Microsatellite instability as indicator of MSH2 gene mutation in patients with upper urinary tract transitional cell carcinoma.
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Aged↗
Biomedical subjects
T Karmouni
Publications and source records attributed to T Karmouni.
[Youssef syndrome (vesico-uterine fistula): three case reports].
The authors report a series of three cases of Youssef syndrome observed over a 10 year period. All the fistulas were secondary to cesarian section. The diagnosis was established on clinical findings in one case. The intravenous urography was performed in all the cases and visualised the uterine cavity in one case. In the remaining cases the diagnosis was established by the retrograd cystography. The treatment was surgical for two patients and the third one refused any treatment. With a mean recoil of fifteen months the results judged on the disappearance of the clinic signs were good in the two patients opered. The objective of this study is to analyse the aetiological, diagnosis and therapeutic aspects of this pathology.
Adult↗
[Endoscopic treatment of vesico-ureteral reflux by submeatic injection of autologous fat. Two case reports].
The authors report two cases of endoscopic treatment of vesico-ureteral reflux by submeatic injection of autologous fat. We describe the technique of prelevement and injection. The immediate results confirm the efficacity of this procedure. The long-term follow-up will allow us to adopt it and to give it some modifications.
Adipose Tissue↗
[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↗
[Percutaneous nephrostomy: use of a simple inexpensive material in emergencies in precarious conditions].
We describe a cheap and simply technique of percutaneous nephrostomy which can be used anywhere. It consists, under local anesthesia, of insertion of a drain into renal cavity using only a needle, a sheat and dilatator. With this technique, we placed 81 PCN with 97% of success, without complication.
Adult↗
[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↗
[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↗
[Percutaneous nephrolithotomy. Report of 211 cases].
The case files of 198 patients with a stone, treated by percutaneous nephrolithotomy between 1985 and 1999, were studied. This series consisted of 113 men and 85 women with a mean age of 41 years (17-71 years). The stone was in the pelvis (167 cases) of the kidney, multiple in 40 cases and staghorn in four cases. The complications were septic in six cases and hemorrhagic in five cases. The overall stone-free rate at three months was 92%.
Adolescent↗
[Complex vesicovaginal fistula. Report of 55 cases].
OBJECTIVE: To specify the clinical and therapeutic peculiarities of complex vesico-vaginal fistulas. MATERIAL AND METHODS: 55 cases of complex vesico-vaginal fistulas are reported. After the clinical diagnostic all the patients had an intravenous excretory urogram. The fistulas were classified according to the Benchekroun classification. RESULTS: The mean age was 34 years (17-70 years). The diagnostic was made clinically in all the patients. Thirteen patients had an abnormal intravenous excretory urogram. The treatment was made by a vaginal way in 45 patients, by an abdominal way in three patients and by a mixed way in two patients. Four patients had an urinary diversion and one refused the treatment. Among the 50 patients whose fistula was treated, 44 (88%) were continent whom 26 (52%) after one operation, 15 (30%) after two operations and three (6%) after three operations. CONCLUSION: The complex vesico-vaginal fistulas as all the vesico-vaginal fistulas are diagnosed clinically. The intravenous excretory urogram is indispensable to search an associated ureteral lesion. The treatment is surgical and usually needs the interposition of a vascularised graft.
Adolescent↗
[Inflammatory pseudotumors of the kidney: a case report].
Inflammatory pseudotumors are uncommon benign tumors of unknown etiology which may develop at several anatomical sites, e.g., the airways and gastrointestinal tissues, soft tissues, the orbit, the spleen, or the lymph nodes. The renal site is extremely rare, and presents the problem of differential diagnosis as the clinical and radiological aspects of this tumor are similar to those of an adenoma or an angiomyolipoma, and suggest the presence of a carcinoma, in particular a cystic renal carcinoma which is also a rare form of tumor. There is therefore a risk that this benign lesion could be misdiagnosed. Due to the good prognosis associated with this type of tumor, in cases where the definitive diagnosis has been established no surgical procedure is necessary. However, the difficulty in making this diagnosis preoperatively means that in general the organ has to be surgically removed so that a histological analysis can be made and the negative or positive findings confirmed. In the present study, the case of an inflammatory pseudotumor of the kidney has been described. In this instance, radical nephrectomy of the left kidney was carried out as the disease was presumed to be renal cell adenocarcinoma. However, the histopathological analysis was negative as regards malignancy, and indicated the presence of an inflammatory pseudotumor. This article raises the question of the problem in establishing a preoperative definitive diagnosis, as a correct diagnosis is often only confirmed following nephrectomy (in cases where the contralateral kidney is healthy).
Carcinoma, Renal Cell↗
[Prostatic leiomyosarcoma (report of 2 cases)].
The authors report 2 cases of prostatic leiomyosarcoma. The first patient was not operated because of a severely debilitated state and died a fortnight after admission to hospital. The second patient underwent cystoprostatectomy with ilio-obturator lymph node dissection. Resection margins and lymph node dissection were negative and no further treatment was required. With a 10-year follow-up, the clinical and radiological assessment was normal. The diagnostic and therapeutic aspects of this rare prostatic tumour are discusses.
Adult↗
[Urologic management of ureteral iatrogenic lesions].
INTRODUCTION: Iatrogenic trauma of the ureter can occur following pelvic, abdominal or retroperitoneal surgery and during laparoscopy or ureteroscopy. MATERIAL AND METHODS: From 1988 to 1998, 30 patients with 34 iatrogenic ureteric injuries were treated in our department. RESULTS: Patients were referred after a mean of 13 days. Endourological treatment was performed as first-line management in 76% of cases of ureteric trauma, with a 71% immediate success rate. In the case of failure, surgery was performed in 78% of cases, with an 83% success rate. Seven patients required nephrectomy and one patient died. CONCLUSION: First-line endourological treatment gives good results. An early diagnosis remains an essential prerequisite to avoid serious complications.
