiring urethral refection in 100 cases, showed good results in only 60% of cases. Type II fistulae, usually treated through a low approach (80%), were treated with 80% good results. Type III fistula, were nearly always corrected (98%) after two procedures. The overall results are good in 80% of cases. The failures concerned in majority the complex vesico-vaginal fistulas type I, are treated by urinary diversion (51 Coffey, 5 Bricker) and since 1975, 73 continent ileocecal or ileal bladders using Benchekrouns' technique.

Adolescent↗
PubMed2003

[Bladder infiltrating tumor: retrospective study of 225 cases].

The authors report a retrospective serial of 225 patients presenting an infiltrating bladder tumor. The infiltrating tumors represent 29.2% of bladder tumors. The middle age of our patients is 59 years with a sex-ratio of 7.3. In the histology, 80% of the tumors are a cell transitional carcinoma and 65% of the patients are classified stage T3T4. The surgical treatment has could be achieved at 73.3% of the cases and 66.7% of the patients had a radical cystectomy. The urinary diversion was essentially an continent urostomy using Benchekroun's hydraulic valve. At 28 months mean follow-up, a locoregional recurrence has been noted from 18% of the Tur achieved alone and 4% of the radical cystectomy. A metastasis has been noted from 18% of the patients and this in a mean delay of 12 months.

Adult↗
PubMed2003

[Superficial pT1G3 bladder tumor: 24 case reports].

The authors report 24 patients presenting a transitional tumor of bladder pT1G3 collected between January 1996 and December 2000. They represent 19% of the superficial tumors of bladder. Two patients had of straightaway a cystectomy after resection for an unverifiable tumor by endoscopy and another after a second resection discovering a real pT2. Only 5 patients received a BCG therapy is 24% of the cases. A recurrence without progression has been noted in 38% of the cases and a progression in 19% of the patients. These last patients had a cystectomy and with a follow-up to 28 months, no recurrence has been noted.

Adult↗
PubMed2003

[Perinephretic phlegmon: about 36 cases].

The authors report a series of 36 cases of perinephric phlegmon during 15 years. The patients are 27 men and 9 women. Mean age was 37 years (ranging between 25 and 70). The promoting factors of PPN are diabetes (27.8%), and kidney calculi (22.3%). Delay diagnosis is more than 3 weeks in 80% of the patients. The clinical symptomatology was dominated by pain, fever and flank mass. Diagnosis is carried out by ultrasonography in 84% and by CT scan whenever it is done. The common germs are negative Gram bacilli and staphylococcus. The treatment consists in antibiotherapy associated to a percutaneous drainage of the collection in 6 patients (16.7%) and a surgical drainage in 30 patients (83.7%). The follow-up are favorable in all cases.

Adult↗
PubMed2001

[Treatment of idiopathic retroperitoneal fibrosis].

Idiopathic retroperitoneal fibrosis is a rare disease and a delay in diagnosis may cause renal failure. Medical treatment i.e. corticotherapy or more recently, tamoxifene has been used successfully. This approach is recommended in patients either with moderate obstruction of the upper urinary, risk of major surgery or in cases of recurrence after surgical treatment. Ureterolysis using conventional surgery or laparoscopy remains the treatment of choice. This procedure should be considered in patients with neoplasic fibrosis, corticoresistant fibrosis or in cases of peri-aneurysm fibrosis.

Humans↗
PubMed2001

[Foreign bodies of the bladder. Report of a new case].

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.

Adult↗
PubMed2001

[Testicular metastasis of prostatic adenocarcinoma. Report of a case].

Metastasis involvement of the testis form prostatic carcinoma is rare. Seventy cases have been reported between 1938 and 1990. We report another case treated by transurethral resection of the prostate, bilateral orchiectomy and nonsteroid androgens and a review of the literature is presented.

Adenocarcinoma↗
PubMed2001

[Scrotal injuries. Report of 40 cases].

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.

