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Biomedical subjects

M N Mhiri

Publications and source records attributed to M N Mhiri.

At least 19 recordsLinked to original sources
PubMed1997

[The pathological prostatic utricle: two case reports].

The prostatic utricle is a small vestigial diverticulum on the posterior surface of the prostatic urethra. It is considered to be pathological when it is abnormally dilated. The prostatic utricle is revealed by signs of vesical irritation and dysuria, sometimes associated with a retrovesical mass on examination. The authors report two cases of pathological prostatic utricle. The first case was an 11-year-old boy presenting with dysuria. Retrograde cystourethrography confirmed the diagnosis. The utricle was resected via a transtrigonal intravesical approach. The second case was a 25-year-old man who presented with dysuria associated with a pelvic mass. IVU and ultrasonography suggested a diagnosis of retrovesical cyst. This patient underwent incomplete resection of the utricle via a retrovesical approach. Based on a review of the literature, the authors emphasize the need to look for a prostatic utricle in a young subject presenting with dysuria, particularly in patients with a malformation of the genitourinary tract (hypospadias, renal agenesis). All pathological prostatic utricles must be treated surgically. The incision is transtrigonal in medium-sized utricles and transperitoneal in large utricles. The utricular cavity must be resected as completely as possible.

Adult↗
PubMed1997

[Renal cell adenocarcinomas. Report of 64 cases].

The authors report 64 renal cell carcinomas observed in 64 patients over a period of 14 years (1982-1995). The mean age was 58 years (range: 20 to 80 years). Male involvement was observed in 34 cases (53%). The clinical symptoms were nonspecific, consisting of haematuria (26 cases), back pain (33 cases) and tumour (8 cases). Twenty patients presented with paraneoplastic syndromes and 4 presented with metastases. The tumour was an incidental finding in 6 cases. Fifty two patients were treated by radical nephrectomy and two by partial nephrectomy. The tumour was associated with venous involvement in 2 cases, lymphatic involvement in 4 cases and distant metastases in 2 cases. The overall 5-year survival was 37% with a poor prognosis in the case of lymph node involvement or metastases and in the case of secondary local recurrence (4 cases) or distant metastases (2 cases).

Adult↗
PubMed1997

[Kidney contusions and traffic accidents. Apropos of the Tunisian experience].

The authors report a retrospective series of 45 cases of blunt renal trauma from a total of 685 cases of blunt abdominal trauma observed between 1989-1993. This multicentre trial was designed to illustrate the severity of this type of trauma and to place it in the context of road accidents in Tunisia.

Abdominal Injuries↗
PubMed1997

[Contusions to the pathologic kidney. A retrospective study, apropos of 34 cases].

The authors report a retrospective study of 34 cases of blunt renal trauma affecting a pathological kidney out of a total of 156 cases of renal trauma. The patients were between the ages of 3 and 60 years, with a male predominance (sex-ratio: 2.4). The predominant cause of trauma was a household accident, in 15 cases (44%). The clinical features were dominated by haematuria and pain. The underlying renal disease was dominated by renal stones (15 cases, 44%) and ureteropelvic junction (UPJ) abnormality (10 cases, 29%). Twelve patients with benign trauma and minimal underlying renal disease were treated conservatively. Surgery was indicated in the remaining 22 patients, but only 20 were actually operated. Nephrectomy was performed in 9 patients and partial nephrectomy was performed in 3 patients. Treatment consisted of UPJ plasty in 2 cases, uretero-caliceal anastomosis in one case, stone surgery in 4 cases and suture of ruptured renal pelvis in one case. The postoperative course was marked by the development of a urinary fistula in 1 patient, cured by drainage and deterioration of hydronephrosis in one patient. Lastly, one patient died from Wilms' tumour. This disease therefore tends to have a fairly benign course, which nevertheless depends on the underlying renal disease.

Accidents, Home↗
PubMed1997

[Kidney injuries in children. Apropos of 65 cases].

The authors report a retrospective series of 65 cases of renal contusion in children affecting 45 boys and 20 girls between the ages of 10 months and 15 years (mean age: 10 years). The causes of renal trauma were dominated by household accidents (53.8%) and road accidents (33.8%). Associated extrarenal lesions were observed in 21.5% of cases. 55.4% of the 65 contusions were considered to be benign, 27.7% of moderate severity and 16.9% were serious. The blunt trauma affected a pathological kidney in 19 cases. Exclusively medical treatment was recommended in 31 patients, while surgery was indicated in the other 34 patients. Apart from one death in a context of multiple trauma, few complications were observed in the group of operated patients and consisted of 4 cases of urinary fistula and 4 cases of infection, all of which resolved.

Accidents, Home↗
PubMed1997

[Traumatic rupture of the anterior urethra. Apropos of 18 cases].

The authors report a retrospective series of 18 cases of rupture of the anterior urethra, with a mean age of 25 years (range: 10 to 45 years). The mechanism of the lesion was trauma by falling onto the perineum (12 cases), road accident (4 cases) and sexual intercourse (2 cases). Urine drainage was ensured by suprapubic catheter (15 cases) or urethral catheter (1 case). The two cases of rupture of the urethra associated with lesions of the corpora cavernosa required urgent surgical repair. In the other cases, simple urine drainage was sufficient to treat partial ruptures of the urethra (11 cases) with only one case of urethral structure. However, end-to-end urethrorraphy was performed in the 4 patients with total rupture of the urethra, with early failure in 3 cases, attributed to delayed surgery. Finally, the course of urethral rupture associated with rupture of the corpora, cavernosa was favourable in terms of both micturition and sexual function.

