Marouene Chakroun

Voluminous Incidental Oncocytic Neoplasm of the Adrenal Gland With Uncertain Malignant Potential

A 74-year-old man presented with right flank pain and a palpable mass in the left flank. Blood pressure was normal. Contrastenhanced computed tomography (CT) showed a 17 × 16 × 12 cm retroperitoneal mass over the left kidney, solid and heterogeneous. There were also 3 retro aortic lymph nodes and bilateral renal lithiasis. Twenty four-hour urinary metanephrines and normetanephrines were normal. The patient underwent a resection of the mass with left adrenalectomy by a lumbar incision. Histological findings revealed an adrenal oncocytic neoplasm (AON) with uncertain malignant potential. Six months after surgery, CT control showed neither local nor distant recurrence.

Vasitis: An Uncommon Diagnosis Mimicking Incarcerated Inguinal Hernia

Vasitis or inflammation of the vas deferens is a rarely described condition. Clinically, it presents with nonspecific symptoms that can be confused with other more common conditions, especially an incarcerated inguinal hernia. The diagnosis may be suggested by ultrasound or, more precisely, by computed tomography.

Liposarcoma of the spermatic cord: A case report and review of literature

a Department of Oncology, Salah Azaiez Institute, Faculty of Medicine of Tunis, Boulevard 9 Avril, Tunis El Manar University, Tunis, France Department of Pathology, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Boulevard 9 Avril, Tunis El Manar University, Tunis, France c Department of Urology, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Boulevard 9 Avril, Tunis El Manar University, Tunis, France

Purple urine bag syndrome, a disturbing urine discoloration

Purple urine bag syndrome (PUBS) is a rare and disturbing situtation for patients relative and the care team. Its mainly observed in long term bedridden with an indwelling urinary cathter use patients. PUBS is usually harmless and asymptomatic, but it may lead to severe conditions with a considerable morbidity and mortality. Authors report a case occurring in a 78 years old male patient, describing clinical and evolutive features, and discussing physiopathology and managment of PUBS.

Female urethral diverticulum containing calculi: A rare and tricky condition

A female urethral diverticulum (UD) is an uncommon clinical entity. It occurs in 0.6–6% of the female population. The diagnosis is often delayed as the symptoms can be misleading. The complications are mainly local consisting in malignant degeneration, urinary infection and stone formation. The latter is reported in 1.5–10% of cases. The key steps in the management of UD with calculi are: a high index of suspicion, the use of imaging studies and open surgical excision. Through presenting a case of female UD with calculi and a literature review, we deal with the diagnostic, therapeutic and evolutive aspects of this pathology.

Splenogonadal fusion - a rare cause of scrotal swelling: a case report

BackgroundSplenogonadal fusion is a rare and benign condition. Diagnosis is challenging for clinicians. Despite its indolence, diagnosis is often confirmed after orchidectomy. Surgery is mandatory, particularly to rule out the extremely rare association with malignancy.Case presentationWe report a case of splenogonadal fusion in a 38-year-old North African man presenting a palpable scrotal mass. We describe clinical aspects, pathogenic hypothesis, radiological features, as well as surgical management principles.ConclusionsSplenogonadal fusion is rarely suspected and diagnosed preoperatively. A diagnosis is made once an ectopic testicular mass is associated with cryptorchidism and suggestive radiological signs. A better knowledge of the clinical and radiological features of splenogonadal fusion provides an opportunity for conservative surgery.

MP26-11 IS PRE-OPERATIVE URINE CULTURE SUFFICIENT TO PREDICT SEPTIC COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTOMY?

INTRODUCTION AND OBJECTIVES: Preoperative urine culture is essential before urologic surgery; its positivity may be associated with a high risk of postoperative complications. Our objective was to evaluate the incidence and the severity of septic complications after percutaneous nephrolithotomy (PNL), and determinate whether preoperative urine culture was predictive of these complications. METHODS: We retrospectively analyzed data of 277 patients who had undergone PNL between 2009 and 2014. Septic complications occurred after surgical procedure were reported and then classified according to severity using the Clavien-Dindo classification. Univariate analysis was used to assess the impact pre-operative urine culture on the occurrence of septic complications. RESULTS: The median age was 46 years (9 e 80). %). The median size of the stone was 30.69 mm (10-70). The average operative time was 167.38 mn (75-300). Complications occurred in 139 patients (55.37%), septic ones in 69 patients (24.9%), including 6 cases of retroperitoneal phlegmon (2.16%), one case of renal abscess (0.36%), 3 cases of pyelonephritis (1.08%), and 4 cases of prostatitis (1.44%). Fever with no etiology has been reported in 56 cases, it was considered as a septic complication. According to severity, grade 4 complications have been reported in 3 patients (1.08%), with recovery after resuscitation. Preoperative urine culture was positive in 17 patients (6.13%); all had peri-operative antibiotherapy adapted to the antibiogram. Seven of these patients (41.17%) had septic complications. In univariate analysis, preoperative urine culture was not predictive of septic complications (OR1⁄41.27; p 1⁄4 0.242). CONCLUSIONS: Pre-operative urine culture was not sufficient to predict septic complications after PNL. Most patients who presented with septic complications post-operatively had negative preoperative urine culture.

The effect of body mass index at the time of donation on postoperative and remote consequences of nephrectomy in 189 living-related kidney donors

Abstract Objective: To analyse the effects of baseline body mass index (BMI) on the postoperative and remote consequences of nephrectomy in living kidney donors, as body weight is conventionally used as an exclusion criterion for kidney donation and a BMI of <35 kg/m2 is often required. Patients and methods: We retrospectively studied 189 living-related kidney donors who had their nephrectomy between 1986 and 2009 in our urology department. We recorded the BMI at the time of donation, and analysed variables after surgery, and clinico-biological factors remotely. The effect of the initial BMI after surgery and much later after nephrectomy was assessed. Results: The mean follow-up was 9.28 years. The mean (range) BMI at the time of donation was 26.5 (18.5–41.1) kg/m2; 33% of donors were overweight (BMI 25–30) and 21% were obese (⩾30), with 10.5% having a BMI of >35 kg/m2. The duration of hospitalisation was not related to the BMI. There was no significant difference between the mean BMI of donors with a simple postoperative history and donors who had complications after surgery. Among obese donors, only 7.7% had a complication, which was a surgical-site infection in all cases. The baseline BMI was higher among donors who maintained normal renal function and no proteinuria than in donors with impaired renal function and/or proteinuria; the difference was not significant. The occurrence of hypertension or diabetes was independent of baseline BMI. Donors with dyslipidaemia had no significantly greater baseline BMI than those with no dyslipidaemia. Conclusion: The BMI at the time of kidney donation does not seem to influence the short- or long-term consequences of nephrectomy in living donors.