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Biomedical subjects

M Tligui

Publications and source records attributed to M Tligui.

17 recordsLinked to original sources
PubMed2006

Lymphoproliferative disorder presenting as a tumor of the renal allograft.

Post-transplant lymphoproliferative diseases (PTLDs) constitute a group of potentially life-threatening complications in solid organ transplantation, occurring in 1-2% of kidney transplant recipients. The absolute number of cases occurring at each transplant center remains small, making it difficult to assess incidence, prognosis, and treatment. We report a case of post-transplant lymphoproliferative disorder that developed in the allograft renal parenchyma 2 years after renal transplantation. This case implies that partial nephrectomy may be a safe and effective treatment protocol for renal lymphoma in allograft kidneys.

Humans↗
PubMed2003

Emergency extracorporeal shock wave lithotripsy (ESWL) for obstructing ureteral stones.

OBJECTIVE: To evaluate emergency treatment of obstructing ureteral stones by in situ extracorporeal shock wave lithotripsy (ESWL) during acute renal colic. PATIENTS AND METHODS: From January 1994 to February 2000, 200 patients (mean age: 42 years) were treated by ESWL (EDAP LT-02) for obstructing ureteral stones causing acute renal colic refractory to medical treatment or recurring within 24hours of such treatment. Stones were visualised by fluoroscopic imaging and/or ultrasound. Follow-up included radiological and/or ultrasound examinations and lasted three months. RESULTS: Mean stone size was 7mm (3-20mm). At three months, 164/200 (82%) patients were stone-free. This rate ranged from 79% to 83% according to the location of the stone, and from 75% to 86% according to the size of the stone. These differences in rate were not significant. Two or three ESWL sessions were required in 79 patients. ESWL was well tolerated in 90% of patients. The only complication was a case of pyelonephritis requiring the placement of a JJ stent, administration of antibiotics, and distant ureteroscopy. The 36 patients, in whom ESWL failed, underwent ureteroscopy (n=23) or lithotripsy with a Dornier machine (n=13). CONCLUSION: Non-deferred ESWL for acute renal colic secondary to obstructing ureteral stones has a satisfactory success rate and very low morbidity.

Acute Disease↗
PubMed2001

[Bilateral emphysematous pyelonephritis].

Based on a case report and a review of the literature, the authors describe the features of bilateral emphysematous pyelonephritis. This rare disease with a poor prognosis constitutes a difficult clinical diagnosis. The positive diagnosis is based on urgent computed tomography. The reference treatment is emergency nephrectomy in an intensive care context.

Aged↗
PubMed2000

[Epididymal gaseous abscess after BCG treatment].

The authors report a case of unilateral epididymitis with caseous abscess after BCG-therapy for superficial bladder tumour. The severity of the lesions required orchidectomy, followed by four-agent tuberculostatic therapy.

Abscess↗
PubMed2000

[Peroperative erection in lower urologic surgery].

Erection is a rare event during lower urinary tract surgery. When it is extremely refractory, endoscopy is impossible and the lower urinary tract surgery may need to be deferred. The development of erection during spinal anaesthesia is due to manipulations before complete installation of sensory block or incomplete blockade of sacral segments (S2 to S4) supplying the nervi erigentes. The mechanism of erection during general anaesthesia remains poorly elucidated. General anaesthesia may suppress central or peripheral sympathetic control of flaccidity. The peripheral target could be the smooth muscle of the cavernous tissue, either by a direct action or via alpha-adrenergic receptors. Psychogenic and reflexogenic stimuli have also been proposed, possibly facilitated by amplification of sensations during stage II anaesthesia. The various treatments are based on experience acquired in the field of priapism. Systemic treatments such as ketamine an beta 2 mimetics or benzodiazepines are not always effective and are associated with considerable adverse effects. Intracavernous injections of alpha-adrenergic drugs constitute the treatment of choice. Phenylephrine and etilefrine are preferred because of their rapid efficacy and particularly their only moderate cardiovascular adverse effects.

Anesthesia↗
PubMed2000

[Predictive factors of successful treatment of lower caliceal calculi with Edap LT02 extracorporeal lithotripsy].

