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R Aboutaieb

Publications and source records attributed to R Aboutaieb.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Treatment of lymphocele after kidney transplantation].

Lymphocele is a possible postoperative complication of renal transplantation and its treatment is still controversial. Over a 3-year period (January 1992 to December 1993), 7 patients with a complicated lymphocele were treated by various modalities. Puncture-drainage was used in 7 cases, Povidone sclerotherapy was performed in 4 cases and internal drainage was performed by surgical marsupialization in one case and by laparoscopy in 4 cases. The results of external drainage and sclerotherapy were disappointing, with 1 good result out of 7 and 1 moderate result out of 4, respectively. On the other hand, internal drainage was effective in every case, whether it was performed by surgical or laparoscopic marsupialization. The latter technique avoids the disadvantages of open surgery in high-risk patients. Laparoscopy appears to be the treatment of choice for post-renal transplantation lymphoceles, as it is simple, rapid and effective.

Adult↗
PubMed1996

[Uretero-ileoplasty].

There are several therapeutic procedures for stenosis of the ureter. Ileal plasty is indicated in case of extended stenosis or those located in the pelvis when the poor quality of the bladder prevents use of a bladder flap. We report 6 surgical cases from 1977 to 1993, there were 4 women and 2 men, mean age 34 years. There was an inflammatory cause in 4 cases (tuberculosis or bilarziosis), retroperitoneal fibrosis in 1 case and idiopathic stenosis in 1. Radiographically, the stenosis was unilateral in the iliac area (3 cases), unilater in the pelvis (1 case) and bilateral and iliopelvic in 2 cases. Associated lesions included bladder injury with a small sclerotic bladder in 3 cases. Partial unilateral was used in 2 cases, bilateral U ileoplasty in 1 and ileouretero-cecocystoplasty in 3. Results were good in 5 cases with a follow-up from 2 months to 7 years. The patient with bilateral U ileoplasy without an antireflux procedure had massive bilateral reflux with renal failure and urinary infections. Ileoureteroplasty is indicated in case of extensive stenosis of the ureter. Results are good if an effective antireflux system is installed.

Adult↗
PubMed1996

[Ureteral reimplantation].

Various techniques of ureteral reimplantation have been described for different indications. After a retrospective study concerning 109 cases and 178 ureteral reimplantations, the authors propose the selective indications for each technique noting the most important results. The indications for reimplantations are numerous and varied: enterocystoplasty (60 cases), iatrogenic lesion of the pelvic ureter (11 cases), inflammatory stenosis (13 cases), renal transplantation (20 cases), primary megaureter (4 cases), stenosis of reimplantation (2 cases). 5 techniques were used in this study: Leduc-Camey, Leadbetter-Politano, Direct, Manchette, Lich-Gregoir. We conclude that in ureterodigestive reimplantation, Leduc-Camey modified method is indicated. In renal transplantation, Lich-Gregoir is the ideal technique. In primary megaureter, the Leadbetter-Politano procedure possibly with ureter modelling improves the results. In iatrogenic lesions of the pelvic ureter, Leadbetter-Politano technique and possibly a hitch-bladder gives a good result.

Adult↗
PubMed1996

[Lithiasis and ectopic pelvic kidney. Therapeutic aspects].

Kidney in ectopic position is dysplasic, and associated to other malformations. The advent of a lithiasis in these conditions rises questions about therapeutic options. We report on five observations of pelvic ectopic kidney with urinary lithiasis. Patients were aged from 16 to 42 years. Kidney was non functional in two cases, or with normal appearance sized 10 to 12 cm. We performed total nephrectomy in two cases, pyelolithotomy in the other cases. Surgical approach was subperitoneal via iliac route. A dismembered pyeloplasty was associated in one case. All patients did well. Radiologic control at 6 and 12 months showed no recurrence in a well functioning kidney. Surgical lithotomy is advocated as a treatment in urinary lithiasis affecting ectopic kidney. It is an easy procedure which permits correction of other associated malformations.

Adolescent↗
PubMed1995

[The therapeutic aspects of urogenital tuberculosis. Apropos of 86 cases].

On the basis of a series of 86 cases of urogenital tuberculosis and a review of literature, a detailed study of the different therapeutic methods of this affection is done. Today, with the tuberculostatic agents, the medical treatment alone is frequently sufficient and ablative surgery is less often mandatory than reconstructive. Different types of short course chemotherapy and the role of associated steroids are reviewed. Finally, the authors stress the indications of ablative surgery and review the different procedures of reconstructive surgery in order to clearly define a logical therapeutic approach.

Adolescent↗
PubMed1995

[Perinephritic cellulitis. Apropos of 75 cases].

