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Biomedical subjects

K Tazi

Publications and source records attributed to K Tazi.

At least 19 recordsLinked to original sources

[Youssef syndrome (vesico-uterine fistula): three case reports].

The authors report a series of three cases of Youssef syndrome observed over a 10 year period. All the fistulas were secondary to cesarian section. The diagnosis was established on clinical findings in one case. The intravenous urography was performed in all the cases and visualised the uterine cavity in one case. In the remaining cases the diagnosis was established by the retrograd cystography. The treatment was surgical for two patients and the third one refused any treatment. With a mean recoil of fifteen months the results judged on the disappearance of the clinic signs were good in the two patients opered. The objective of this study is to analyse the aetiological, diagnosis and therapeutic aspects of this pathology.

Adult↗

[Perineoscrotal gangrene: report of 51 cases. Diagnostic and therapeutic features].

OBJECTIVE: To approach the treatment of Fournier's gangrene. So, pathophysiology and etiology are recalled. METHODS: The authors present 51 cases of Fournier's gangrene treated from 1989 to 1998, their age ranged from 19 to 89 years. Data were collected on admission signs and symptoms, physical examination. Aggressive surgical debridement of all necrotic tissues was performed, Intravenous antibiotics and resuscitation fluid were also administered. RESULTS: All patients were male. In 20 cases (39%), there was no identifiable cause, and in 31 cases (61%), the etiology of gangrene was urethral (33%), anorectal (28%) and unknown (19%). The average hospital stay was 30 days. Three cases underwent unilateral orchidectomy, six colostomy and in 17 cases, a suprapubic catheter was inserted. Mortality was high (18%) and essentially associated to debilated state and toxi-infectious context. CONCLUSION: Fournier's gangrene is a true urologic emergency potential lethal, which requires aggressive antibiotic and surgical treatment.

Adult↗

[Retroperitoneal liposarcoma. Case report].

We report one case of retroperitoneal liposarcoma treated by surgery and radiotherapy. With the literature, we discuss the pathologic and therapeutic aspect of this lesion.

Diagnosis, Differential↗

[Complex vesicovaginal fistula. Report of 55 cases].

OBJECTIVE: To specify the clinical and therapeutic peculiarities of complex vesico-vaginal fistulas. MATERIAL AND METHODS: 55 cases of complex vesico-vaginal fistulas are reported. After the clinical diagnostic all the patients had an intravenous excretory urogram. The fistulas were classified according to the Benchekroun classification. RESULTS: The mean age was 34 years (17-70 years). The diagnostic was made clinically in all the patients. Thirteen patients had an abnormal intravenous excretory urogram. The treatment was made by a vaginal way in 45 patients, by an abdominal way in three patients and by a mixed way in two patients. Four patients had an urinary diversion and one refused the treatment. Among the 50 patients whose fistula was treated, 44 (88%) were continent whom 26 (52%) after one operation, 15 (30%) after two operations and three (6%) after three operations. CONCLUSION: The complex vesico-vaginal fistulas as all the vesico-vaginal fistulas are diagnosed clinically. The intravenous excretory urogram is indispensable to search an associated ureteral lesion. The treatment is surgical and usually needs the interposition of a vascularised graft.

Adolescent↗

[Martius' technique in the treatment of complex vesicovaginal fistula].

Sixteen cases of vesicovaginal fistulae (including 14 urethrovaginal fistulae), were treated vaginally using Martius' procedure. The authors describe the technique for the interposition of a labial fat pad, between the bladder and the vagina. The results are good. Thirteen patients have been cured. In one case a second was necessary using Guittes technique. There was two failures.

Adult↗

[Inflammatory pseudotumors of the kidney: a case report].

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).

Carcinoma, Renal Cell↗

Leiomyosarcoma of the prostate: a study of two cases.

Leiomyosarcoma of the prostate is rare neoplasm that accounts for less than 0.1% of prostate malignancies. A number of treatment approaches have been adopted including radical surgery, radiotherapy and chemotherapy, but in no instance has a successful outcome been obtained. Prostate leiomyosarcoma has a poor prognosis, although survival time can vary. For these reasons, it is important to correctly identify this disease and report its occurrence, type of treatment, and the response to therapy of each patient diagnosed as having leiomyosarcoma of the prostate in an attempt to improve our understanding of the natural history of these lesions.