OBJECTIVE: To determine the predictive factors of success of extracorporeal shock-wave lithotripsy (ESWL) for lower caliceal stones. PATIENTS AND METHODS: The case files of 100 patients with a single stone in the lower pole of the kidney, ranging in size from 6 to 25 mm, treated by EDAP LTO2 extracorporeal lithotripsy between 1994 and 1997, were studied. Pretreatment intravenous urography was reviewed to assess the characteristics of the stone, to measure the pyelocaliceal angle and to study the anatomy of the lower pole of the kidney. RESULTS: The overall stone-free rate at 3 months was 57%. The success rate was 67.18% for stones smaller than 1 cm and 38.88% for stones larger than 1 cm. Stones denser than bone were successfully treated in 45.5% of cases, those less dense than bone were successfully treated in 71.11% of cases. The success rate was 86.04% when the pyelocaliceal angle was greater than 90 degrees and 35.08% when this angle was less than 90 degrees. The stone-free rate was 75% when the caliceal stalk was less than 3 cm and 37.5% when the stalk was greater than 3 cm. CONCLUSION: In this series, the size of the stone, its density, the pyelocaliceal angle and the length of the caliceal stalk were predictive elements of the success of ESWL for lower caliceal stones. The pyelocaliceal angle was the most significant factor. A very dense stone on the plain abdominal film with a diameter of 1 cm or more and presenting unfavourable anatomical factors should be treated by percutaneous nephrolithotomy as the first-line procedure.

Adult↗
PubMed2000

[Pelvic endometriosis with ureteral obstruction. Case report].

The authors report 1 clinical case of pelvic endometriosis. The urinary symptoms and the radiological appearance of endometriosis with compression of the ureter are non specific. The diagnosis was established by histological examination of the resection specimen. The authors describe the therapeutic approach based on radical surgery designed to eradicate the endometriosis, while remaining as conservative as possible in order to allow subsequent pregnancy, and the place of urological surgery combined with medical treatment with LHRH analogue.

Adult↗
PubMed2000

[Balloon catheter parieto-renal dilatation in percutaneous kidney surgery].

OBJECTIVE: To compare two techniques of parieto-renal dilatation for percutaneous surgery: Alken dilators and balloon catheter. MATERIAL AND METHODS: This prospective, non-randomized study was conducted between July 1999 and April 2000 in 20 patients undergoing percutaneous renal surgery. 10 patients were dilated with a balloon catheter (NephroMax, Boston Scientific) and the other 10 patients were dilated with Alken metal dilators. Statistical analysis was performed with the Mann-Whitney test. RESULT: The dilatation time and x-ray exposure time were shorter during balloon catheter dilatation (statistically significant difference) and the two techniques were associated with a comparable morbidity. CONCLUSION: Balloon catheter parieto-renal dilatation significantly decrease dilatation and x-ray exposure times and very considerably simplifies this operative step, essential to the success of percutaneous surgery.

Adult↗
PubMed1999

[Emphysematous pyelonephritis: apropos of a case and review of the literature].

Based on a case report and a review of the literature, the authors describe the features of emphysematous pyelonephritis. This rare disease with a poor prognosis constitutes a difficult clinical diagnosis. The positive diagnosis is based on urgent computed tomography. The reference treatment is emergency nephrectomy in an intensive care context.

Emergencies↗
PubMed1999

[Outpatient treatment of pelvic ureteral calculi with extracorporeal lithotripsy. Report of a series of 200 patients consecutively treated].

OBJECTIVE: To demonstrate the feasibility of first-line outpatient treatment of symptomatic stones of the pelvic ureter (sometimes immediately following an episode of renal colic), without anaesthesia, by extracorporeal shock-wave lithotripsy using a latest generation apparatus (EDAP LT02) with concomitant dual guidance. PATIENTS AND METHODS: The mean age of the patients was 45 years. The mean stone diameter was 7 mm (range: 3 to 25 mm). Lithotripsy was performed under dual ultrasound and fluoroscopic guidance. All patients were reviewed at 3 months with follow-up and x-rays. RESULTS: Fragmentation was considered to be complete in 79% of cases, partial in 10.5% of cases and absent in 10.5% of cases. Overall, 87% of stones were completely eliminated at 3 months. The only complication was fever of 38.5 degrees C requiring urinary tract drainage and subsequent ureteroscopy. Complementary treatment was necessary in 26 cases: ureteroscopy (n = 20), alkalinization (n = 1), Dornier ESWL (n = 5). CONCLUSION: ESWL by EDAP LT02 allows first-line outpatient treatment of stones of the pelvic ureter with a satisfactory success rate.

