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Diagnosis and Treatment of Primary Hyperparathyroidism with Repeated Bilateral Renal Stones (13 Cases Report)
Li Feiyu,
Xu Rui,
Liu Li,
Ding Yancai,
Ma Xiao Yun
Issue:
Volume 6, Issue 1, June 2022
Pages:
1-4
Received:
23 November 2021
Accepted:
6 December 2021
Published:
8 January 2022
Abstract: Background to discuss the clinical characteristics of primary hyperparathyroidism (PHPT) with renal stones. Methods Clinical data of 13 Patients diagnosed With Primary hyperparathyroidism with repeated renal stones during May. 2006 to Oct. 2019 were analyzed retros Pectively. Results 13 patients, 4 males, 9 females, 7 kidney stones, 3 ureteral stones, 3 kidney and ureteral stones, 7 unilateral stones, 6 bilateral stones, 7 cases of rapid postoperative recurrence of kidney and ureteral stones were diagnosed with PHPT, 6 cases of preoperative diagnosis with pHPT; in all cases, blood calcium and parathyroid glandular hormone were significantly increased, 6 cases of blood phosphorus were decreased; 12 cases were diagnosed with thyroid ultrasound and neck CT, and the operation was performed One case was diagnosed as hyperparathyroidism by 99mTc-MIBI. Conclusions Parathyroidectomy is effective to treat the disease which can reduce recurrence of kidney stones remarkably. Early diagnosis and treatment of Primary hyperparathyroidism is helpful to reduce stone recurrence and Preserve renal function.
Abstract: Background to discuss the clinical characteristics of primary hyperparathyroidism (PHPT) with renal stones. Methods Clinical data of 13 Patients diagnosed With Primary hyperparathyroidism with repeated renal stones during May. 2006 to Oct. 2019 were analyzed retros Pectively. Results 13 patients, 4 males, 9 females, 7 kidney stones, 3 ureteral ston...
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Management of Erectile Dysfunction in Chronic Kidney Failure in Congo
Armel Melvin Ondongo Atipo,
Steve Aristide Ondziel-Opara,
Daniel Tony Sinomono Eyeni,
Gabriel Aime Ossombo,
Roland Bertile Banga Mouss,
Yannick Dimi Nyanga,
Anani Wencesl Severin Odzebe,
Prosper Alain Bouya
Issue:
Volume 6, Issue 1, June 2022
Pages:
5-9
Received:
21 December 2021
Accepted:
10 January 2022
Published:
17 January 2022
Abstract: Objective: To evaluate the management of erectile dysfunction (ED) in chronic kidney failure (CKF) patients in Congo. Patients and method: This was a cross-sectional study with prospective data collection over a period of 9 months, carried out in the nephrology departments of three hospitals in Congo. The IIEF-5 score was used to assess erectile function. We included all CRD patients with ED over 18 years of age. Results: The mean age of the patients was 54.4±(range: 20 years and 81 years). Cardiovascular risk factors were dominated by high blood pressure which accounted for 86 patients (91.5%). BMI was normal in 76 patients (80%). Grade 2 hypertension was noted in 47 patients (49.47%). Two patients (2%) did not have secondary sexual characteristics. The average duration of CKF was 3 years. The onset of ED was preceded by CKF in 92 cases (96.8%). The onset of ED was gradual in 72 cases (78.2%). The circumstance of the occurrence of ED was found in five cases (5.2%). Penile stiffness was low in 86 cases (90.5%). Sixty-four patients (67.4%) did not have a nocturnal erection. Other associated sexual disorders were decreased libido in 46 cases (48.4%), anorgasmia in 53 cases (55.8%) and premature ejaculation in 47 cases (49.47%). The mean IIEF 5 score was 11.38±4.44. Erectile dysfunction was severe in 43 cases (45.2%). Examination of the penis was normal in all cases. Erectile dysfunction was difficult to bear in 51 cases (53.7%). The testosterone level was between 5.5-32 nmol / L in 44 patients (68.8%). FSH and LH levels were increased in 60% of cases. The prolactin level between 1.8 - 29.2 micrograms / l in 14 cases (70%). The medical treatment of erectile dysfunction concerned 36 patients (37.8%). Conclusion: ED has psychological consequences that accentuate the suffering of patients. Modification of these risk factors must be undertaken early. IPDE5 have improved the management of erectile dysfunction
Abstract: Objective: To evaluate the management of erectile dysfunction (ED) in chronic kidney failure (CKF) patients in Congo. Patients and method: This was a cross-sectional study with prospective data collection over a period of 9 months, carried out in the nephrology departments of three hospitals in Congo. The IIEF-5 score was used to assess erectile fu...
