Acta urologica Belgica最新文献

Fracture of the penis is a rare surgical emergency. A case is presented where a 7.5 mHz ultrasonography probe was used to demonstrate the tear in the corpus cavernosum. Ultrasonography was able to identify the site and extent of the injury. Preoperative ultrasonography shows the best place for surgical incision and can be used to avoid negative surgical exploration.

Lymph node metastases are rarely detected during radical prostatectomy (55/647 patients in our series or 8.5%) and several authors consider that lymphadenectomy is unnecessary in most cases. Criteria based on clinical stage, PSA and tumor grade have been elaborated in order to avoid pelvic lymph node dissection in a low risk population. It is commonly admitted that patients with clinically localized prostate cancer, a PSA level < 10 ng/ml, and a Gleason score < 7 could be spared a pelvic lymphadenectomy. In our series, these patients account for 12% of positive nodes. The best treatment for prostate cancer patients with a nodal disease is controversial. We compare the evolution of two groups of patients: radical prostatectomy alone or combined with an immediate adjuvant hormonal treatment. We observe a difference between the two groups for biological progression (PSA failure) but not yet for clinical progression nor for survival as our mean follow-up in only 6 years.

We report one case of "sex-cord stromal tumor" composed by Leydig and Sertoli cells. An epidermoid cyst of the testicle will be described. Finally, a case of scrotal leiomyoma is reported.

Objective: This research is designed to explore the relationship between the results of routine prostatic fluid and sperm examination obtained from 106 married male young people.

Methods: The subject of the present research included 106 married young men who underwent pre-martial checkups. Leukocyte count, pH value, and lecithin body in prostatic fluid were measured and compared with the data of sperm examination.

Results: The results showed that when leukocyte count in prostatic fluid was over 10/HPF, the survival rate of sperms decreased significantly, liquefying time prolonged significantly (p < 0.001), sperms decreased in number from 54.42 million/mm3 to 38.93 million/mm3 with rise in pH value.

Conclusions: Our research reveals a positive correlation between increased leukocytes in prostatic fluid and infertility.

We report a case of Fordyce angiokeratoma which presented with bleeding from the scrotum. The difference between Fordyce's angiokeratoma and Fabry's angiokeratoma corporis diffusum is described. The diagnosis, treatment and prognosis of scrotal angiokeratoma are discussed.

Aims: Duplex ultrasonography and pulsed doppler analysis or dynamic infusion cavernosometry and cavernosography are used for functional evaluation of penile arterial or venous dynamics during a pharmacological erection. The accuracy of the echographic investigations is correlated to the investigator experience. Cavernosometry and cavernosography are more invasive technique than the radioisotope erection penogram, which is a reproductive and reliable test.

Material and methods: We investigate 60 patients. Neurological, psychological and endocrinological etiology are excluded. The technique is described: thyroid is blocked by potassium perchlorate, bloodpool is labelled with Tc99m, a dynamic study is performed over 60 mn with intracavernous injection of PGE1 5g or Papaverine 30 mg at T10mn, ROIS are defined by computer processing, a phalogram curve is provided.

Results: This noninvasive test sorts out arteriogenic, venogenic and psychogenic impotence by a qualitative curve analysis. The quantitative parameters depending on numerous time consuming variables have proved to be of poor clinical use and non significant. We objectivate 20 psychogenic impotence, 27 arteriogenic impotence, 7 venous leakage and 6 mixed (arteriogenic and venogenic) impotence. Statistic evaluation of arteriogenic lesions comparative by doppler technique reveals a sensitivity of 83% and a specificity of 87%. The advantages of the test are; ambulatory, objective, noninvasive and reliable investigation. In the same time, "qualitative" data evaluates the response to a pharmacological induced erection.

Conclusions: The radioisotope erection penogram is a noninvasive, reproductive and reliable screening test for vasculogenic impotence.

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.

Seventy-seven hypospadias, selected from a series of 504 treated in our institution, were operated using the pediculated transverse "onlay" preputial graft. We try to demonstrate that this technique produces excellent functional and cosmetic results. Chordee can be corrected using extensive dissection of the urethral plate with association, if necessary, of a Nesbit type of dorsal plication. Complications rate, in our hands, is lower in comparison to the technique described by John Duckett, where the urethral plate is divided and a complete urethral tube is performed. We report 4 fistulas, one distal end breakdown of the repair and one postoperative hematoma that had to be revised. Because of this low complication rate, in many cases, the "onlay" pediculated graft replaces advantageously the Duckett type of repair.

Biopsies are indispensable for the diagnosis of the adenocarcinoma of the prostate. Multiple transrectal ultrasound-guided prostatic biopsies are accurate and sure. However, haemorrhagic and infectious complications are not rare. The anamnesis and the intermission of anticoagulant drugs are the best prophylaxis to prevent haemorrhagic complications. The advantage of prophylactic antibiotic therapy has not been absolutely demonstrated. Nevertheless, before biopsies, bacteriuria must be treated. Indeed, pre-biopsy bacteriuria seems to be correlated to septic complications after the procedure.