[Treatment of posttraumatic rupture of the posterior part of the urethra using endoscopic reconstruction].
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Adolescent↗
Biomedical subjects
M Hachimi
Publications and source records attributed to M Hachimi.
[Penis fracture: mechanism, evaluation, treatment and treatment outcome].
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Adolescent↗
[Treatment of urethro-rectal fistulas. Apropos of 5 cases].
Urethro-rectal fistulas, consisting of prostato-rectal fistulas and fistulas communicating between the bulbo-membranous urethra and the rectum, are rare, easily diagnosed diseases, which essentially raise a problem of choice of surgical technique. Although the predominant aetiology is currently iatrogenic, many other less frequent aetiologies can also be responsible. Treatment is usually surgical with a large number of possible incisions. In the light of 5 cases, the authors review the various surgical techniques allowing cure of these fistulas, and indicate the advantages and disadvantages or each one.
Adult↗
[Migration of an intrauterine device into the bladder. Report of a case].
PURPOSE: We report an uncommon case of a bladder lithiasis arising from an intrauterine device (i.u.d.). CASE REPORT: A female patient with i.u.d. for 13 years consulted for frequent episodes of cystitis. Patient evaluation demonstrated a bladder stone. RESULTS: Treatment was cystolithotomy, which dislodged two stones. One stone was attached to the IUD. CONCLUSION: Bladder calculus arising from an IUD is very rare. We review the literature.
Adult↗
[Benign prostatic hypertrophy: clinical and therapeutic aspects. Review of 1,280 cases].
Between 1989 and 1996, 1,280 patients aged 41 to 100 years were operated for BPH. 70% of patients were treated at the stage of complications such as acute urinary retention, haematuria, bladder stones or renal failure. 549 patients (42.9%) were treated by transvesical prostatectomy (TVP), 668 patients (52.18%) underwent transurethral resection (TURP) and only 63 (4.92%) were treated by bladder neck incision (BNI). Early postoperative complications essentially consisted of infections: wound infection (15%), followed by vesico-cutaneous fistula (2%), epididymo-orchitis (0.7%) and urinary tract infection (1.5%). Late post-operative assessment revealed retrograde ejaculation in 100% of cases after transvesical surgery, 80% of cases after TURP and almost no cases (4%) after BNI. The permanent urinary incontinence rate was 1.18% after TURP and 1.0% after transvesical surgery. The shortest mean postoperative stay was 5 days in the BNI group versus 12.5 days after transvesical surgery. Finally, the postoperative mortality, essentially due to septic shock and myocardial infarction, was (0.8%). The BPH complication rate is proportional to the delay in diagnosis and management. Transurethral resection remains the most effective treatment with the lowest morbidity.
Adult↗
[Secondary sclerosis of the prostatic compartment after surgical treatment of benign prostatic hypertrophy].
In an 8-year period, 10 patients/1,280 developed bladder neck sclerosis following prostatectomy--an incidence of 0.78%. The mean age is 66 years (range 45-88).clinical signs of the disease are characteristic of infravesical obstruction confirmed by uroflow and X-ray examination. The best results for the treatment of the contracture were obtained after bladder neck incision and transuretral resection of the bladder neck contracture which gave--with mean follow-up of 12 months (range 7-24 months)--0% incidence of recurrence but after bladder neck dilatation it rose 100%.
Aged↗
[Prostatic chronic lymphocytic leukemia. Report of 2 cases].
Infiltration of the prostate is frequent in the course of leukaemia. It is usually asymptomatic or may present in the form of classical bladder neck obstruction. The diagnosis is generally established during investigation of the prostate by biopsy or during treatment by resection. The authors report two cases of prostatic involvement in chronic lymphocytic leukaemia.
Diagnosis, Differential↗
[Prostatic tuberculosis. Report of 2 cases].
The authors report two cases of isolated tuberculosis of the prostate. This is a very rare site. The symptoms are not specific and the diagnosis is usually made on histological examination. Treatment is based on antituberculous chemotherapy.
Aged↗
[Renal cancer in adults. Review of 68 cases].
The authors report a series of 68 cases of renal cancer observed over a 9-year period. Patients consisted of 33 women (49%) and 35 men (51%), with a mean age of 53 years (range: 23-85 years). The clinical features were polymorphic, dominated by loin pain (44%), haematuria (37%), a lumbar mass (19%), alteration of the general state (7%). The diagnosis was established by ultrasonography in 59 patients and CT-scan in 63 patients. The mean tumour diameter was 11 cm (4-22 cm) and two cases presented bilateral tumours. The time to diagnosis ranged from 1 month to 7 years. Staging reflected the advanced stage of the cancer. Treatment was surgical for 58 patients (58%). A lumbar incision was performed, in 40% of cases. Radical nephrectomy was performed in 82%, and partial nephrectomy was performed in 3% of patients. Histological examination of the specimen showed renal cell carcinoma in 75% of cases. The lymph nodes removed were invaded in 20% of cases. The mean follow-up was 29 months (6 to 84 months), normal at one year for 44 patients (86%) and at 5 years for 16 patients (31%). Tumour recurrence in the renal compartment was observed in 2 patients (4%). Asynchronous metastases occurred in 11 patients (21.5%) after 21 months. (range: 12-48 months). The overall 5-year survival was 100% T1, 69% T2 and 50% T3.
Adult↗
[Desmoid tumor of the mesentery secondary to colectomy. An exceptional cause of ureteric obstruction].