Humans↗

[Comparative results of the treatment of post-traumatic ruptures of the membranous urethra with endoscopic realignment and surgery].

OBJECTIVE: Retrospective, comparative study of the long-term results of endoscopic realignment and surgery in the treatment of complete rupture of the posterior urethra. MATERIAL AND METHODS: Between 1989 and 1998, 40 men were managed for traumatic posterior rupture of the membranous urethra: 30 were treated by endoscopic realignment for complete rupture while 10 were treated by surgery (perineal or transsymphyseal incision) for a long stenosis (> 3 cm) secondary to extensive rupture of the urethra. RESULTS: With a mean follow-up of 30 months (12 to 72 months), all patients treated by endoscopic realignment are continent and urinate with a satisfactory urine output (Qmax > or = 15 ml/s). This result was obtained after internal urethrotomy in 7 patients (23.33%) and transperineal urethroplasty in one patient. Six patients developed persistent impotence (20%). For the ten patients treated surgically, the voiding stream was considered to be satisfactory (Qmax > 15 ml/s in 6 patients while 4 developed short strictures accessible to endoscopic urethrotomy. Nine patients are continent, while one completely incontinent patient with perineal fistulas required a continent cystostomy. Four out of 10 patients reported sexual impotence. CONCLUSION: Endoscopic realignment of complete rupture of the membranous urethra is a simple, minimally aggressive technique, ensuring optimal preservation of continence and sexuality in young subjects.

Adolescent↗

[Urogenital tuberculosis. Experience in 10 years].

OBJECTIVE: To review the clinical, imaging and therapeutic aspects of urogenital tuberculosis. MATERIAL AND METHODS: From April 1989 to April 1999, 57 patients with urogenital tuberculosis were reviewed in our department. This series consisted of 32 males and 25 females with a mean age of 40 years (range: 18 to 72 years). RESULTS: The most frequent clinical symptoms were irritative symptoms (47.3%). Fever, anorexia and weight loss were rare (11%). 16% of patients had an isolated genital lesion. 14% presented with renal failure (mean serum creatinine: 18 mg/l). Only 3 cases (5.2%) presented with bacilluria. Urography showed abnormalities in 80% of cases. The most frequent abnormality was a non-functioning silent kidney in 23 cases (40.3%). The positive diagnosis was based on bacteriological (5 cases) and histological data (52 cases). Treatment consisted of antituberculous chemotherapy in all patients, in combination with surgery (75%), and/or endourological procedures (26.3%). Nephrectomy is still indicated for non-functioning tuberculous kidneys in order to prevent the development of hypertension, abscess and fistulas. CONCLUSION: The diagnosis of urogenital tuberculosis is difficult and often late. A surgical or endourological procedure is often necessary to preserve renal function and to improve quality of life.

Adolescent↗

[Prostatic leiomyosarcoma (report of 2 cases)].

The authors report 2 cases of prostatic leiomyosarcoma. The first patient was not operated because of a severely debilitated state and died a fortnight after admission to hospital. The second patient underwent cystoprostatectomy with ilio-obturator lymph node dissection. Resection margins and lymph node dissection were negative and no further treatment was required. With a 10-year follow-up, the clinical and radiological assessment was normal. The diagnostic and therapeutic aspects of this rare prostatic tumour are discusses.

Adult↗

[Unusual form of adrenal pheochromocytoma: asymptomatic cystic mass].

We report an adrenal cyst discovered in a 26-year-old woman with abdominal pain. Imaging (ultrasonography, computed tomography) demonstrated a 12 cm adrenal cystic mass suggestive of hydatic cyst of adrenal. She undergoes surgical exploration, when blood pressure increases. Pheochromocytoma diagnosis is reconsidered. Cystic pheochromocytoma is a rare tumour of the adrenal gland that can pose a diagnostic challenge.

Adrenal Gland Neoplasms↗

[Hypospadias in adults].

