1
|
Saadi A, Bedoui MA, Mokadem S, Zaghbib S, Boussaffa H, Bellali M, Ayed H, Bouzouita A, Derouiche A, Allouche M, Chakroun M, Slama RB. Anatomy and anatomical variations of adrenal veins and its application to adrenal venous sampling. Surg Radiol Anat 2024; 46:543-550. [PMID: 38429406 DOI: 10.1007/s00276-024-03331-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE Our aim was to study the anatomy of the left and right main adrenal veins (LAV and RAV) and to identify their anatomical variations in order to see the practical application of these findings to adrenal venous sampling (AVS). METHODS Our work is based on dissection of 80 adrenal glands from fresh corpses in the forensic medicine department. We studied the number, the drainage, the direction and the level of termination of the main adrenal veins. RESULTS The average length of the LAV was 21 mm. It ended in 100% of cases at the upper edge of the left renal vein with a mean connection angle of 70° and after an anastomosis with the lower phrenic vein in 36 cases(90%). The average length of the RAV was 9 mm. It ended in 100% of cases at the level of the retro hepatic inferior vena cava (IVC) mainly on its posterior face in 21 cases (53%) and on its right lateral border in 18 cases (45%). The mean angle of the RAV in relation to the vertical axis of the IVC was 40°, with extremes ranging from 15° to 90°. CONCLUSIONS AVS seems to be easier on the left than on the right side because of the greater length of the adrenal vein (21 mm vs. 9 mm) and a greater angle of connection (70° with the left renal vein vs. 40° with the IVC), which explains the lower success rate of cannulation and the more frequent occurrence of blood sample contamination on the right side.
Collapse
Affiliation(s)
- Ahmed Saadi
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Mohamed Ali Bedoui
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia.
| | - Seif Mokadem
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Selim Zaghbib
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Hamza Boussaffa
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Mohamed Bellali
- University of Tunis El Manar, Faculty of Medecine of Tunis, Charles Nicolle Hospital, Department of Legal and forensic medicine , Tunis, Tunisia
| | - Haroun Ayed
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Abderrazek Bouzouita
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Amine Derouiche
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Mohamed Allouche
- University of Tunis El Manar, Faculty of Medecine of Tunis, Charles Nicolle Hospital, Department of Legal and forensic medicine , Tunis, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| | - Riadh Ben Slama
- University of Tunis El Manar, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of Urology, Tunis, Tunisia
| |
Collapse
|
2
|
Bouzouita A, Rehaiem A, Saadi A, Zaghbib S, Chakroun M, Ayed H, Ferjani A, Derouiche A, Boubaker IBB, Slama MRB. Antimicrobial prophylaxis protocol based on rectal swab culture before prostate biopsy to prevent infectious complications: a prospective randomized comparative study. Int Urol Nephrol 2024:10.1007/s11255-024-03998-7. [PMID: 38448785 DOI: 10.1007/s11255-024-03998-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/16/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE To evaluate the benefit of targeted antibiotic prophylaxis (TAP) based on rectal swab culture in comparison with standard empiric antimicrobial prophylaxis in patients undergoing transrectal ultrasound-guided needle biopsy of the prostate (TRUS-BP), as well as to assess rate of fecal carriage of Fluoroquinolone-resistant Enterobacterales FQRE. PATIENTS AND METHODS We prospectively analyzed data that randomized 157 patients within two groups: (G1) TAP according to rectal swab performed 10 days before PB; (G2): empirical antibiotic prophylaxis with ciprofloxacin. Prevalence of FQRE digestive carriage and risk factors were investigated. Incidence of infectious complications after (TRUS-BP) in each group was compared. RESULTS G2 included 80 patients versus 77 in G1. There was no difference between the two groups regarding age, diabetes, prostate volume, PSA, number of biopsy cores, and risk factors for FQRE. In G2, the prevalence of FQRE digestive carriage was 56.3% all related to E. coli species. In the case of digestive carriage of FQRE, TAP according to the rectal swab culture with third-generation cephalosporins was performed in 73.3%. Patients with FQRE had history of FQ use within the last 6 months in 17.8% (p = 0.03). Rate of febrile urinary tract infection after PB was 13% in G1 and 3.8% in G2 (p = 0.02). CONCLUSIONS Incidence of FQ resistance in the intestinal flora of our local population was prevalent. Risk factor for resistance was the use of FQ within the last 6 months. TAP adapted to rectal swab, mainly with third-generation cephalosporins, significantly reduced the rate of infectious complications after (TRUS-BP).
