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K el Khader

Publications and source records attributed to K el Khader.

At least 19 recordsLinked to original sources
PubMed2003

[Psychological, sexual and social aspects of bladder exstrophy in adulthood. Analysis of 3 cases].

Rare congenital malformation, bladder exstrophy is usually treated soon after birth. Based on three cases report of bladder exstrophy in adulthood (two men and one women aged from 21 to 25 years), the authors emphasize the importance of psychological, sexual, and social disorders caused by this affection treated at this age. Urinary problems were excluded of this study. The authors stress the necessity of an early management of this malformation, if possible at birth in order to minimize these consequences.

Adult↗
PubMed2001

[Bladder exstrophy in the adult: therapeutic features. Report of 3 cases].

Bladder exstrophy is a malformation which the incidence is estimated at 3.3 per 100,000 births. It is usually treated in the first hours of life. The authors report three cases of bladder exstrophy treated in adult life with continent urinary diversion such as Benchekroun continent ileocaecal bladder (CICB). After a literature review on the management of bladder exstrophy, they studied clinical and therapeutical particularities of the bladder exstrophy in adulthood.

Adult↗
PubMed2001

[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↗
PubMed2001

[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↗
PubMed2001

[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↗
PubMed2001

[Unusual testicular tumor: Leydig, Sertoli, and granulosa cell mixed tumor].

We report an unusual case of a mixed granulosa-Sertoli-Leydig cell testicular tumor in a 16 year old man, who presented with bilateral gynaecomastia. A few cases have been published in the literature. Based on a case report, the authors describe the clinical, histopathological and therapeutical features of this rare affection.

Adolescent↗
PubMed2001

[Urethral diverticulosis in women. Analysis of 15 cases].

OBJECTIVE: To evaluate the aetiopathogenic, diagnostic and therapeutic aspects of urethral diverticula in women. MATERIAL AND METHODS: Over a 10-year period (January 1990 to December 1999), 15 patients with a mean age of 36 years (range: 25 to 46 years) with urethral diverticulum were included in this study. The mean parity was 2 with a history of long and difficult delivery in 6 cases. All patients presented lower urinary tract symptoms with a clinical diverticulum on gynaecological examination (14 cases) or on retrograde and voiding cystourethrography (14 cases) or intravenous urography (one case). Diverticulectomy was performed via a transvaginal approach in the dorsal position. RESULTS: There were no postoperative complications. All patients were reviewed with a mean follow-up of 3 years. The urinary symptoms had completely disappeared in 14 cases. One patient was reoperated for recurrent diverticulum. CONCLUSION: Young women with recurrent voiding disorders must be examined for the presence of urethral diverticulum that can be confirmed by cystourethrography. Transvaginal diverticulectomy in the lithotomy position is the operation which ensures the best results.

Adult↗
PubMed2001

[Transitional cell carcinoma on ureteral stump after nephrectomy for pyonephrosis].

The authors report a case of transitional cell carcinoma of the left ureteral stump in a 66-year old man treated by nephrectomy for pyonephrosis 6 years previously and cystoprostatectomy for bladder tumour 13 years previously. In the light of this case and based on a review of the literature, they essentially discuss the diagnostic and aetiopathogenic problems raised by this disease.

Aged↗
PubMed2001

[Spontaneous hematoma of the adrenal glands].

We report an uncommon case of unilateral spontaneous hematoma of the right adrenal gland in a 22-year old young man. Preoperative diagnosis was made by ultrasonography and CT-scan. A right adrenalectomy was performed. Pathological evaluation showed an isolated hematoma without adrenal abnormalities. The diagnostic and therapeutic aspects are discussed.

Adrenal Gland Diseases↗
PubMed2000

[Our results with percutaneous nephrolithotomy. Report of 61 cases].

Between January 1990 and December 1997, 61 patients with renal calculi underwent percutaneous nepholithotomy. In the immediate postoperative period, 49 renal units (80.3%) were stone-free. At three months, our overall success rate was 91.8% after spontaneous elimination of non-significant residual calculi (< 3 mm). Complications were observed in 9.8% (six cases); hemorrhage and sepsis were the major complications. Percutaneous nephrolithotomy is an effective, safe and reliable alternative to the open operation.

Adolescent↗
PubMed1999

[Bologna procedure in stress urinary incontinence with stage III cystocele (with or without vaginal hysterectomy)].