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A Nomogram for Predicting Pelvic Lymph Node Metastasis in Prostate Cancer
Xu Yang,
Chen Rui,
Li Shuofeng,
Zhang Chi,
Zheng Yuxin,
Li Wang
Issue:
Volume 6, Issue 1, June 2022
Pages:
10-14
Received:
25 December 2021
Accepted:
19 January 2022
Published:
26 January 2022
Abstract: Background: Prostate cancer (PCa) is prone to lymph node metastasis. In this report, the authors described a model predictive of the probability of lymph node metastasis in prostate cancer patients. Methods: Two-hundred seventy-eight middle-high-risk PCa patients who received laparoscopic radical prostatectomy (LRP) combined with extended pelvic lymph node dissection (e-PLND) in our hospital were selected as the subjects and the authors performed a retrospective analysis. According to the postoperative pathological results, the patients were divided into a pelvic lymph node metastasis group (n=100) and a non-pelvic lymph node metastasis group (n=178). Univariable and multivariable logistic regression analyses were performed to identify independent risk factors for pelvic lymph node metastasis from PCa. Finally, a clinical prediction model nomogram was further established and verified, and a calibration plot was drawn to verify the accuracy of the model. Results: The TPSA level, FPSA level, PI-RADS score, biopsy ISUP classification and Gleason score of the two groups were statistically different (P<0.05), and there was no statistical difference between the age groups (P>0.05). Receiver operating characteristic curve (ROC) showed that the best diagnostic cut-off value of TPSA was 77.45 ng/ml (AUC=0.785, 95%CI: 0.729-0.842), and the best diagnostic cut-off value of FPSA was 0.085 ng/ml (AUC=0.282, 95%CI: 0.215-0.348). Univariable and multivariable logistic regression analyses showed that, TPSA level (OR=1.00, 95%Cl: 1.000-1.006, P<0.05), FPSA level (OR=0.00, 95%Cl: 0.000-0.089, P<0.01), PI-RADS score (OR=9.26, 95%CI: 5.278-16.248, P<0.01) and biopsy ISUP grade (OR=1.69, 95%CI: 1.163-2.450, P<0.01) were independent predictors of pelvic lymph node metastasis. Conclusions: The nomogram established in this study has a good predictive ability for pelvic lymph node metastasis in patients with PCa, and can provide a reference for the selection of clinical treatment options.
Abstract: Background: Prostate cancer (PCa) is prone to lymph node metastasis. In this report, the authors described a model predictive of the probability of lymph node metastasis in prostate cancer patients. Methods: Two-hundred seventy-eight middle-high-risk PCa patients who received laparoscopic radical prostatectomy (LRP) combined with extended pelvic ly...
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Comparative Study Between Anderson-Hynes Pyeloplasty Through Transperitoneal Laparoscopic Approach Versus Vertical Lumbotomy Approach in UPJO Repair
Issue:
Volume 6, Issue 1, June 2022
Pages:
15-18
Received:
29 October 2021
Accepted:
4 January 2022
Published:
28 January 2022
Abstract: Background: Since 1949 dismembered pyeloplasty technique which was introduced by Anderson and Hynes has been the gold standard for the surgical correction of UPJO. And for decades Laparoscope has been the preferred approach. However, in Egypt - like many other developing countries- there is a limitation of laparoscopic interventions due to the limited number and distribution of laparoscopic sets. This limited availability forced many urologists in general hospitals to refer UPJO patients to tertiary centers and university hospitals, which added more burden on the already exhausted facilities. Objective: In this paper, we tried to explore options available to urologists who are working in areas where laparoscopic sets aren’t available. We suggested the vertical lumbotomy approach to be explored in this study. Method: The study was conducted at El Demerdash Hospital in 2016. It included 20 patients with symptomatic UPJO. Patients were allocated to the 2 groups, 10 patients each using the closed envelop method. Results: Significantly shorter hospital stay in the vertical lumbotomy group. No statistically significant differences were noted between the studied group regarding postoperative pain, frequency of irritative LUS, hematuria, and pyuria. Study limitations: There were limitations of the study that might have affected its results such as the experience caliber of both teams, there were no unified preset criteria for post-operative management and there wasn't enough data about the learning curve of each approach. Conclusion: The laparoscopic approach for correction of UPJO is still the gold standard, however in some areas in developing countries which might be deprived of enough laparoscopic sets, the vertical lumbotomy approach can be utilized after proper training. This study results shouldn't be applied in hospitals where the laparoscopic approach is established for UPJO surgery.