Collapse
Affiliation(s)
- A Bouzouita
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - A Rehaiem
- Microbiology Departments, Charles Nicolle Hospital, Tunis, Tunisia.
- Faculty of Medicine of Tunis, LR99ES09 Research Laboratory (Antimicrobial Resistance), University of Tunis El Manar, 1007, Tunis, Tunisia.
| | - A Saadi
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - S Zaghbib
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - M Chakroun
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - H Ayed
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - A Ferjani
- Microbiology Departments, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, LR99ES09 Research Laboratory (Antimicrobial Resistance), University of Tunis El Manar, 1007, Tunis, Tunisia
| | - A Derouiche
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - I Boutiba-Ben Boubaker
- Microbiology Departments, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, LR99ES09 Research Laboratory (Antimicrobial Resistance), University of Tunis El Manar, 1007, Tunis, Tunisia
| | - M R Ben Slama
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
3
|
Saadi A, Mokadem S, Bedoui MA, Zaghbib S, Hermi A, Bellali M, Boussaffa H, Ayed H, Bouzouita A, Allouche M, Chakroun M, Slama RB. A cadaveric anatomical study of the adrenals: vascular relationship. Endocrine 2024; 83:483-487. [PMID: 37932646 DOI: 10.1007/s12020-023-03585-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023]
Abstract
The adrenal gland is a retroperitoneal organ with intimate relationships with neighboring organs but also with the large retroperitoneal vessels. Our aim was to study the vascular relationships of the adrenal gland with the large abdominal vessels. Our work is an anatomical dissection of 80 fresh cadaveric adrenals. The subjects didn't have a history of retroperitoneal surgery. Dissection conditions were similar to those in the living. All measurements were made in situ. On the right side, the average distance between the adrenal gland and the renal vein (DR) was 13 mm (0-20). In one case, the adrenal gland laid directly on the right renal vein (DR = 0). The average length L, over which the right adrenal gland entered behind the inferior vena cava (IVC), was 8 mm (0-12). In 4 cases, the right adrenal was lateral to the IVC and in 6 cases the length L exceeded 10 mm. On the left side, the mean distance DL, separating the adrenal gland from the left renal vein was 8 mm with extremes ranging from 0 mm to 18 mm. In eleven cases, the adrenal gland laid directly on the left renal vein. The right adrenal gland has a close relationship with the IVC and is often located behind it. This close relationship helps to explain the increased incidence of IVC lesions during surgery. The left adrenal gland has an intimate relationship with the left renal vein and often lies on top of it. This explains the risk of injury to the left renal pedicle during left adrenal surgery.
Collapse
Affiliation(s)
- Ahmed Saadi
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Seif Mokadem
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Mohamed Ali Bedoui
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia.
| | - Selim Zaghbib
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Amine Hermi
- University of Tunis El Manar Faculty of Medicine of Tunis, Anatomy department, Tunis, Tunisia
| | - Mohammed Bellali
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of legal and forensic medicine, Tunis, Tunisia
| | - Hamza Boussaffa
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Haroun Ayed
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Abderrazek Bouzouita
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Mohamed Allouche
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Department of legal and forensic medicine, Tunis, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| | - Riadh Ben Slama
- University of Tunis El Manar Faculty of Medicine of Tunis, Charles Nicolle Hospital, Urology Department, Tunis, Tunisia
| |
Collapse
|
4
|
Bedoui MA, Saadi A, Zaghbib S, Mokadem S, Boussaffa H, Hermi A, Ayed H, Bouzouita A, Chakroun M, Ben Slama R. Risk factors for sepsis and mortality in patients with emphysematous pyelonephritis : a series of 68 cases (case series). Ann Med Surg (Lond) 2024; 86:240-244. [PMID: 38222707 PMCID: PMC10783401 DOI: 10.1097/ms9.0000000000001475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/26/2023] [Indexed: 01/16/2024] Open
Abstract
Background Emphysematous pyelonephritis (EPN) is a rare and severe necrotizing infection of the kidney with a high rate of complications and mortality. Our aim was to investigate risk factors of urosepsis and mortality in case of EPN. Materials and methods Between January 2010 and December 2022 the charts of patients diagnosed with EPN were retrospectively reviewed. Patients medical records were collected and data including demographics, BMI, EPN type, the organism causing the infection and biochemical variables were registered. The authors performed an univariate and multivariate logistic regression analysis for sepsis, septic shock, and mortality. Statistical significance was defined as a P-value of <0.05. Results Our study included 68 patients (63% females, mean age 58.6 years old). Forty-eight patients (70.6%) had diabetes. Half of the patients (50%) presented with sepsis and 11 patients (16.2%) developed a septic shock. The following factors were associated with sepsis by univariate analysis: diabetes (P=0.01), higher blood sugar on admission (P=0.01), higher leukocytic count (P<0.001), higher lymphocytic count (P<0.001), and lower platelet to leukocytes ratio (P<0.001). Multivariate regression analysis revealed that the main risk factors of urosepsis were the leukocytic (OR: 85.7; 95% CI: 9.177-800.486; P<0.001) and lymphocytic count (OR: 6.65; 95% CI: 1.228-36.050; P=0.028). Neither of the variables was significantly associated with a higher risk of mortality. Conclusion Leukocytic and lymphocytic count on admission are independent simple predictors for sepsis in patients with EPN.