Adolescent↗
PubMed2001

[Consultation skills in urology: a model for teaching and evaluation].

OBJECTIVE: Consultation activity is an important aspect of urological practice, but the specific teaching of this activity is underdeveloped. The objective of this study was to establish a list of consultancy skills as a basis for a planned and structured approach to teaching and evaluation of consultancy skills in urology. MATERIAL AND METHOD: Two-step qualitative protocol: 1) Establishment of an initial list of skills based on data of the literature; 2) Submission of this list to a series of "focus groups" (urologists, interns, referring physicians) in order to validate and progressively refine the model. RESULTS: The items identified were classified into 3 distinct lists: 1) theoretical knowledge; 2) technical skills specific to urology, predominantly performed in the consulting setting, 3) interpersonal skills exclusively concerning the consultant-referring physician relationship. CONCLUSIONS: The consensual specification of these skills can be used to objectively define teaching and evaluation strategies for urology consultancy skills.

Referral and Consultation↗
PubMed2000

The hydraulic antireflux valve: a new technique for reimplanting dilated ureters.

PURPOSE: Wide ureters have a high risk of urinary reflux if they are implanted in the intestinal segment. Since 1978, we used the continence hydraulic valve as an antireflux device without staples. MATERIALS AND METHODS: A total of 40 patients, 20-65 years old (mean age 50), 36 with bilaterally severely dilated ureters and 4 with unilaterally dilated ureters underwent reconstructive surgery by intestinal segments with a hydraulic antireflux valve (HAV). RESULTS: Mean follow-up was 62 months (range 14-110); upper tract dilatation had improved or stabilized in all patients but one in whom bilateral dilatation occurred with HAV stenosis. All patients underwent follow-up loopogram studies which revealed 2 cases of reflux (4 ureterorenal units). In 1 of the 2 patients the urinary reflux occurred after dessusception (disinvagination) of the nipple. CONCLUSIONS: The HAV is a safe and reliable procedure in preventing reflux when implanting wide ureters into intestinal segments. This technique can be used in continent urinary diversions with intestinal pouches, and can also be used at the proximal level of an ileoureteroplasty. There is no need for staples.

Adult↗
PubMed2000

[Nephrogenic metaplasia of the ureter].

The authors report a case of nephrogenic metaplasia of the ureter in a 35-year-old patient presenting with left low back pain, haematuria and frequency. Physical examination was not contributive. IVU showed a filling defect in the left iliac ureter. Ureteroscopy demonstrated a tumour nodule in the left iliac ureter. Ureteroscopic biopsy with histological examination showed nephrogenic metaplasia of the ureteric mucosa. Treatment consisted of ureterotomy with resection of the ureteric polyp, followed by closure of the ureterotomy over a double J stent. The course was favourable and postoperative follow-up (IVU, cystoscopy) at 6 months and 12 months was normal.

Adult↗
PubMed2000

[Urinary candidiasis revealed by ureteral obstruction: report of 2 cases].

There has been an increase in the frequency of candidiasis urinary infections, which mainly affect diabetic or immunodepressed patients. However, the obstruction of the upper urinary tract by fungal infection is a rare occurrence. The introduction of novel antifungal agents has improved the treatment of fungal infection. In this study, two cases have been reported of urinary candidiasis infections with obstruction of the upper urinary tract which were successfully treated with fluconazole in combination with ureteral catheterization.

Adult↗
PubMed2000

[Contribution of lumboscopy in the treatment of pyeloureteral junction syndromes. Report of 25 cases].