INTRODUCTION: In order to evaluate the long-term results and complications, the authors reviewed the files of 14 adult patients operated for the first time for hypospadias. MATERIAL AND METHODS: This study was based on retrospective analysis of the files of 15 adults between the ages of 17 and 36 years operated for hypospadias between 1989 and 1999. The findings of the first visit concerned the site of the urethral meatus, the presence and severity of chordee and the primary and secondary sexual characteristics. Urine culture was performed in all patients. RESULTS: The follow-up was 12 months to 8 years. Six of the 15 patients were treated by urethroplasty alone and 9 patients underwent urethroplasty with correction of chordee. 40% of patients (3 cases of anterior hypospadias, 2 cases of midpenile hypospadias and 1 vulviform hypospadias) obtained a good long-term result. In the case of complications (fistula, stenosis or distal necrosis of the tube), a single reoperation allowed good results to be achieved in 80% of the series. CONCLUSION: The results of treatment of hypospadias in adult patients differ from those obtained in children despite the use of similar surgical techniques.

Adolescent↗

[The York Manson approach in the treatment of prostato-rectal fistulae].

The York Mason approach appears to be one of the most suitable techniques for the treatment of prostato-rectal fistulas, as it provides a maximum chance of success with no morbidity, as no cases of anal incontinence have been reported to date. The authors report a case of prostato-rectal fistula secondary to transurethral resection of the prostate for benign prostatic hyperplasia treated by the YORK MASON posterior trans-anosphincteric approach.

Fistula↗

[Uretero-vaginal fistula. Therapeutic alternatives concerning 10 cases].

OBJECTIVE: Our purpose was to study aetiopathogenic, diagnostic and therapeutic aspects of ureterovaginal fistulas. STUDY DESIGN: A retrospective study concerned 10 ureterovaginal fistulas. The main causes were gyneacoligical and obstetrical procedures. The diagnosis was based on clinical considerations and intravenous pyelography in all cases. Various therapeutic methods were used: Fistulas has managed in three cases by ureteroneocystostomy. Five cases were managed with ipsilateral ureteroureterostomy, the segment of ureter below the fistula was identified using ureteroscopic perforation of this segment in three cases. In one case the fistula was successfully managed by ureteroscopic placement of ureteral stent. In case whose fistula was developed after cancer pelvic we choice abstention. RESULTS: Late radiology showed success of the procedure in 7 patients and persistance of hypotony in 2 cases treated by u reteroneocystostomy. CONCLUSION: Ureterofistula is rare, but a relative frequent complication of pelvic surgery whose prevention is the most efficient treatment. Ureteroureterostomy is a good procedure when ureteroscopy is performed.

Adult↗

[Paratesticular rhabdomyosarcoma in the young adult].

The authors report a case of paratesticular thabdomyosarcoma in a young adult. This tumour is more frequent in children than in adults. Rhabdomyosarcoma is the commonest variety of soft tissue sarcoma in children and young adults. It represents 6.5% of all malignant tumours in paediatrics with an annual incidence of 4 to 7 cases/million children. The primary paratesticular site is considered to have a good prognosis in comparison with other rhabdomyosarcomas, despite the frequency of retroperitoneal lymph node invasion. This superficial site allows rapid diagnosis and consequently often complete resection of the tumour. The multidisciplinary treatment of paratesticular rhabdomyosarcoma has improved control of the disease with a 2-year survival of 80%.

Adult↗

[Treatment of inflammatory urethral stenosis with endoscopic urethrotomy].

Urethral stricture, mainly consisting of cases of inflammatory stricture, is a frequent occurrence in Morocco. Numerous techniques have been proposed to treat these disorders, including internal endoscopic urethrotomy (IEU). Initially described by Otis and Maisonneuve using a blind approach, IEU was then further developed by Saches who carried out direct vision urethrotomy. It rapidly became established as the method of choice for primary treatment of urethral stricture, and classical surgery was limited to those cases in which this method had failed. However, although this technique is relatively simple and appears to be efficient, there is in fact a high relapse rate, necessitating repeated IEU; therefore at present there is a tendency to return to the classical methods of anastomotic resection and urethroplasty after the second or third IEU. Although the relapse rate is low for short, single or bulbar strictures, it is high for penile strictures and for those with accompanying severe periurethral fibrosis. In this study, we have reported the results of a homogeneous series of 149 cases of urethral stricture treated by internal urethrotomy. The aim of this retrospective study was to better define the indications for adopting this technique, and also to determine the reasons for failure. The various alternatives to IEU (resection, plasty) have been examined, as has their respective failure rate.

Adolescent↗