Objective. - To evaluate the influence of continent external urinary diversion type Mitrofanoff on male sexuality.Material and methods. - Between 1992 and 2011, 140 patients underwent continent urinary diversion type Mitrofanoff at an academic hospital. Among 76 men, 46 were interviewed about their sexuality after this operation. This study was performed using a set of validated questionnaires (IIEF, DAN PSS and Urolife), grouped by the model of the CTMH. Patients were divided according to their marital status: group 1: patients married before surgery (15 cases), group 2: patients married after surgery (7 cases) and group 3: singles (24 cases).Results. - In the first group, the functional dimension of sexuality was positive with an overall score of 81%, the sexual discomfort score was assessed at 26 % and the sexual satisfaction score was 77%. In the second group, sexual function was considered conserved in all cases with a satisfaction score estimated at 98%. These patients reported a feeling of well-being following the disappearance of urinary incontinence with integrity of their body images. In contrast, in the last group, relatively impaired sexual function was noted (65%) with a satisfaction score estimated at 59%. These disorders were multifactorial, mainly related to neurological causal pathology.Conclusion. - To our knowledge, this is the first study about male sexuality in patients with a continent urinary diversion type Mitrofanoff. Marital status has a major role in the sexuality of these patients. A prospective study with pre- and postoperative evaluation will better clarify the factors affecting sexuality in these patients. (C) 2015 Elsevier Masson SAS. All rights reserved.

Purpose. - Deep dorsal vein thrombosis of the penis is spontaneously remitting benign throm-bophlebitis. We propose to describe clinical assessment, diagnosis and differential diagnosis of deep dorsal vein thrombosis of the penis and to observe its natural course over time.Patients and methods. - Seven patients between ages of 13 and 50 years who self-presented for swelling penile, had diagnosis of deep dorsal vein thrombosis of the penis. Initial history, examination and Doppler ultrasound were undertaken. This was supplemented by blood screening for coagulation defects.Results. -All patients consulted for a painful penis. Priapism were noted in three patients. Doppler ultrasound which realized in all cases, revealed thrombosis of the deep dorsal vein of the penis. The first aetiology of the venous thrombosis was hemopathy (three cases). Early anticoagulants with low molecular weight heparin were instaured. Patients with priapism were treated with aspiration and irrigation of the corpa cavemosa and had good evolution. Specific treatment (chemotherapy, corticosteroid) was used in two patients. However, definitive erectile dysfunction persists in two patients. One among these patients had clinical history of priapism.Conclusion. - Dorsal vein thrombosis of the penis should be considered as a urologic urgency. Its natural course tends to be one of spontaneous resolution. Usually a benign condition, careful etiological search with risk factors is needed to avoid missing exceptional causes. But, followup is of utmost importance because risk of erectile dysfunction, which need early diagnosis, effective treatment and psychological support. (C) 2014 Elsevier Masson SAS. All rights reserved.

Herein, we report a rare case of metastasis of prostate cancer in the orbit with pertinent literature review. Although, prostate cancer can metastasize in any organ, yet orbital metastasis indicates an aggressive disease course with eminent loss of vision. Very few similar cases have been reported in the literature. (C) 2014 Pan African Urological Surgeons' Association. Production and hosting by Elsevier B.V. Open access under CC BY-NC-ND license.

Le ganglioneurome est une tumeur neurogène bénigne, rare, qui se développe à partir des cellules ganglionnaires sympathiques et qui se localise essentiellement dans la région rétropéritonéale. Nous rapportons cinq cas de ganglioneuromes rétropéritonéaux, ayant eu une exérèse complète de la tumeur avec évolution favorable. Le diagnostic a été confirmé par l’examen anatomopathologique. La fréquence, le diagnostic, les données de l’imagerie et le traitement de cette tumeur rare sont discutés.