In spite of the contribution of the new techniques of radiology and the use of new antibiotics, the diagnosis of perinephric abscess remains difficult and late and is at the origin of high morbidity and mortality. 75 cases of perinephric abscess collected during 15 years are reviewed. We studied the etiopathogenic, diagnostic, bacteriologic and therapeutic characteristics of this affection. Urinary signs are found in 26.7% of patients, diabetes in 17% and extra urinary origin is found in 11% of patients. Diagnostic delay is over one month in 75% of patients. Ultrasonography is carried out in 55 patients showing evocative images of perinephric abscess in 96% of cases. Computed tomography seems more performant than ultrasonography. Gram negative bacillus and staphylococcus are the germs which are the most frequently found. Surgical drainage associated to antibiotherapy is realized in all patients with collected perinephric abscess (73 cases). Evolution is often favourable in spite of the expanse of the abscedation. Literature data about pathogenesis, bacteriology, diagnosis and treatment of this affection are discussed.

Abscess↗
PubMed1995

[Evaluation and treatment of closed traumas of the kidney].

On the basis of a series of fifty-one blunt renal injuries and a review of literature, the characteristics of this affection are reviewed. This trauma typically occurs in young adults. Minor injuries are the most frequent (75.5 percent) and associated lesions are not rare. Computed tomography is the imaging technique of choice for renal trauma assessment. It can, sometimes, be replaced by urography-ultrasonography couple. Indications of these imaging modalities are reviewed. A classification in four types, adapted to new imaging methods, is proposed to harmonize or to compare therapeutic indications. The different therapeutic methods, their indications and their particularities are studied and a simple decisional strategy is proposed.

Accidents, Traffic↗
PubMed1995

[Augmentation enterocystoplasty. Apropos of 15 cases].

We reviewed the efficacy of augmentation enterocystoplasty about 15 cases, based on technical modalities and intestinal loop used. There were 10 tuberculosis bladders, 2 bilharzial bladders, 2 interstitial cystitis and one neurogenic bladder. We used for bladder augmentation the sigmoid (7 cases), ileum (6 cases) and coeco-ileum (2 cases). Ureteroileoplasty is associated in three cases for large tuberculous ureteral stenosis, and reimplantation of ureter in the neobladder is realised in seven cases. The results with detubularized ileum were excellent. We observed in one patient persistence of dilatation of upper urinary tract after use of detubularized sigmoid. The results with use of ileocoecum are poor. We observed good results by using detubularized ileum, so we prefer this intestinal loop than the others. There was no significative difference between different detubularisation technics. Reimplantation of ureter inneobladder is indicated when there is terminal ureteral lesions.

Adolescent↗
PubMed1995

[Percutaneous alcoholization of simple serous cysts of the kidney].

Benign renal cysts are usually asymptomatic: They require a minimally invasive treatment if they cause complaints such as flank pain or other compressive complications. During a 6 month period, 14 patients were treated for benign renal cyst using an ultrasound guided puncture. Presenting complaints were flank pain (12 cases), hypertension (1 case), polycythaemia (1 case). Only cyst of 5 centimeters diameter or more were assigned to this treatment. After needle puncture, the cyst was evacuated and then filled with sterile 95% alcohol. Clinical and anatomical results, after 6 months, were good in 9 cases, 2 cases showed good anatomical results with persistence of initial symptoms, and there were 3 failures corresponding to large cysts of 10 cm diameter or more. Percutaneous alcoholization of moderate benign cysts is a safe, simple and reliable method.

Adult↗
PubMed1995

[Pseudocystic ureteritis. Apropos of a case].

The authors report one case of ureteritis cystica in a young adult. The diagnosis was made by intravenous urography and confirmed by histologic examination. The patient was treated surgically (nephro-ureterectomy). The etiopathogenic, clinical and therapeutic aspects are discussed with a review of literature.

Adult↗
PubMed1995

[Two-stage surgical treatment of urethral stenosis].

We analysed the results of two-operation procedures for cutaneous urethroplasty performed over a 10 year period. From 1983 to 1993, 44 patients had a Leadbetter urethroplasty. The indication in all cases was stenosis of the bulbal or bulbomenbranous urethra complicated by urethro-cutaneous fistula. After the first operation, 10 patients (22.7%) had a stenosis of one or both of the urethrostomy orifices, requiring one or more further procedures. The second operation concerned 18 patients (40.9%) and gave goods results in 10 (55.5%). Poor results were due to recurrence of the stenosis in 3 cases (16.6%), perineal suppuration in 1 (5.5%), failure of the skin plasty in 1 (5.5%) and formation of a stenosis by a tuft of hair in 1 (5.5%). Finally, 2 patients were lost to follow-up. Mean interval between operations was 8 months. It appears, despite the drawbacks and uncertain results, that sequential operations for cutaneous urethroplasty are indicated when stenosis of the urethra is complicated by fistulization or perineal infection.

Adolescent↗
PubMed1994

[Traumas of the ureter. Apropos of 29 cases].