Abstract: Background: Since 1949 dismembered pyeloplasty technique which was introduced by Anderson and Hynes has been the gold standard for the surgical correction of UPJO. And for decades Laparoscope has been the preferred approach. However, in Egypt - like many other developing countries- there is a limitation of laparoscopic interventions due to the limi...
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Back from the Bread: Delayed Presentation of an Ingested Foreign Body
Rachel Hawthorne,
Anthony Koupparis
Issue:
Volume 6, Issue 1, June 2022
Pages:
19-22
Received:
8 January 2022
Accepted:
5 February 2022
Published:
16 February 2022
Abstract: Background: Foreign body ingestion is often uneventful and rarely requires surgical intervention. It can however become problematic, predominantly affecting the gastrointestinal tract or more rarely the genitourinary tract. Few cases of the latter have been described. Objective: The aim of this case report is to raise awareness of the potentially indolent presentation of foreign body ingestion resulting in urological complications. Method: We report a unique case of a forty year old presenting with suprapubic pain, urgency and frequency twenty years following inadvertent ingestion of a needle. Results: Following initial investigation for common causes of lower urinary tract symptoms, ultrasound and computer tomography located the needle within a perivesical cavity associated with the bladder dome. Attempted removal via laparoscopy and open approach was unsuccessful. The patient ultimately underwent robotic assisted laparoscopic partial cystectomy in order to excise the cavity and foreign body. Conclusion: Extra-luminal migration of foreign bodies from the gastrointestinal to the genitourinary tract is rare but should be considered as a differential for urological symptoms in difficult cases when the aetiology remains elusive. Access to radiological imaging remains vital to enabling verification of the diagnosis. Optimal management involves localisation and excision of the foreign body and any containing cavity or fistulae. This may require advanced techniques including intra-operative imaging and a robotic-assisted laparoscopic approach.
Abstract: Background: Foreign body ingestion is often uneventful and rarely requires surgical intervention. It can however become problematic, predominantly affecting the gastrointestinal tract or more rarely the genitourinary tract. Few cases of the latter have been described. Objective: The aim of this case report is to raise awareness of the potentially i...
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Laparoscopic Donor Nephrectomy with Terminal Hand Assisted Technique: Experience in 60 Donors and Recipients
Ahmed Reda,
Mahmoud Magdy,
Rabea Ahmed Gadelkareem,
Ahmed Serag Safwat,
Atef Mohammed Abdellatif,
Hassan Aboulella,
Nashwa Azoz,
Paolo Fornara,
Nasreldin Mohammed
Issue:
Volume 6, Issue 1, June 2022
Pages:
23-26
Received:
11 January 2022
Accepted:
3 February 2022
Published:
16 February 2022
Abstract: Introduction: The limitation of cadaveric organ donations and the rapidly increasing number of patients with end stage renal disease awaiting kidney transplantation made living kidney donation indispensable. An important contribution to the revolution in living nephrectomy technique is hand assisted donor nephrectomy. Herein, we report our experience in hand assisted donor nephrectomy technique and its effect on the graft outcome. Methods: During the period from January 2012 till December 2015, 60 cases of hand-assisted laparoscopic donor nephrectomies were performed including 35 females and 25 males with a median age of 46.3±11.6 years. Results: Our mean operative donors' time was 93±21.8 minutes, and mean warm ischemia time was 48±9.1 seconds. Donor hospitalization time was between 3 and 5 days (mean 4 days). Follow up of the graft function after one year revealed mean serum creatinine of 1.56±1.03 mg/dl, mean GFR of 39.8±10.9 ml/min/1.73m and renal Doppler resistive index of 0.62±0.15. Conclusion: Laparoscopic donor nephrectomy with terminal hand assisted technique is a minimally invasive surgery that may improve donor acceptance and can become the procedure of choice in the near future. Also this technique has a good outcome concerning both warm ischemia time and graft outcome.