Introduction: Leydig cells tumors of the testis are uncommon, representing between 1 and 3% of the testicular tumors and for which the natural history and therapy are debated between radical orchitectomy and organ-sparing surgery.Subjects and methods: We report three new cases of Leydig cells tumors, treated in our department and we discuss the clinical, diagnostic and therapeutic aspects of this uncommon tumor.Results: The mean patient age was 29 years (23-37 years). Medical referral was for a testicular pain in two and gynecomastia in one case. All patients were treated surgically, through an inguinal incision and the procedure included clamping of the spermatic cord. During surgery, frozen section were analyzed in two cases and the tumor enucleation with organ-sparing surgery was performed. The other patient had an unilateral orchidectomy and controlateral tumorectomy. The mean follow-up was 40 months with no local recurrence.Conclusion: Patients diagnosed with Leydig cells tumors have a good prognosis; this study shows the safety of conservative surgery treatment, provided it is subsequently followed by close surveillance, as it preserves maximum fertility, and these tumors usually have a favorable prognosis. (C) 2013 Pan African Urological Surgeons' Association. Production and hosting by Elsevier B.V.

Angiosarcoma is a rare malignant tumour occurring in less than 2% of soft tissue sarcomas. Angiosarcoma involving the kidney usually represents metastasis from skin or visceral primary lesions, while angiosarcoma primarily occurring in the kidney is a very rare neoplasm. We report a case of angiosarcoma of the right kidney in a 59-year-old male. The computed tomography scan showed a solid tumour with a low increased density after administration of contrast medium. Histological examination of the piece of nephrectomy confirmed the diagnosis.

Objective.-To identify the clinical features of unconsummated marriage (UCM) amongst couples, the etiological factors, the therapeutic approaches and to clarify the different evolutive aspects.Patients and methods.- In this retrospective study, the files of 80 consecutive couples followed for UCM between 2000 and 2010 at our andrology consultation were reviewed.Results.- The mean age of the husbands was 36years (22-82years), that of the brides was 28years (17-57years). The average length of marriage was 14months (range 3months-7years). Couples had little knowledge of sexology. The sexual dysfunctions noted were: erectile dysfunction in 40% of cases, premature ejaculation in 5%, a combination of premature ejaculation with erectile dysfunction and decreased libido in 15%, vaginismus in 12.5% and the associated causes (erectile dysfunction with vaginismus) in 27.5%. The first-line treatment was based on a sexological approach consisting of sex education and sex therapy, associated in some cases with oral drugs and as second-line treatment, sometimes intracavernous injections. After a mean follow-up of 5months (range 1-15months), the outcomes of treatment were: good prognosis with consummation of marriage in 57 cases (71.25%), failure with UCM in 18 cases (22.25%) and not known in five cases (6.25%).Conclusion.- UCM is quite frequent in the Arab Islamic world. The best treatment is prevention based on sexual education of youngsters and treatment of sexual dysfunctions for people who consult before marriage. (C) 2013 Elsevier Masson SAS. All rights reserved.

Objective. - To identify the clinical features of unconsummated marriage amongst couples, the etiological factors, the therapeutic approaches and to clarify the different evolutive aspects.Patients and methods. - In this retrospective study, the files of 80 consecutive couples followed for unconsummated marriage between 2000 and 2010 at our andrology consultation were reviewed.Results. -The mean age of the husbands was 36 years (22-82 years), that of the brides was 28 years (17-57 years). The average length of marriage was 14 months (range 3 months-7 years). Couples had little knowledge of sexology. The sexual dysfunctions noted were: erectile dysfunction in 40% of cases, premature ejaculation in 5%, a combination of premature ejaculation with erectile dysfunction and decreased libido in 15%, vaginismus in 12.5% and the associated causes (erectile dysfunction with vaginismus) in 27.5%. The first-line treatment was based on a sexo-logical approach consisting of sex education and sex therapy, associated in some cases with oral drugs and as second-line treatment, sometimes intracavernous injections. After a mean follow-up of 5 months (range 1-15 months), the outcomes of treatment were: good prognosis with consummation of marriage in 57 cases (71.25%), failure with unconsummated marriage in 18 cases (22.25%) and not known in five cases (6.25%).Conclusion. - Unconsummated marriage is quite frequent in the Arab-Islamic world. The best treatment is prevention based on sexual education of youngsters and treatment of sexual dysfunctions for people who consult before marriage. (C) 2013 Elsevier Masson SAS. All rights reserved.