Collapse
Affiliation(s)
- Mohamed A. Bedoui
- Department of Urology, Faculty of Medicine of Tunis, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
| | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Sawadogo H, Saadi A, Zaghbib S, Ksentini M, Chakroun M, Ben Slama M. Squamous and glandular metaplasia related to a renal pelvis stone leading to secondary pyeloureteral junction syndrome. Urol Case Rep 2023; 51:102555. [PMID: 37719031 PMCID: PMC10502348 DOI: 10.1016/j.eucr.2023.102555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023] Open
Abstract
Keratinizing squamous metaplasia of the renal pelvis is a rare lesion of the upper urinary tract that can occur in the context of chronic aggression to the urothelium, potentially leading to a secondary pyeloureteral junction syndrome. We report the case of a 43-year-old patient discovered intraoperatively in relation to a renal pelvis stone causing a pyeloureteral junction syndrome. The extemporaneous histological examination ruled out a malignant process, and we performed a pyeloplasty according to KUSS-ANDERSON technique. This pathology should be recognized by the urologist for appropriate management. Treatment is conservative, with extended follow-up to detect recurrences or carcinomatous degenerations.
Collapse
Affiliation(s)
- H. Sawadogo
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - A. Saadi
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - S. Zaghbib
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - M. Ksentini
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Pathology Department, Tunisia
| | - M. Chakroun
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - M.R. Ben Slama
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| |
Collapse
|
6
|
Saadi A, Bedoui MA, Zaghbib S, Boussaffa H, Mokaddem S, Nacef IB, Ayed H, Bouzouita A, Derouiche A, Khiari K, Chakroun M, Slama RB. Validation of the Aldosteronoma Resolution Score as a Predictive Resolution Score of Hypertension After Unilateral Adrenalectomy for Primary Aldosteronism in a North-African Population. World J Surg 2023; 47:2776-2783. [PMID: 37667066 DOI: 10.1007/s00268-023-07155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Unilateral primary aldosteronism (UPA) is the most frequent surgically curable form of endocrine hypertension. Adrenalectomy is the cornerstone of treatment for UPA, but outcomes after surgery are variable. Aldosteronoma Resolution Score (ARS) is a four-item predictive score for the cure of hypertension after adrenalectomy for UPA and has been demonstrated to be valid in different populations. We aimed in this study to validate the accuracy of this score in a North-African population. METHODS Between 2000 and 2021, the charts of 71 Tunisian patients who underwent laparoscopic adrenalectomy for UPA were retrospectively reviewed. Postoperative outcomes were assessed using the primary aldosteronism surgical outcome (PASO) criterion. The accuracy of the ARS was determined retrospectively by receiver operating characteristic curve and area under the curve. RESULTS Thirty-four patients (48%) had complete clinical success according to the PASO criteria. Multivariate regression analysis revealed that the main determinants of complete clinical success were the absence of diabetes (OR: 5.205), a BMI <30 (OR: 4.930), a number of antihypertensive medications ≤2 (OR: 8.667), a plasma ARR >332 (OR: 4.554) and an ARS score ≥3 (OR: 2.056). Cure rates were, respectively, 21.1, 51.6, and 66.6% for patients with a score ARS 0-1, 2-3, and 4-5. The AUC of the ARS was 0.837. CONCLUSION The ARS is a sufficiently predictive score in our North-African population. It may be used preoperatively to predict the outcome after adrenalectomy in these populations.