Abstract: Introduction: The limitation of cadaveric organ donations and the rapidly increasing number of patients with end stage renal disease awaiting kidney transplantation made living kidney donation indispensable. An important contribution to the revolution in living nephrectomy technique is hand assisted donor nephrectomy. Herein, we report our experien...
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First Congolese Case Report of Mucinous Adenocarcinoma of the Bladder at Brazzaville University Hospital
Ondziel-Opara Steve Aristide,
Ondongo Atipo Armel Melvin,
Mouamba Fabien Gael,
Mouss Banga Roland Bertille,
Dimi Nyanga Yannick Isjody,
Odzébé Anani Wencesl Severin,
Bouya Prosper Alain
Issue:
Volume 6, Issue 1, June 2022
Pages:
27-29
Received:
23 January 2022
Accepted:
8 February 2022
Published:
16 February 2022
Abstract: Bladder tumors are the second most common genitourinary tumor after prostate tumors. In addition, it is known that urothelial carcinoma is the most common histological form. It accounts for 90% of all bladder tumors. Primary adenocarcinoma of the bladder is a rare malignant tumor. Consequently, an extension assessment is required to exclude any secondary tumor extension. Clinical presentations are not specific and remain dominated by hematuria. His prognosis is poor, and his management is essentially surgical by performing a total cystectomy associated with an extensive lymph node dissection due to radio-chemo-resistance. Background The authors report the first case of bladder adenocarcinoma. It was a 65-year-old patient who consulted at university hospital of Brazzaville for a dysuria type of slow start-up, weak jet and a total hematuria, evolving for 1 month before his consultation. The anamnesis noted a notion of smoking intoxication of a package year for 10 years. The histological diagnosis was made on basis of the results of the analysis of the trans urethral resection parts of the bladder tumor. In order to rule out any secondary extension, a radiological assessment made of computerized tomography (CT) had been carried out. The evolution was quickly fatal. Conclusion Bladder adenocarcinoma is a Clinical Anatomy Variant entity whose Its aggressive nature makes the prognosis poor, hence the interest in making the diagnosis early.
Abstract: Bladder tumors are the second most common genitourinary tumor after prostate tumors. In addition, it is known that urothelial carcinoma is the most common histological form. It accounts for 90% of all bladder tumors. Primary adenocarcinoma of the bladder is a rare malignant tumor. Consequently, an extension assessment is required to exclude any sec...
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Vest-like Closure of Bulbospongiosus Muscle Flap During Augmented Anastomotic Urethroplasty
Susan MacDonald,
Nathan Michalak,
Ross Decter
Issue:
Volume 6, Issue 1, June 2022
Pages:
30-33
Received:
10 November 2021
Accepted:
7 February 2022
Published:
25 February 2022
Abstract: Introduction: Long urethral strictures with an obliterative segment remain a technical challenge when attempting a durable operative repair. An augmented anastomotic urethroplasty using buccal mucosa is typically performed in these cases, but the ideal position of the buccal graft is still under debate. Materials and Methods: A retrospective review was performed of a series of patients who underwent a novel technique of buccal graft placement during an augmented anastomotic urethroplasty. In these cases a ventrally placed buccal graft was quilted to a double layered vest-like closure of the bulbospongiosus muscle. Six cases in total were performed by a single surgeon at a tertiary academic center between 2008 and 2012 and outcomes were reviewed. IRB approval was attained for the study. Results: Mean stricture length was 7.3cm and median follow up was 2 years and 2 months with a range from 3 months to 12 years. Mean postoperative flow rates in short term follow up were 37ml/s and long term follow up 27.6ml/s. Three patients required no further intervention, two underwent dilation at 9 and 12 years postoperatively and one required redo urethroplasty. Conclusions: This new technique of using quilting a ventrally placed buccal graft to double layered bulbospongiosus muscle backing during anastomotic urethroplasty for long partially obliterative urethral strictures shows potential and warrants further study.
Abstract: Introduction: Long urethral strictures with an obliterative segment remain a technical challenge when attempting a durable operative repair. An augmented anastomotic urethroplasty using buccal mucosa is typically performed in these cases, but the ideal position of the buccal graft is still under debate. Materials and Methods: A retrospective review...