OBJECTIVES: The vaginal approach constitutes a solution for all types of urinary stress incontinence (USI). The type of surgery depends on the position of the bladder neck and urethra, the quality of the sphincter and the severity of genital prolapse. The objective of this study was to evaluate the efficacy of the Bologna procedure in the treatment of urinary stress incontinence (USI) with stage III cystocele. MATERIAL AND METHODS: This procedure can repair genital prolapse and USI via a 2 cm suprapubic incision, with vaginal hysterectomy, and intraoperative cystoscopy. The patient is placed in the lithotomy position and a Crossen T-shaped vaginal incision is made releasing the anterior wall and allowing the creation of 2 pedicled vaginal flaps posterior to the urethral meatus. The flaps, passed through the suprapubic pelvic fascia, support the bladder neck by means of 2 nonresorbable sutures to the rectus abdominis muscles. Fifty-four patients were treated by the Bologna procedure with or without vaginal hysterectomy from 1990 to 1996 and were reviewed with a mean follow-up of 30 months (16 to 46 months). All women (mean age: 63.4 years) underwent a preoperative clinical examination, renal ultrasound, cystoscopy and urodynamic assessment (37 cases). RESULTS: Twelve patients developed postoperative complications (9 local infections, 3 cases of deep vein thrombosis with one pulmonary embolism). All complications were treated by local drainage and/or removal of the suspension sutures. Continence was excellent in 45 women (83.3%), improved in 4 (7.4%), and unchanged in 5 (9.3%). The anatomical results were excellent with correction of prolapse in 48 patients (89%). Six patients subsequently developed prolapse of the vaginal dome and 5 complained of voiding discomfort. CONCLUSION: USI and genital prolapse must be treated simultaneously. The vaginal approach is minimally invasive and can treat both diseases during the same operation.

Aged↗
PubMed1999

[Microsurgical epididymal sperm aspiration (MESA), testicular biopsy and intracytoplasmic sperm injection (ICSI) in the treatment of male infertility].

OBJECTIVE: To assess if ICSI using epididymal or testicular spermatozoa is effective in the treatment of couples with male factor infertility. MATERIAL AND METHODS: 56 couples suffering from male infertility underwent a total of 88 treatment cycles of ICSI, in combination with microsurgical epididymal sperm aspiration (MESA): 62 cycles, or testicular sperm retrieval: 26 cycles. RESULTS: Overall, fertilization rate was 63% per injected metaphase II oocyte. In MESA group, fertilization rate was 64% compared to 61% embryos in testicular sperm aspiration. The overall pregnancy rate was 26% per started ICSI cycle. Pregnancy rates were also similar in both group: 24% for MESA and 32% for testicular sperm extraction. 9 pregnancy (41%) were obtained using cryopreserved epididymal sperm (6 cases) or testicular sperm (3 cases). CONCLUSION: ICSI combined with epididymal or testicular sperm achieved a high fertilization and pregnancy rate. It constitutes an efficient alternative in the treatment of men suffering of testicular failure or azoospermia not amenable to surgical reconstruction.

Adult↗
PubMed1998

[Conservative treatment of stage III kidney injuries].

OBJECTIVE: The aim of this study is to evaluate the safety and effectiveness of conservative management in stage III renal trauma. MATERIAL AND METHODS: We reviewed the records of 150 patients who presented in our institution with renal trauma between 1986 and 1995. RESULTS: Minor injuries (stage I and II: 100 cases) were treated with expectant management. Only 3 patients required nephrectomy in this group. Stage III injuries were seen in 40 patients. The great majority (85%) were treated conservatively with renal sparing procedures such as endourologic techniques (14 cases), nephrorraphy or partial nephrectomy (20 cases). Total nephrectomy was performed in 15% of the cases and only for severely injured kidney or major associated intraabdominal injuries. In this group, none of the patients suffered from hypertension at follow-up. All patients (10 cases) with pedicle injury (stage IV) required total nephrectomy. CONCLUSION: Stage III renal trauma with urinary extravasation can safely be treated conservatively.

Adolescent↗
PubMed1998

Unusual case of Munchausen's syndrome: factitious vesical lithiasis.

We report an uncommon case of a 38-year-old woman who admitted for bladder lithiasis undergoing repeated surgical management and being apparently recurrent. The intravenous pyelography and retrograde urethrocystography clear the urinary tract. Biologic evaluation eliminates any metabolic or endocrine cause. The confirmation of a factitious origin is given by fluorescence X analysis of the extracted stones which conclude to calcium carbonate structure and psychiatric care. The self-intromission of these calculi into the bladder is due to the personality disorder being in the frame of Munchausen's syndrome. Two years later, no recurrence is noted and an excellent psychiatric care is achieved.

Adult↗