Collapse
Affiliation(s)
- Ahmed Saadi
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Mohamed Ali Bedoui
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia.
| | - Selim Zaghbib
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Hamza Boussaffa
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Seif Mokaddem
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Ibtissem Ben Nacef
- Department of Endocrinology, Charles Nicolle Hospital, University of Medicine of Tunis, Tunis, Tunisia
| | - Haroun Ayed
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Abderrazek Bouzouita
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Amine Derouiche
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Karima Khiari
- Department of Endocrinology, Charles Nicolle Hospital, University of Medicine of Tunis, Tunis, Tunisia
| | - Marouene Chakroun
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Riadh Ben Slama
- Department of Urology, Charles Nicolle Hospital, University of Medicine of Tunis, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| |
Collapse
|
7
|
Saidani B, Saadi A, Bedoui MA, Zaghbib S, Chakroun M, Slama RB. Leiomyosarcoma of the bladder: A review and a report of four further cases. Int J Surg Case Rep 2023; 110:108735. [PMID: 37657389 PMCID: PMC10509912 DOI: 10.1016/j.ijscr.2023.108735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/03/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Our study aims to expose the experience of our department in dealing with bladder leiomyosarcomas and illustrate the management tools of this rare pathology. CASE PRESENTATION We present a retrospective study of 4 cases of bladder leiomyosarcoma, gathered in the Department of Urology during the period of 1996-2022. All our patients were exclusively male and aged between 35 and 73 years. No history of pelvic irradiation nor chemotherapy was found in our patients. Three patients had high-grade leiomyosarcoma and pT2 stage whereas only one had a low-grade tumour. Three patients underwent radical treatment by cystoprostatectomy with extensive bilateral pelvic lymph node dissection and one patient was treated by endoscopic re-resection and endoscopic monitoring. We noticed 2 lymph nodes and liver metastasis recurrences in 2 patients treated by radical surgery while 2 patients didn't present recurrences at two years of follow-up. CLINICAL DISCUSSION To date, there is no clear and precise therapeutic approach for the treatment of bladder leiomyosarcoma. Little is known about the long term survival associated with these tumours. All studies agree that the prognosis for bladder leiomyosarcoma is poor, if not diagnosed early, especially those presenting with an undifferentiated tumour grade, distant metastatis and treated without surgical therapy. CONCLUSION Bladder leiomyosarcoma is a rare and highly aggressive tumour. The anatomopathological examination provides diagnosis and prognosis assessment. Radical surgery remains the most suitable therapeutic approach.
Collapse
Affiliation(s)
- Bilel Saidani
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Ahmed Saadi
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Mohamed Ali Bedoui
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Tunis, Tunisia.
| | - Selim Zaghbib
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Marouene Chakroun
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Riadh Ben Slama
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Tunis, Tunisia
| |
Collapse
|
8
|
Aouini H, Saadi A, Boussaffa H, Zaghbib S, Chakroun M, R BS. A juxtaglomerular cell tumor revealed by a hemorrhagic stroke. A case report. Urol Case Rep 2023; 50:102535. [PMID: 37621391 PMCID: PMC10445440 DOI: 10.1016/j.eucr.2023.102535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
With about 110 cases reported in literature, juxtaglomerular cell tumors are rare. We report a 25 years old patient who was admitted in neurology for a hemorrhagic stroke secondary to a cerebral aneurysm rupture due to high blood pressure. Etiological investigations showed a solid mass of the left kidney. A radical nephrectomy was realized and pathological examination and immunohistochemical profile concluded to juxtaglomerular cell tumor. The originality of this observation is based on the mode of presentation of a rare renal tumor by a malignant high blood pressure.
Collapse
Affiliation(s)
- H. Aouini
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - A. Saadi
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - H. Boussaffa
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - S. Zaghbib
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - M. Chakroun
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ben Slama R
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
9
|
Saadi A, Bedoui MA, Zaghbib S, Mokadem S, Boussaffa H, Hermi A, Ayed H, Bouzouita A, Derouiche A, Chakroun M, Slama RB. Can radiological scores predict difficulties in removal of encrusted ureteral stents? Urolithiasis 2023; 51:108. [PMID: 37612572 DOI: 10.1007/s00240-023-01482-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
In the present study, we aimed to report our single-center experience in encrusted ureteral stent management and to compare the utility of two different scoring systems in patient management. This is a retrospective study of patients who underwent various surgical procedures to remove encrusted ureteral stent. Encrusted stent grading was performed using KUB and FECal grading sytems. FECal grading system scored from Grade 1 to Grade 5 according to stone size, location, and degree of stent incrustation and the KUB score is the sum of the stone burden scores of three different parts of an encrusted stent within the kidney, ureter, and bladder determined using a scale from 1 to 5 according to the maximal diameter of encrustation. We compared these two classifications for the prediction of perioperative outcomes. Fifty patients were included in the study (52% female, mean age 48 years). The mean time from ureteral stent insertion until diagnosis of encrustation was 11.4 ± 13.6 months. High-grade incrustations (FECal Grade 3, 4, and 5) accounted for 62% of cases. The mean KUB score was 9.8 ± 2.7. The average number of procedures required to remove the stent was 1.71 ± 1.38. Multimodal surgery was required to remove 42% of the stents. Both, a total KUB score ≥ 9 and high-grade FECal classification were found to be significant predictors of longer operative time (> 100 min), need for multiple surgeries, and need for invasive surgery. While high-grade FECal classification showed a significant association with need for multimodal surgery (OR 6.92, p = 0.008), a total KUB score ≥ 9 showed no association (OR 2.91, p = 0.086). These two scores seem to be good indicators in predicting difficulties for surgical management of encrusted ureteral stent with a clear advantage of the FECal score in terms of prediction of multimodal surgery.