OBJECTIVE: Evaluation of the results of lumboscopic repair of ureteropelvic junction syndromes. MATERIAL AND METHOD: Retrospective study of 25 consecutive lumboscopic retroperitoneal pyeloplasties performed over 3 years in 14 women and 11 men with symptomatic ureteropelvic junction syndrome. RESULTS: The mean operating time was 200 minutes (range: 120-360 minutes) and mean blood loss was 60 ml. Surgical conversion was necessary in three cases due to the difficulty of dissection and in one case because of rupture of the ureter. Analgesic prescription was generally only necessary for the first 2 postoperative days. The mean hospital stay was six days (range: 2-16 days). Patients were able to return to work an average of 10 days after the operation. With a mean follow-up of 9 months (range: 6 to 18 months), all patients were asymptomatic except for one patient who reported pain at a trocar site. Follow-up urography at 3 months showed marked improvement in 18 patients (85.7%), moderate pyelocaliceal dilatation in 2 cases and one failure. CONCLUSION: Lumboscopic pyeloplasty is an alternative to endopyelotomy. It provides a comparable success rate to that of conventional surgery, while reducing the morbidity, length of hospital stay and convalescence. However, it requires mastery of intracorporeal suture techniques.

Adult↗
PubMed2000

[Staghorn lithasis. Report of 98 cases].

In cases of staghorn lithiasis, the calculus is formed in the excretory cavities of the kidney. It is considered to be a severe type of calculus due to its effect on renal function, associated urinary infection, and its frequent recurrence. In the present study, 98 cases of staghorn calculi have been reported, which were treated over an 8-year period (1990-1997). The patient population consisted of 56 women (62%) and 34 men (38%). The mean age was 46 years (age range: 20-73 years). A history of urolithiasis was noted in 23 cases (26%). The mean time from the onset of symptoms to diagnosis was four years. The clinical symptomatology was as follows: in the right kidney was involved in 54 cases, and both kidneys were affected in eight cases. The calculus was radio-opaque in 94 cases (96%), complete in 29 cases (29%), partial in 69 cases (71%), and associated with caliceal extension in 36 cases (40%). In 47 subjects (52%) other lithiasic sites were found, i.e., caliceal in 41 cases, and ureteral in six cases; Impairment of the renal parenchyma was noted in 33 cases (45%). Urinary infection were found in 30 cases (34%). Renal function was impaired in 15 patients. Staghorn lithiasis was severe in a significant number of subjects, i.e., in 59 cases (60%). Surgical treatment consisted of nephrolithotomy (37 cases), pyelonephrolithotomy (28 cases), pyelolithotomy (18 cases) total nephrectomy (14 cases), and partial nephrectomy (one case).

Adult↗
PubMed2000

[Unusual tumor: liposarcoma of the spermatic cord].

Spermatic cord liposarcoma is a rare tumour, as only 60 cases have been reported in the literature. They represent 7% of all malignant spermatic cord tumours. The authors report a new case of spermatic cord liposarcoma unusual by its inflammatory and fibrotic features, occurring in an 83-year-old man in poor general health. Treatment consists of surgical resection as widely as possible. Adjuvant radiotherapy is sometimes effective on local recurrences. Despite the slow rate of progression of this tumour, prolonged surveillance is required due to the high risk of late recurrence.

Aged↗
PubMed1999

[Adrenal gland pheochromocytoma. Report of 26 cases].

The authors analyse of a series of 26 patients (17 females and 9 males) with a mean age of 32 years (range: 18 to 55 years) operated for adrenal phaeochromocytoma. All patients were hypertensive. The laboratory assessment (assay of blood catecholamines and urinary catecholamine metabolites) performed in more than 2/3 of cases confirmed the diagnosis in more than 80% of cases. The topographic diagnosis was facilitated by computed tomography. Fifteen patients received preoperative treatment with alpha-blockers or calcium channel blockers. Various incisions were used, but a lumbar incision was the most frequent. Blood pressure was controlled postoperatively in 24 patients. Two patients died 1 and 2 postoperatively. New diagnostic modalities (CT, MRI) have facilitated the diagnosis and the site of localization of phaeochromocytomas, thereby improving the choice of incision. Patient-specific preoperative preparation and appropriate anaesthesia facilitate successful adrenal gland surgery.

Adolescent↗