Adult↗
PubMed1997

Retroperitoneal laparoscopic nephrectomy of native kidneys in renal transplant recipients.

BACKGROUND: The purpose of this study was to compare retroperitoneal laparoscopic nephrectomy in transplant recipients and in other patients scheduled for nephrectomy. METHODS: From February 1994 to July 1996, 15 transplant recipients and 17 other patients underwent a total of 36 retroperitoneal laparoscopic nephrectomies for various indications. Operative time, morbidity, and hospital stay were compared between the two groups. RESULTS: The average operating time for the 36 procedures was 95+/-38 min (range, 35-180 min). It was shorter in transplant recipients (81+/-32 min) than in other patients (100+/-39 min, P<0.05). There was one postoperative complication in the transplant recipient group. The average length of the postoperative hospitalization was 3.7+/-1.4 days (range, 2-8 days). CONCLUSIONS: The retroperitoneal laparoscopic approach for nephrectomy is as safe and effective in renal transplant recipients as in other patients. Postoperative stay and delay to resumption of oral immunotherapy are short. This approach has become our first-line approach for native nephrectomy in transplant recipients.

Adolescent↗
PubMed1997

In situ extracorporeal shock wave lithotripsy for acute renal colic due to obstructing ureteral stones.

The purpose of the present study was to evaluate in situ extracorporeal shock wave lithotripsy (ESWL) for the treatment of obstructing ureteral stones causing acute renal colic. In situ ESWL with an EDAP LT-02 piezo-electric lithotriptor was used in a prospective study to treat 67 patients with obstructing ureteral stones causing acute renal colic. Patients were treated without anesthesia on an out-patient basis or during a one-day hospital stay. The overall one month stone-free rate was 94% (94% for proximal stones and 95% for distal stones). The overall success rate after a single ESWL session was 81%. Treatment was well tolerated in 90% (60/67) of patients. There was one case of non-obstructive pyelonephritis and one of ureteral edema. These rates compare well with published reports for delayed treatment in patients without renal colic. Immediate ESWL for cases of acute renal colic due to obstructing ureteral stones is an effective treatment strategy that warrants wider consideration.

Acute Disease↗
PubMed1997

[Cowper's gland: anatomic, physiological and pathological aspects].

Cowper's glands are small appendages of the male genital tract, that are sometimes observed on intravenous urography voiding films. They are involved in the immune defence of the genitourinary tract, play a role in fertility, and secrete many glycoproteins, including PSA. They can be visualized in the form of a duct image parallel to the urethra, sometimes associated with opacification of the gland on IVU. This image can be differentiated from a fistula, extravasation of contrast agent, urethral duplication, or an artefactual image, by the course parallel to the urethra, the upper limit not exceeding the urogenital diaphragm, and the position of the orifice. These glands can be affected by neoplastic, infectious, stone and especially cystic disease: syringocele. The physician should think of these glands in patients with unusual genitourinary symptoms in order not to miss disease of these organs, and to prescribe appropriate treatment.

Bulbourethral Glands↗
PubMedDate not supplied

Helical CT and 3D reconstruction of ureteropelvic junction obstruction: accuracy in detection of crossing vessels.

PURPOSE: The purpose of our study was to evaluate the accuracy of 3D helical CT and its value in surgical planning for the treatment of ureteropelvic junction obstruction (UPJO). METHOD: CT scans and 3D reconstruction of renal vessels and the renal pelvis were performed in 20 cases of UPJO treated by open surgery. We analyzed scans in search of a vessel at the junction and its position relative to the UPJ. Helical CT scans and 3D reconstructions were correlated with macroscopic surgical findings. RESULTS: CT scans demonstrated the presence of a UPJO in all cases. Crossing vessels were present at the junction in 13 of 20 cases. The vessel crossed the junction posteriorly in six cases and anteriorly in seven cases. Macroscopic surgical findings were in agreement with helical CT reconstructions in 100% of the cases. CONCLUSION: Axial scans together with 3D reconstruction are an accurate way of detecting crossing vessels when UPJO occurs, and the choice of the most adequate surgical technique is facilitated.

Humans↗