Résumé Introduction Sous nos climats, la circoncision reste l’intervention la plus couramment pratiquée chez le garçon. Elle est souvent réalisée par un personnel paramédical non qualifié, ou même en dehors du milieu médical dont les notions de chirurgie et d’asepsie sont aléatoires. Elle est réputée comme chirurgie bénigne, mais des complications majeures parfois très graves, engageant le pronostic sexuel, voire vital, peuvent survenir. Le but de ce travail était de rapporter les amputations du gland secondaires à la circoncision et reçues en milieu hospitalier urologique. Patients et méthode Nous rapportons huit cas d’amputation du gland suite à une circoncision en milieu extrahospitalier selon les méthodes traditionnelles. Résultats L’âge moyen des enfants est de six ans (trois à huit ans). L’amputation du gland était faite lors de la circoncision dans quatre cas, dont deux avec section complète. Dans les autres cas, il s’agissait d’une nécrose du gland à cause d’un arc électrique lors de l’utilisation inadéquate du bistouri électrique. Une reconstruction urgente du gland n’avait pu être réalisable que dans trois cas. Le gland sectionné dans le quatrième cas était de mauvaise qualité. On n’a noté qu’un seul succès de revascularisation du gland. Le délai de consultation en cas de nécrose du gland était de trois jours en moyenne. Le traitement n’avait consisté qu’en la réalisation d’une méatoplastie pour obtenir un méat urétral satisfaisant avec réfection de la peau pénienne. Conclusion La section du gland demeure une complication, certes rare de la circoncision mais très grave, engageant le pronostic sexuel ultérieur de l’enfant. Cela rend cette intervention non anodine et doit inciter à ne la réaliser qu’en milieu spécialisé par un personnel compétent.

INTRODUCTION: Cystic lymphangioma is a rare benign vascular tumor that may arise in various sites, revealed at any age. Abdominal locations represent less than 10% of the cases preferentially involving the mesentery. We report a case of primary lymphangioma arising from the kidney.PRESENTATION OF CASE: A 50-year-old woman was admitted for severe left lumbar pain. Abdominal ultrasonography and computed tomography revealed a 6 x 10 cm multiloculated cystic mass with hydronephrosis, extending along the left renal hilum. Surgical exploration revealed a retroperitoneal cystic tumor. Anatomopathologic examination concluded it to be a cystic lymphangioma.DISCUSSION: The cystic lymphangioma is a benign malformative tumor of the lymphatic system. Surgery is the best curative treatment with complete excision, the prognosis is excellent.CONCLUSION: Primary renal lymphangioma is exceedingly rare. Medical imaging has certain limits for the diagnosis which required histological confirmation. The treatment of choice is surgical. (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd. Open access under CC BY-NC-ND license.

Kidney grafts with multiple arteries have been suspected to be associated with a higher incidence of vascular and urological complications and to affect subsequent renal function. We intend to compare renal transplant short and long-term outcomes between grafts with single versus multiple arteries.

Bladder-stone formation is common problem following continent urinary diversion with augmentation cystoplasty. We describe a minimally invasive technique using electro hydraulic vesicolithotripsy via a Mitrofanoff conduit.

To define the role of the digestive tract as substitute material for the repair of extensive lesions of the ureter.

Nutcracker syndrome is a rare cause of hematuria in children. Clinical signs relate to compression of the left renal vein between the aorta and the superior mesenteric artery. The diagnosis is suggested on cystoscopy, which reveals unilateral hematuria, and confirmed by imaging. We report the case of a 4-year-old child who presented nutcracker syndrome confirmed by CT angiography of the abdomen after excluding the other causes of hematuria. Through this observation, we emphasize the reality of this syndrome in children and the value of imaging in the evaluation of this rare affection. (C) 2011 Elsevier Masson SAS. All rights reserved.