Collapse
Affiliation(s)
- Ahmed Saadi
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Mohamed Ali Bedoui
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia.
| | - Selim Zaghbib
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Seif Mokadem
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Hamza Boussaffa
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Amine Hermi
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Haroun Ayed
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Abderrazek Bouzouita
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Amine Derouiche
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Marouene Chakroun
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| | - Riadh Ben Slama
- Urology Department, University of Medicine of Tunis, Charles Nicolle Hospital, 9th April 1938 Boulevard, Bab Saâdoun, 1007, Tunis, Tunisia
| |
Collapse
|
10
|
Saadi A, Bedoui MA, Zaghbib S, Boussaffa H, Mokaddem S, Nacef IB, Ayed H, Derouiche A, Khiari K, Chakroun M, Ben Slama R. Predictors of successful outcome after adrenalectomy for unilateral primary aldosteronism. Front Endocrinol (Lausanne) 2023; 14:1205988. [PMID: 37635962 PMCID: PMC10454906 DOI: 10.3389/fendo.2023.1205988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/18/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Unilateral primary aldosteronism (UPA) is the most frequent surgically curable form of endocrine hypertension. Adrenalectomy is the cornerstone of treatment for UPA, but outcomes after surgery are variable. The cause of resistant hypertension after surgery is still a matter of debate. Our aim was to investigate cure rates after surgery and to evaluate preoperative factors that might influence the surgical outcome. Methods Between 2000 and 2021, the charts of 71 Tunisian patients who underwent laparoscopic adrenalectomy for UPA were retrospectively reviewed. Preoperative medical records were collected and follow-up data (1-158 months) were registered. Antihypertensive medication doses were calculated using defined daily doses (DDD) and postoperative outcomes were assessed using the Primary Aldosteronism Surgical Outcome (PASO) criterion. Results Of 91 enrolled patients, 71 (59% women, mean age 46 years, median length of follow-up 21 months) were suitable for evaluation. Thirty-four patients (48%) had complete clinical success according to the PASO criteria. The most relevant factors associated with complete clinical success on univariate analysis were: absence of diabetes (p= 0.007), low body mass index (BMI) (p= 0.001), lower preoperative DDD (p= 0.01), preoperatively controlled blood pressure (p= 0.024), higher plasma aldosterone to renin ratio (ARR) (p= 0.001), adenoma subtyping (p <0.001) and aldosteronoma resolution score (ARS) (p= 0.002). Multivariate regression analysis showed that the major predictors of complete clinical success were absence of diabetes (OR: 5.205), a BMI < 30 (OR: 4.930), a plasma ARR > 332 (OR: 4.554) and an ARS ≥ 3 (OR: 2.056). Conclusion Complete and partial clinical response rates were achieved in respectively 48 and 43% of cases. The main predictors of complete resolution of hypertension were absence of diabetes, low BMI, high plasma ARR and high ARS. Taking these factors into account may help identify patients at risk of persistent postoperative hypertension who may require long-term surveillance and medication.