The origin of ureteral trauma is often iatrogenic, particularly after gynaecologic surgery, and causes diagnostic and therapeutic problems. The characteristics of this affection are reviewed in a retrospective study of 29 traumatic lesions of the ureter collected over a 17 year period. Three ureteral trauma were by penetrating injury and twenty six were iatrogenic. For the latter, hysterectomy was the principal cause (17 cases). Urine leakage through the vagina was the most frequent clinical symptom (20 cases). In the majority of cases, intravenous urography was sufficient to make the diagnosis. Uretero-hydronephrosis was noticed in 17 cases, and extravasation in 14 cases. The majority of iatrogenic lesions (20 cases) was diagnosed after a one month delay. Lower third of the ureter was the most frequent site of injury in iatrogenic traumas (10 cases), whereas the upper third was the site of predilection of penetrating traumas (3 cases). Four vesico-vaginal fistulaes and two resto-vaginal fistulaes were associated to ureteral iatrogenic lesions. Various therapeutic methods were used. For mid and lower ureteral lesions, psoas-bladder hitch was the most frequent procedure (11 cases). On the other hand, for upper ureteral lesions, ureteral anastomosis was done in three cases. Only one nephrectomy was done, after an iatrogenic lesion diagnosed very late, with a non functioning kidney. We noticed six surgical failures: four after termino-terminal anastomosis, and two after Boari-Küss's procedure. The data of literature concerning etiopathogeny, diagnosis, therapeutic modalities and prevention of traumatic lesions of the ureter and reviewed.

Adolescent↗
PubMed1994

[The role of corticotherapy and endoscopy in the treatment of urogenital tuberculosis].

Despite the efficacy of new tuberculostatic agents, urogenital tuberculosis still constitutes a threat to renal function due to fibrosis secondary to healing of the lesions. The authors studied the place of corticosteroids, and endoscopic and percutaneous procedures in the treatment of 86 cases of urogenital tuberculosis. Corticosteroids were coprescribed with tuberculostatic agents in 20 patients: 16 ureteral strictures were treated with 8 success and 8 failures, 8 contracted bladders were treated with 5 success and 3 failures. Three cases of retraction of the renal pelvis were treated by corticosteroids with 2 successes and one failure. Ureteral stricture was treated by retrograde ureteral stenting in 5 cases and by percutaneous antegrade ureteral stenting in one case with 4 successes and 2 failures. This study more clearly defines the indications for corticosteroids and endoscopic treatment with particular reference to new endoscopic surgery techniques.

Adolescent↗
PubMed1994

[Pathological horseshoe kidney. Therapeutic aspects].

The authors report the various therapeutic modalities of uropathies associated with horseshoe kidney, based on a series of 20 pathologic horseshoe kidneys, associated with 12 cases of renal stones, 5 ureteropelvic junction obstructions, 3 kidney tumors, 2 cases of pyonephrosis and finally 1 traumatic horseshoe kidney. The specific anatomic and surgical features of this uncommon malformation are emphasized and the therapeutic features of each uropathy associated with horseshoe kidney are discussed.

Adenocarcinoma↗
PubMed1994

[Vesico-uterine fistulas. Analysis of 19 cases].

Over a 15 year period (1977-1992), the authors have collected 19 cases of vesico-uterine fistulas. These vesico-uterine fistulas rank in third place of genito-urinary fistulas and occur in young patients (mean age is 30 years). Obstetrical etiology is recognised in .95% of cases (cesarean section and dystocic delivery). Leak of urine is present in 95% of cases, and is isolated in 47% or associated with intermittent hematuria in 48%. Diagnosis of this affection is based upon clinical examination with methylene blue test. Communication between bladder and uterus is proved by the issue of methylene blue through the uterus cervix. This communication may be confirmed by opacification (urography and hysterography). Perfect continence is obtained by surgical treatment. Fertility of these patients is often affected.

Adolescent↗
PubMed1994

[Carcinosarcoma of the bladder. Apropos of two cases].

The authors report two cases of carcinosarcoma of the bladder, review the literature, and study the clinical, histological, therapeutic and evolutive aspects of this unusual tumor. It is a rare tumor which represent less than 0.5 per cent of all cancers of the bladder. It is three times more frequent in men than in women. Hematuria is the most frequent alarming symptom and pathogenesis is still a matter of debate. Diagnosis is based on the pathological examination including immunohistochemical study and, if necessary, with electron microscopy examination. The tumor contains two highly malignant cellular components: one is epithelial and the other is mesenchymal. Treatment is not well codified. Early diagnosis and radical cystectomy seem to improve the prognosis, which is usually poor. 5 year survival rate is about 20 per cent.

Carcinosarcoma↗
PubMed1994

[Isolated retrovesical hydatid cyst. Apropos of two cases].

Isolated retrovesical location of hydatid cyst is a very uncommon condition. Clinical patterns appear after a long course of the cyst. They are represented by hypogastric mass associated with compressive manifestations. Ultrasonography is essential for diagnosis and identification of other sites. When diagnosis is unclear, then CT scan plays a role. Cystectomy and pericystic resection, as extensive as possible, is the adequate treatment that gives successful results in most cases.

Adult↗