Desmoid tumours are rare lesions with a local invasive potential and a risk of recurrence, considered to be benign due to the absence of metastases. They are classified as fibromatoses and may be associated with Gardner's syndrome. The authors report an unusual case, in a 33-year-old woman, of a desmoid tumour invading the right ureter with upper tract dilatation. Etiologic factors (traumatic, hormonal, auto-immune...) are discussed, together with the treatment of choice to lower the risk of recurrence.
Abdominal Neoplasms↗
[Primary non-Hodgkin's malignant lymphoma of the adrenal gland. Case report and review of the literature].
Primary lymphoma of the adrenal gland is an exceptional site for non-Hodgkin's malignant lymphoma, as fewer than 50 cases have been reported in the international literature. To our knowledge, this is the first reported case of intraoperative discovery. The diagnosis of primary adrenal lymphoma can be suggested in the case of bilateral involvement and adrenal insufficiency, but there are no specific clinical or complementary criteria. The main differential diagnoses are adrenal metastases and adenomas. Management is often that of an incidentaloma. Primary NHML of the adrenal gland has a poor prognosis with a mean survival of 15 months. Only one case with a survival of 8 years has been reported in a patient treated with adjuvant radiotherapy, while basic treatment consists of combination chemotherapy. Our patient was treated by adrenalectomy followed by close surveillance.
Adrenal Gland Neoplasms↗
[Severe injury of the female urethra resulting from pelvic fracture. Report of a case].
The authors report the case of a woman presenting with urethrovesical rupture and vaginal fistula following pelvic trauma. This is a rare lesion, only 30 cases were reported in the literature [12]. The diagnosis may be initially missed, as it requires a meticulous emergency uro-gynaecological examination. Lesions involve the bladder and almost all of the urethra, injuring both the smooth and the striated sphincters. Treatment by reconstructive surgery after good exposure of the fistula achieved a good anatomical result and a moderate functional result.
Adult↗
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↗
[Rigid ureteroscopy. Apropos of 88 cases].
Rigid ureteroscopy has become a common tool for the diagnosis and management of several diseases of the upper urinary tract. Between April 1990 and April 1996, 92 ureteroscopy procedures were performed in 88 patients in the B Urology Department of Avicennes hospital for diagnostic or therapeutic purposes. The commonest therapeutic procedure was stone manipulation (72 cases). The overall success rate was 90.8% (Distal ureter: 89.6%, mid ureter: 80%, lumbar ureter: 100%) and the complication rate was 4%. Therapeutic ureteroscopy was also used to dry ureterovaginal fistula (4 cases) and ureteral fistula with retroperitoneal urinoma (2 cases), and to remove a double J stent which had migrated into the pelvic ureter (3 cases). Diagnostic ureteroscopy was performed for 7 ureteral strictures including 3 extrinsic compressions and 4 ureteral strictures all treated with dilatations after biopsy. One false passage was observed among diagnostic ureteroscopy procedures. Rigid ureteroscopy is a minimally invasive and reliable technique for the management of ureteric calculi and for the diagnosis and treatment of other ureteric lesions.
Adolescent↗
Endoscopic percutaneous drainage of a renal echinococcal cyst during percutaneous nephrolithotomy.
In Morocco, hydatid disease is endemic and constitutes a major problem of public health. Renal echinococcal cyst ranks third after pulmonary and hepatic locations. We report a case of renal echinococcal cyst diagnosed during percutaneous nephrolithotomy which was treated endoscopically. To our knowledge, this situation has not been reported previously in the literature.
Adult↗
[Percutaneous endopyelotomy. Apropos of 27 cases].
27 percutaneous endopyélotomies were performed in 27 patients from February 1989 to January 1996 to treat 20 cases of congenital hydronephrosis and 7 cases of acquired stenosis. Strictures of uretero-pelvic junction were treated by electrocautery with postoperative drainage using a double J stent in 11 cases, or Redon drain in 16 cases. The evaluable results for 25 patients with a mean follow-up of 11 months showed an overall success rate of 80%. This technique is the treatment of choice for acquired stenosis and stage I and II congenital hydronephrosis (Cendron).
Adolescent↗
[Vestigial retrorectal dermoid cyst. Apropos of a case].
A case of recto-rectal congenital development cyst is described in 35-year-old man. This cyst presented in the form of voiding symptoms. Computed tomography revealed the relation and components of the development cyst. Treatment consisted of complete surgical excision via a transabdominal approach.
Adult↗
[Fractures of the penis: apropos of 56 cases].
OBJECTIVES: To review the diagnostic and epidemiological aspects and especially to demonstrate the value of emergency surgical treatment. PATIENTS AND METHODS: In 8 years (1989-1996), 56 fractures of the penis in 55 patients were surgically repaired as an emergency procedure immediately after admission. The skin incision was often elective and longitudinal. After evacuation of the haematoma, the fracture was sutured with slowly resorbed suture material. The presence of a concomitant urethral lesion was systematically investigated and repaired. RESULTS: The mean age was 30 years, and 72.75% of patients were unmarried men. The mean operating time was 40 min and the mean hospital stay was 1.5 days. The immediate postoperative course was always favourable. In 36 long-term evaluable patients, sexual activity was resumed with no difficulties of erection or intromission. No case of chordee of the penis was observed, but two patients presented a cicatricial nodule. CONCLUSION: Fracture of the penis is a rare disease and is diagnosed clinically. Emergency surgical treatment is the only guarantee of a good functional prognosis.
Adult↗