Collapse
Affiliation(s)
- Ahmed Saadi
- Department of Urology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Ali Bedoui
- Department of Urology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Selim Zaghbib
- Department of Urology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Hamza Boussaffa
- Department of Urology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Seif Mokaddem
- Department of Urology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ibtissem Ben Nacef
- Department of Endocrinology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Haroun Ayed
- Department of Urology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Amine Derouiche
- Department of Urology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Karima Khiari
- Department of Endocrinology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Marouene Chakroun
- Department of Urology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| | - Riadh Ben Slama
- Department of Urology, University of Medicine of Tunis, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
11
|
Zaghbib S, Saadi A, Boussaffa H, Ayed H, Slama MRB. Management strategies and root causes of missed iatrogenic intraoperative ureteral injuries with delayed diagnosis: a retrospective cohort study of 40 cases. Patient Saf Surg 2023; 17:21. [PMID: 37496033 PMCID: PMC10373270 DOI: 10.1186/s13037-023-00372-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Intraoperative iatrogenic ureteral injuries represent rare technical surgical complications with the potential for adverse patient outcomes, particularly when the diagnosis is delayed. Ideally, these technical complications are recognized and repaired intraoperatively. This study was designed to investigate the root causes and outcomes of missed intraoperative ureteral injuries at a tertiary urology referral centre in Tunisia. METHODS This is a retrospective cohort study in a tertiary urology referral centre in Tunis from January 1st, 2015, to December 31st, 2020, including all patients with iatrogenic ureteral injury, not diagnosed intraoperatively. The factors associated with the success of endoscopic treatment and those associated with the unfavourable evolution were investigated. RESULTS A total of 40 iatrogenic ureteral injuries were included. Gynaecological surgery was responsible for 85% of ureteral injuries, mainly during hysterectomies (55%). The symptoms were dominated by low back pain (37.5%) and pyelonephritis (25%). Endoscopic treatment was attempted in 22 cases, it was sufficient in 12 cases. Ureteral injury required surgical treatment in 24 cases, and ureteroneocystostomy was performed in 16 cases. Nephrectomy was performed in eight cases, representing 20% of injuries, including three cases as the first treatment for late-diagnosed cases with a destroyed kidney. In the analytical study, endoscopic treatment was sufficient in 50% in case of ureteral fistula versus 27% in case of ureteral stenosis (p = 0.04). Nephrectomy was performed in 10% of cases when ureteral injury was diagnosed within the first month postoperatively compared to 60% of cases when this delay exceeded one month (p = 0.004). CONCLUSION Iatrogenic ureteral injuries discovered postoperatively are mostly secondary to gynaecologic surgery. Although endoscopic treatment is usually performed as a first treatment, a more aggressive surgical is often necessary, with a nephrectomy rate of 20%.
Collapse
Affiliation(s)
- Selim Zaghbib
- Urology department, Charles Nicolle Hospital, 1001 Boulevard du 09 Avril, Tunis, Tunisia.
| | - Ahmed Saadi
- Urology department, Charles Nicolle Hospital, 1001 Boulevard du 09 Avril, Tunis, Tunisia
| | - Hamza Boussaffa
- Urology department, Charles Nicolle Hospital, 1001 Boulevard du 09 Avril, Tunis, Tunisia
| | - Haroun Ayed
- Urology department, Charles Nicolle Hospital, 1001 Boulevard du 09 Avril, Tunis, Tunisia
| | | |
Collapse
|
12
|
Saadi A, Maatougui J, Hermi A, Mokadem S, Boussaffa H, Zaghbib S, Bellali M, Allouche M, Jrad M, Ayed H, Bouzouita A, Derouiche A, Chakroun M, Ben Slama MR. Management of blunt renal trauma on pre-existing diseased kidneys: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:2432-2436. [PMID: 37363469 PMCID: PMC10289701 DOI: 10.1097/ms9.0000000000000594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/22/2023] [Indexed: 06/28/2023] Open
Abstract