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Nephrectomies: Indications, Approaches and Post-operative Morbidity at Conakry University Hospital – Guinea
Barry Mamadou II,
Bah Mamadou Diawo,
Sow Thierno Amadou Oury,
Atoumane Affed,
Gnammi Ricardo Lahoumbo,
Diallo Thierno Mamadou Oury,
Bah Mamadou Bissiriou,
Cisse Demba,
Kante Daouda,
Bah Ibrahima,
Diallo Abdoulaye Bobo,
Bah Oumar Raphiou
Issue:
Volume 6, Issue 1, June 2022
Pages:
34-38
Received:
29 December 2021
Accepted:
26 January 2022
Published:
25 February 2022
Abstract: Aim: To report the indications, the approach and the complications of nephrectomy in the urology department of the University Hospital of Conakry. Material and methods: Retrospective descriptive study of 10 years duration, from October 1, 2006 to September 30, 216, on 34 patients who underwent nephrectomy. The parameters studied were: age, sex, operative indication, approach, type of nephrectomy, postoperative morbidity and mortality. The average follow-up was 12 months. Results: Between October 2006 and September 2016, 7064 surgical procedures were performed, including 34 nephrectomies, i.e. 0.48% of cases. Nephrectomy was indicated in 13 cases of renal tumor, 12 cases of pyeloureteral junction syndrome, 6 cases of pyonephrosis and 3 cases of American Association of Surgeons of Trauma stage IV kidney trauma.) Lumbotomy was the approach in 22 patients. Nephrectomy was extended in 16 patients and total in 18 others. We noted 4 cases of bleeding complications, 4 cases of parietal suppuration, 2 cases of death and 1 case of phlebitis. Conclusion: The indication for nephrectomy was rare in the department. The indications were varied, the most common being renal tumors and decompensated pyelo ureteral junction anomaly. Early management of renal pathologies would reduce the indication for nephrectomy.
Abstract: Aim: To report the indications, the approach and the complications of nephrectomy in the urology department of the University Hospital of Conakry. Material and methods: Retrospective descriptive study of 10 years duration, from October 1, 2006 to September 30, 216, on 34 patients who underwent nephrectomy. The parameters studied were: age, sex, ope...
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Study of the Risk Factors of Erectile Dysfunction in Diabetic Subjects at the University Hospital of Libreville
Steevy Ndang Ngou Milama,
Adrien Mougougou,
Dimitri Mbethe,
Olagui Giscard Smith,
Herman Gael Boundama,
Edgard Brice Ngoungou
Issue:
Volume 6, Issue 1, June 2022
Pages:
39-44
Received:
30 January 2022
Accepted:
19 February 2022
Published:
28 February 2022
Abstract: Introduction: The objective of this study was to describe the risk factors of erectile dysfunction (ED) in diabetic patients at the University Hospital of Libreville. Material and Methods: This was a prospective descriptive-analytical study of type 1 and 2 diabetic patients aged over 18 years whose erectile function was assessed using the French translation of the IIEF-5 score. Results: 396 patients were selected with a mean age of 53 ± 13.6 years. People with type 2 diabetes represented 84.1% of the cases. Of the patients selected, 186 (47%) had diabetes for less than 5 years. Erectile dysfunction was found in 79.8% of patients (n=316), with a severe form in 19.7% of cases. Among the patients affected, 74.4% (n=235) had not sought medical advice before the onset of ED. Several risk factors were found, such as duration of diabetes (p<0.001), alcohol (p<0.001), diabetic retinopathy (p<0.001), diabetic nephropathy (p=0.004), and heart disease (p=0.004). In multivariate analysis, only advanced age, unbalanced diabetes, alcohol consumption, microangiopathy, mixed degenerative pathology, and duration of diabetes greater than 10 years remained statistically significant in ED. Conclusion: The prevalence of erectile dysfunction is significant in people with diabetes. Several factors associated with ED are clearly identified. They should be sought at the time of diagnosis of diabetes to make patients aware of the risk of ED associated with it. This would allow the physician to talk to the patient about ED, thus short-circuiting any difficulty the patients may have in discussing it voluntarily even when they are suffering from it.
Abstract: Introduction: The objective of this study was to describe the risk factors of erectile dysfunction (ED) in diabetic patients at the University Hospital of Libreville. Material and Methods: This was a prospective descriptive-analytical study of type 1 and 2 diabetic patients aged over 18 years whose erectile function was assessed using the French tr...