Accidents, Traffic↗
PubMed1996

[Serious urinary infections and pregnancy].

Retention of infected urine in the upper urinary tract which is due to obstruction is a serious condition during pregnancy. The authors report their experience on five cases and propose attitudes to adopt against such emergency. Ultrasounds allow accurate diagnosis of the obstruction and may be helpful to find its etiology. Plain X ray film could be of interest mainly for stone recognition after the third month of gestation. Surgical treatment, when possible allows either relief of obstruction and cure of the original disease, otherwise performance of percutaneous nephrostomy represents a better way of drainage until the end of pregnancy.

Adult↗
PubMed1996

[Adrenal cortex adenomas. A retrospective series of twenty cases].

The authors report 20 cases of adrenal cortex tumours which were collected over a period of 12 years (1984-1995). Sixty five per cent of patients were females. They were aged between 27 months and 85 years with a mean of 40 years. Clinical symptoms were dominated by hypertension (11 cases). Seven cases were discovered incidentally and a precocious puberty syndrome presented in the form of 2 cases. Surgery was performed in 18 cases. Adrenalectomy was performed in 16 cases and tumor removal in 2 others. Four patients underwent other procedures such as nephrectomy or splenectomy. Three adrenal tumors were considered to be malignant. Postoperative follow-up was marked by two deaths; otherwise the postoperative course was uneventful.

Adenoma↗
PubMed1996

[Adrenal pheochromocytoma. Report of six cases].

The authors report 6 cases of adrenal pheochromocytoma seen over a period of 3 years (1993-1995). All patients were females, aged between 17 and 43 years with a mean of 35 years. Clinical manifestations consisted of either sustained hypertension, with episodes of hypersudation and palpitations, or paroxysmal hypertension which was revealed during surgery ; the disease was sometimes discovered incidentally. C.T and ultrasound showed in every cases adrenal mass as 3 to 6 cm usually located on the left side (5 cases). All patients were operated via lumbotomy and adrenalectomy was performed. In one case an associated thrombus within the vena cava was removed. Postoperative follow-up was uneventful except for one patient who developed a recurrent episode of hypertension.

Adolescent↗
PubMed1996

[Bladder hernia apropos of a case report].

The authors report a case of bladder hernia associated to prostatic benign hyperplasia. The diagnosis is confirmed by intra-venous urogram and computed tomography imaging. The reintegration of the bladder in the abdomen was performed in association to endoscopic resection of the prostate. Bladder hernia is rare condition. Surgical treatment of bladder hernia is associated to the etiology (prostatic benign hyperplasia...) of the hernia to prevent recurrence.

Diagnostic Imaging↗
PubMed1996

[Bladder hernias].

The authors report 5 cases of bladder herniation through inguinal ring. All the patients were males aged between 52 and 72 years with a mean of 63 years. The clinic symptoms were non specific. In four cases the diagnosis was made by IVP. In the fifth case the bladder herniation was discovered after an incidental opening of the bladder during a right inguinal hernia repair. Four patients were operated on for replacement of the bladder and repair of the hernial ring; the procedure followed was Mac Vay technique in two cases, Shouldice in one case and placement of a Mersuture prosthesis in another case. The fifth patient was operated on because of major constraint related to his general conditions. Results was quite satisfactory in all operated cases with a mean control of 24 months.

Aged↗
PubMed1995

[Cancer of the testis in cryptorchidism. Apropos of 5 cases].

Five cases of cancer of the testicle in patients with cryptorchidism are presented. In one case the tumour occurred 16 years after cure for cryptorchidism at 15 years of age. In the other cases, the tumour developed on a testicle in an inguinal or intra-abdominal position. In two cases, it was impossible to remove the tumour which had developed on an intra-abdominal position. These patients died. These cases emphasize the importance of surgical cure in all cases of cryptorchidism, preferable before the age of 2 years, in order to improve functional prognosis and reduce the risk of cancerization. The gravity of cancer of the testicle in cases of cryptorchidism is often discovered too late.

Adult↗
PubMed1995

[Urinary calculi in a geriatric setting].

The authors report a retrospective series of 174 patients with urolithiasis. They were all age between 65 and 88 years. This group represents one tenth of all patients treated for urinary stones in the Urology department of Sfax over the last decade. Neither the clinical symptoms nor radiological findings observed in this group differed from those other patients hospitalized for urolithiasis; on the other hand associated diseases related to aging appear to be well represented which alters the management, prognosis and outcome in this type of patients.

Aged↗
PubMed1994

[Nephrectomy in children. Apropos of 55 cases].

Based on a series of 55 children undergoing nephrectomy, the authors describe the clinical, laboratory, radiological, therapeutic and prognostic features for each aetiology. They define the criteria for resection of the affected kidney.

Adolescent↗
PubMed1994

[Bladder tumors in patients under 40 years of age].

A total of 13 patients under the age of 40 years were treated for bladder carcinoma. One child had a bladder sarcoma. 8 patients had a superficial transitional cell carcinoma with no evidence of recurrence after endoscopic resection. Four patients had invasive bladder carcinoma. Superficial bladder carcinoma would appear to have a good prognosis in patients under 40 years of age.

Adolescent↗
PubMed1994

[Male internal pseudohermaphroditism or a man with a uterus].

Mullerian structures were discovered during cure of bilateral ectopic testes in a 14-year-old boy. The original feature of this case was the presence of both testes on the same side. The Mullerian structures were left in place as they were intimately adherent to the vas deferens. This attitude was adopted as no degeneration of these structures has been described and because of the possibility of reproduction of these patients during adulthood.

Adolescent↗