Pathological kidney trauma is a special entity. Congenital or acquired lesions may interfere with clinical presentation, radiological imaging, and the therapeutic approach. Objective Our objective was to determine the clinical, radiological, and therapeutic features of this entity. Materials and methods The medical records of 37 observations were retrospectively collected from January 1992 to February 2022. All cases were explored by a kidney ultrasound and/or a computed tomography scan, and classified according to the American Association of Surgery of Trauma. Pre-existing renal abnormalities were found in 37 patients among 203 (18.2%). The most common underlying lesion were urolithiasis (37.8%) followed by pyelo-ureteral junction syndrome (32.4%). Surgical abstention was decided in 11 cases, four nephrectomies were performed as a matter of urgency, and seven nephrectomies were performed remotely. The cure of uropathy was performed after an average delay of 3 months. Conclusion Kidneys with underlying pathology are habitually more susceptible to trauma. Contusions are often benign contrasting with a high nephrectomy rate.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Mohamed Bellali
- Department of Legal Medicine
- Department of Foresnic Medicine, Faculty of Medicine, Faculty Tunis Manar, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Allouche
- Department of Legal Medicine
- Department of Foresnic Medicine, Faculty of Medicine, Faculty Tunis Manar, Charles Nicolle Hospital, Tunis, Tunisia
| | | | | | | | | | | | | |
Collapse
|
13
|
Hermi A, Saadi A, Mokadem S, Boussaffa H, Zaghbib S, Haroun A, Bouzouita A, Derouiche A, Chakroun M, Ben Slama MR. Retrovesical hydatid cyst: an unusual location of hydatid disease about a case series. Ann Med Surg (Lond) 2023; 85:722-726. [PMID: 37113869 PMCID: PMC10129112 DOI: 10.1097/ms9.0000000000000380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/25/2023] [Indexed: 04/29/2023] Open
Abstract
Hydatid disease is an endemic zoonosis in regions with temperate climates where pastoral farming is common. Retrovesical localization is rare. Given the rarity of this entity, the lack of personal clinical experience, and the difficulty with detecting early symptoms, the diagnosis remains elusive for years. Methods This is a 30-year retrospective, descriptive and analytic study of seven patients who were hospitalized and operated on in the Department of Urology during 30 years (1990-2019). Outcomes The average patient age was 54 years (range: 28-76). Signs of bladder irritation were the predominant presenting complaint. No cases of hydaturia were noted. Preoperative diagnosis was based on ultrasonography and serology tests. Hydatid serology was positive for three patients. In three cases, a hydatid cyst of the liver was associated. A partial cystopericystectomy was performed for five patients, it was total for one patient. The resection of the prominent dome was realized once. No cystovesical fistula was found. The mean postoperative stay was 16 days. The postoperative course was uneventful for five patients. Urinary fistula occurred in one patient. One case of infection of the residual cavity was observed. One patient had a retroperitoneal cyst recurrence requiring reoperation. Conclusion The preoperative diagnosis of retrovesical hydatid cysts is based mainly on ultrasonography. Open surgery is the treatment of choice. Different approaches are possible. Given the rarity of this entity, management should be guided by experienced experts.
Collapse
Affiliation(s)
- Amine Hermi
- Corresponding author. Address: Department of Urology, Faculty of Medicine, Charles Nicolle Hospital, Tunis, Tunisia 1007. Tel.: +216 5570 4699. E-mail address: (A. Hermi)
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Mokadem S, Chakroun M, Hermi A, Saadi A, Zaghbib S, Ben Slama MR. Air gun accident: A case report of a penile injury. Urol Case Rep 2023; 47:102371. [PMID: 36910506 PMCID: PMC9995279 DOI: 10.1016/j.eucr.2023.102371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/05/2023] Open
Abstract
Air rifle, although considered as a toy, can cause injuries ranging from trivial to very grievous. The severity of injuries depends on the type of air rifle, the distance of firing, and the anatomic site at which the bullet hits. We present a case involving a young boy, who was accidently hit by an air rifle while playing. The Bullet penetrated the penis through the glans to be lodged in between the distal extremities of the corpus cavernosum behind the urethra. The surgical treatment was performed and the results were good.
Collapse
Affiliation(s)
- Seif Mokadem