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Prognosis of Hydronephrosis in Cervical Cancer at the Libreville Cancer Institute
Steevy Ndang Ngou Milama,
Adrien Mougougou,
Euloge Ibinga,
Dimitri Mbethe,
Audrey Bikene Bi Ntoutoume,
Ernest Belembaogo
Issue:
Volume 6, Issue 1, June 2022
Pages:
45-50
Received:
28 January 2022
Accepted:
21 February 2022
Published:
9 March 2022
Abstract: Introduction: In Gabon, cervical cancer is second only to breast cancer. Urological complications such as ureteral obstruction and hydronephrosis can occur in the course of this pathology. This work aimed to evaluate the impact of hydronephrosis on the overall survival of patients. Patients and Methods: the records of patients followed at the ICL from January 1, 2015, to December 31, 2019, a period of 5 years, were collected. The study included patients followed for cervical cancer and who had a complete medical record: histological evidence and extension workup. Patients not followed up at ICL were not included in the study. Results: the records of 183 patients with cervical cancer during the study period were retained. The mean age was 55.3±14.1 years, with extremes of 21 and 89 years. Stages II, III, and IV accounted for 87.4% of cancers, and stages III and IV (51.3%) represented the majority of clinical stages. In univariate survival analyses, assessed from the date of cancer diagnosis, patients with hydronephrosis during their cancer had poor survival compared with those without. Patients who had no hydronephrosis had better overall survival at three years (85%) compared with those who had developed urologic complications (54%). Conclusion: hydronephrosis has a negative effect on the prognosis of cervical cancer, and indeed, it significantly decreases the overall survival of patients with cervical cancer. Therefore, it is essential to screen them systematically to treat them as effectively as possible.
Abstract: Introduction: In Gabon, cervical cancer is second only to breast cancer. Urological complications such as ureteral obstruction and hydronephrosis can occur in the course of this pathology. This work aimed to evaluate the impact of hydronephrosis on the overall survival of patients. Patients and Methods: the records of patients followed at the ICL f...
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The Anatomical Repair Technique to Correct Penile Hypospadias Provides Excellent Long-term Function with Low Complications
De Silva Lindamullage Amila,
Cserni Tamas,
Hennayake Supul
Issue:
Volume 6, Issue 1, June 2022
Pages:
51-55
Received:
7 February 2022
Accepted:
23 February 2022
Published:
15 March 2022
Abstract: Introduction There are various techniques described for repair of penile hypospadias. Objective To present the anatomical repair technique and to discuss the lessons learned from this technique over 18 years. Methods All consecutive patients with penile hypospadias who underwent anatomical repair of urethra, spongiosum, bucks and dartos fascia and foreskin by the 3rd author, with a minimum of 1 year follow up from January 2003 to March 2020 at the Royal Manchester Children's Hospital, United Kingdom, were included in the study. No formal ethics approval taken as this study was done as a service evaluation. Perioperative and follow up data were recorded prospectively in the departmental database. SIPP 21 was used for statistical analysis. Fisher’s Exact Test used for sub-group analysis. Findings were considered statistically significant at p<0.05. Results 368 patients had surgery at a median age of 18 months. 94.6% had no complications, 4.1% had minor and 1.3% had significant complications. 77.5% had a distal ectopic meatus. The mean length of urethroplasty was 8mm. To widen the urethral plate, a meatoplasty (M) was performed in 34% and urethral plate incision (UPI) in 14%. Catheters were used in 71% for a median duration of 7 days, and 40% had a 6F catheter. Regards to meatal stenosis the only statistically significant causative factor was UPI with 6fr catheter. P value=0.02. Conclusions Anatomical repair provides a completely normal penis with minimal complications. Meatoplasty widens the urethral-plate and reduces the risk for meatal stenosis.
Abstract: Introduction There are various techniques described for repair of penile hypospadias. Objective To present the anatomical repair technique and to discuss the lessons learned from this technique over 18 years. Methods All consecutive patients with penile hypospadias who underwent anatomical repair of urethra, spongiosum, bucks and dartos fascia and ...