Humans↗
[Complex tubercular ureteral stenoses (report of 2 cases treated with permanent double-J catheter].
Two patients presenting complex tuberculous ureteral strictures on an only existing kidney were treated with definitive double J stent changed every 6 months. This treatment modality was well tolerated. On the basis of two cases and literature review, different therapeutic measures are discussed.
Adult↗
[Role of antibiotic prophylaxis in ambulatory cystoscopy].
BACKGROUND: There has been a great deal of discussion regarding the necessity of antibiotic prophylaxis in transurethral cystoscopy. In order to clarify this complicated issue, a randomized prospective study was performed on 126 patients planned for cystoscopy. PATIENTS AND METHODS: 126 patients who underwent urethrocystoscopy and did not have pyuria and bacteriuria were included and divided randomly into 2 groups: group 1 received 400 mg of norfloxacine and group 2 nothing. Urinalysis were performed on all patients 3 days after the examination. Statistical analyses were performed using Chi 2 test and the level of significance was set at 5%. RESULTS: The global rate of infection was 5%. In the group 1 the incidence of infection was 3% (2/67) vs 5.1% (5/59) in group 2. There were no significant differences in the incidence in the background factor between the 2 groups of patients (p > 0.05). CONCLUSION: Prophylactic administration of antibiotic before cystoscopy does not decrease the incidence of urinary tract incidence and it is not necessarily in patients with sterile urine.
Adult↗
[Major renal trauma: report of 18 cases].
The authors report a retrospective study concerning 18 patients having major renal trauma. The patients study group was comprised of 11 males (61%) and seven females (39%) with a mean age of 23 years. The etiologic agents were traffic accident (eight cases), falls (five cases) and stab wounds (five cases). Gross hematuria was present in all the patients. After radiologic investigations the renal injuries were classified according to the American Association for Surgery of Trauma. Two patients were in stage V, seven in stage IV and nine in stage III. Three patients were operated in emergency for hemodynamic instability, two had a total nephrectomy and one a partial nephrectomy. Five patients underwent surgery between the 5th and 7th day, three had a suture of the renal parenchyma under a nephrostomy, one a partial nephrectomy and the third a total nephrectomy. Two patients had only a urinary drainage by placement of an ureteral stent in order to diminish the urohematoma. Eight patients were treated conservatively and all were in stage III. The mean retreat was 16 months. There was no mortality and among the eight patients who underwent surgery, none had complications, aside from two wound infections. The patients who were managed conservatively had good progression; they all had a control by computed tomography which showed that the urohematoma had decreased. None of the patients developed hypertension or infection of the urohematoma.
Adolescent↗
[Primary neuroendocrine carcinoma of the bladder: diagnosis and treatment].
OBJECTIVE: This rare but aggressive bladder tumour presents the morphological and immunohistochemical characteristic, common to all neuroendocrine tumours observed in other organs. This study analyzed the diagnostic criteria and therapeutic results obtained in 5 consecutive patients over a 3-year period. MATERIALS AND METHODS: 5 patients (3 men and 2 women) suffering from primary small cell carcinoma of the bladder were evaluated. Histological diagnosis, treatment modalities and outcome were reviewed. RESULTS: The main clinical presentation was macroscopic haematuria. All tumours were invasive at the time of diagnosis. 4 patients were treated by trans urethral resection alone, 2 of whom also received adjuvant radio-chemotherapy. One patient was treated by radical cystectomy. The 4 patients treated by conservative treatment modality had progression and a shorter survival, in contrast with patient treated by radical cystectomy. CONCLUSION: The urologist must recognize this rare histological entity, which have a poor prognosis and requires multidisciplinary management. Treatment must consist of a combination of neoadjuvant or adjuvant chemotherapy and surgery to achieve the best results.
Adult↗
[Epidermoid carcinoma of the male urethra].
Squamous cell carcinoma of the male urethra is exceptional, as all urethral tumours represent less than 1% of urinary tract tumours. Treatment depends on the stage and site of the lesion, but the prognosis remains very poor despite aggressive treatment, including mutilating resection surgery with or without associated radiotherapy. However, the current hope for patients with squamous cell carcinoma of the urethra resides in radiotherapy-chemotherapy combination protocols based on the results obtained in squamous cell cancers of the oesophagus and anus.
Aged↗
[Treatment of stafhorn calculi. Report of 71 cases].
OBJECTIVE: We retrospectively investigated 63 patients suffering from 71 staghorn calculi, who were treated with primary surgical monotherapy, in order to determine long-term. results and the fate of the residual stones. MATERIAL AND METHODS: Mean follow-up was 2.6 years. There were 63 patients (32 men, 31 women). The treatment was pyelolithotomy alone in 26 cases; nephrolithotomy alone in 14 cases; pyelolithotomy associated with nephrolithotomy in 18 cases; percutaneous nephrolithotomy (PCNL) in two cases; extracorporeal shock-wave lithotripsy (ESWL) in one case; and nephrectomy in ten cases. RESULTS: At the conclusion of therapy the stone-free rate was 94.1%. The complication was septic complications in 12 patients, hemorrhage that needed transfusion in five case and fistula in one case. After four and six years, two patients developed renal insufficiency and two patients had a recurrence of stones. CONCLUSION: Primary surgery of complex staghorn calculi is justified because of its better results than PCNL associated with ESMIL.
Adolescent↗