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Safety and Efficacy of Angio-embolization for Complex Renal Cell Carcinoma and Angiomyolipoma: Experience and Results in 20 Patients
Ahmed Mohamed Moeen,
Mohamed Abdel Basir Sayed,
Amro Farouk Mourad,
Tarek El-Diasty,
Mohamed M. El-Barody
Issue:
Volume 6, Issue 1, June 2022
Pages:
56-62
Received:
12 April 2022
Accepted:
7 May 2022
Published:
24 May 2022
Abstract: Objective: To evaluate the efficacy and safety of renal artery embolization in treatment of complex angiomyolipoma and renal cell carcinoma. Patients and Methods: Twenty patients were included in this study, 11 patients with primary renal cell carcinoma and 9 patients with AML. These patients were examined by US, CT or and MRI before RAE to evaluate size of the tumor, assess extension of renal cell carcinoma, exclude distant metastasis and assess the complications of angiomyolipoma. Renal artery embolization yield, complications and the impact of patient`s management were analyzed. Results: This study included 20 patients (12 males and 8 females). The age range was 17-75 (47.8±15.5) years. The type of renal masses were renal cell carcinoma in 11 patients and angiomyolipoma in 9 patients (5 bilateral and 4 unilateral). According to the modified Clavien system, 4 patients developed Grade I complication (3 patients developed flank pain (15%) treated with oral analgesics and 1 patient (5%) developed self-limiting perinephric hematoma which resolved spontaneously under antibiotic coverage. Conclusion: RAE is a safe, effective and well tolerated treatment of AML either if large sized which is liable to rupture or symptomatic to stop bleeding. Also, it allows preoperative de-vascularization of RCC to facilitate its surgical resection and as palliative treatment if RCC is un-resectable or metastatic.
Abstract: Objective: To evaluate the efficacy and safety of renal artery embolization in treatment of complex angiomyolipoma and renal cell carcinoma. Patients and Methods: Twenty patients were included in this study, 11 patients with primary renal cell carcinoma and 9 patients with AML. These patients were examined by US, CT or and MRI before RAE to evaluat...
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Paratesticular Embryonal Rhabdomyosarcoma (RMSE-PT): A Case Study in the Surgery Department of the Regional Hospital of Ziguinchor (Senegal)
Thierno Amadou Oury Sow,
Samba Thiapato Faye,
Mory Sangaré,
Mohamed Habiboulah Moustapha Ova,
Ibrahima Diallo,
Abdoulaye Sadjo Diallo,
Alhassane Ismael Touré,
Cheikh Diouf
Issue:
Volume 6, Issue 1, June 2022
Pages:
63-65
Received:
5 May 2022
Accepted:
24 May 2022
Published:
9 June 2022
Abstract: Introduction: Paratesticular embryonal rhabdomyosarcoma (RMSE-PT) is a rare and aggressive malignant mesenchymal tumor developed at the expense of connective tissue, representing approximately 7% of all rhabdomyosarcomas. Embryonic and alveolar histological types are most common in children, the pleomorphic type occurs exclusively in adults, and the prognosis is poor. The treatment method consists of tumor resection surgery, radiotherapy, and/or adjuvant chemotherapy. Here, we report a case of paratesticular embryonal rhabdomyosarcoma in a 3-year-old child. Through this observation, we discuss the diagnostic and therapeutic. Methods: In this report, our patient was a 3-year-old child with a large, painless right purse that had evolved over four months and was gradually increasing in volume. Physical examination detected a right scrotal mass, hard, painless, necrotic, suggestive of gangrene, while the left testicle was palpated at the bottom of the bursa, of normal appearance. The diagnosis revealed scrotal gangrene. Results: During the surgery, a large inguinoscrotal tumor was realized, and the realization of a right orchidectomy by the scrotal way with complete excision and dissection of an inguinal lymph node was finally made. The tumor markers (beta-human chorionic gonadotropin and alpha-fetoprotein) were negative, except for lactate dehydrogenase (LDH), which was increased. The surgical specimen's immunohistochemistry revealed an embryonic rhabdomyosarcoma invading the spermatic cord. The ultrasound revealed a tumor mass in the right testis. Computed tomography performed one month after surgery was normal. Conclusions: The care is multidisciplinary, combining surgery, polychemotherapy, and radiotherapy. The rarity of the clinical and the delay in diagnosis were the aggravating factors in the prognosis of our patient.
Abstract: Introduction: Paratesticular embryonal rhabdomyosarcoma (RMSE-PT) is a rare and aggressive malignant mesenchymal tumor developed at the expense of connective tissue, representing approximately 7% of all rhabdomyosarcomas. Embryonic and alveolar histological types are most common in children, the pleomorphic type occurs exclusively in adults, and th...
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