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Marouene Chakroun
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Amine Hermi
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Ahmed Saadi
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Selim Zaghbib
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| | - Mohamed Riadh Ben Slama
- University of Tunis El Manar, Faculty of Medicine, Charles Nicolle Hospital of Tunis, Urology Department, Tunisia
| |
Collapse
|
15
|
Saadi A, Bedoui M, Zaghbib S, Mokaddem S, Ben Nacef I, Boussaffa H, Ayed H, Derouiche A, Khiari K, Chakroun M, Ben Slama R. Predictors of successful outcome after adrenalectomy for primary aldosteronism. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01140-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
16
|
Zaghbib S, Saadi A, Boussaffa H, Bedoui M, Bouzouita A, Derouiche A, Hedri H, Abderrahim E, Ayed H, Chakroun M, Ben Slama R. Vascular complications of renal transplantation: Risk factors and impact on graft survival. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
17
|
Yacoub A, Ayadi A, Ayed W, Ayari S, Chebbi S, Magroun I, Ben Afia L, Mersni M, Mechergui N, Brahim D, Ben Said H, Bahri G, Youssef I, Ladhari N, Mziou N, Grassa A, M'rad M, Khessairi N, Krir A, Chihaoui M, Mahjoub S, Bahlous A, Jridi M, Cherif Y, Derbal S, Chebbi D, Hentati O, Ben Dahmen F, Abdallah M, Hamdi I, Sahli F, Ouerdani Y, Mnekbi Y, Abaza H, Ajmi M, Guedria A, Randaline A, Ben Abid H, Gaddour N, Maatouk A, Zemni I, Gara A, Kacem M, Maatouk I, Ben Fredj M, Abroug H, Ben Nasrallah C, Dhouib W, Bouanene I, Sriha A, Mahmoudi M, Gharbi G, Khsiba A, Azouz M, Ben Mohamed A, Yakoubi M, Medhioub M, Hamzaoui L, Azouz M, Ben Attig Y, Hamdi S, Essid R, Ben Jemia E, Rezgui B, Boudaya MS, Hassine H, Dabbabi H, Fradi Y, Cherif D, Lassoued I, Yacoub H, Kchir H, Maamouri N, Khairi W, Ben Ammar H, Abaza H, Chelbi E, Merhaben S, Neffati W, Ajmi M, Tarchalla S, Boughzala S, Gazzeh M, Gara S, Labidi A, Touati H, Nefzi AM, Ben Mustpha N, Fekih M, Serghini M, Boubaker J, Zouiten L, Driss A, Meddeb N, Driss I, Walha S, Ben Said H, Bel Hadj Mabrouk E, Zaimi Y, Mensi A, Trad N, Ayadi S, Said Y, Mouelhi L, Dabbèche R, Belfkih H, Bani M, Moussa A, Souissi S, Trabelsi Werchfeni B, Chelly S, Ezzi O, Ammar A, Besbes M, Njah M, Mahjoub M, Ghali H, Neffati A, Bhiri S, Bannour R, Ayadi S, Khouya FE, Kamel A, Hariz E, Aidani S, Kefacha S, Ben Cheikh A, Said H, Dogui S, Atig A, Gara A, Ezzar S, Ben Fradj M, Bouanène I, M'kadmi H, Farhati M, Dakhli N, Nalouti K, Chanoufi MB, Abouda SH, Louati C, Zaaimi Y, Dabbeche R, Hermi A, Saadi A, Mokaddem S, Boussaffa H, Bellali M, Zaghbib S, Ayed H, Bouzouita A, Derouiche A, Allouche M, Chakroun M, Ben Slama R, Gannoun N, Kacem I, Tlili G, Kahloul M, Belhadj Chabbah N, Douma F, Bouhoula M, Chouchene A, Aloui A, Maoua M, Brahem A, Kalboussi H, El Maalel O, Chatti S, Jaidane M, Naija W, Mrizek N, Sellami I, Feki A, Hrairi A, Kotti N, Baklouti S, Jmal Hammami K, Masmoudi ML, Hajjaji M, Naaroura A, Ben Amar J, Ouertani H, Ben Moussa O, Zaibi H, Aouina H, Ben Jemaa S, Gassara Z, Ezzeddine M, Kallel MH, Fourati H, Akrout R, Kallel H, Ayari M, Chehaider A, Souli F, Abdelaali I, Ziedi H, Boughzala C, Haouari W, Chelli M, Soltani M, Trabelsi H, Sahli H, Hamdaoui R, Masmoudi Y, Halouani A, Triki A, Ben Amor A, Makni C, Eloillaf M, Riahi S, Tlili R, Jmal L, Belhaj Ammar L, Nsibi S, Jmal A, Boukhzar R, Somai M, Daoud F, Rachdi I, Ben Dhaou B, Aydi Z, Boussema F, Frikha H, Hammami R, Ben Cheikh S, Chourabi S, Bokri E, Elloumi D, Hasni N, Hamza S, Berriche O, Dalhoum M, Jamoussi H, Kallel L, Mtira A, Sghaier Z, Ghezal MA, Fitouri S, Rhimi S, Omri N, Rouiss S, Soua A, Ben Slimene D, Mjendel I, Ferchichi I, Zmerli R, Belhadj Mabrouk E, Debbeche R, Makhloufi M, Chouchane A, Sridi C, Chelly F, Gaddour A, Kacem I, Chatti S, Mrizak N, Elloumi H, Debbabi H, Ben Azouz S, Marouani R, Cheikh I, Ben Said M, Kallel M, Amdouni A, Rejaibi N, Aouadi L, Zaouche K, Khouya FE, Aidani S, Khefacha S, Jelleli N, Sakly A, Zakhama W, Binous MY, Ben Said H, Bouallegue E, Jemmali S, Abcha S, Wahab H, Hmida A, Mabrouk I, Mabrouk M, Elleuch M, Mrad M, Ben Safta N, Medhioub A, Ghanem M, Boughoula K, Ben Slimane B, Ben Abdallah H, Bouali R, Bizid S, Abdelli MN, Ben Nejma Y, Bellakhal S, Antit S, Bourguiba R, Zakhama L, Douggui MH, Bahloul E, Dhouib F, Turki H, Sabbah M, Baghdadi S, Trad D, Bellil N, Bibani N, Elloumi H, Gargouri D, Ben Said M, Hamdaoui R, Chokri R, Kacem M, Ben Rejeb M, Miladi A, Kooli J, Touati S, Trabelsi S, Klila M, Rejeb H, Kammoun H, Akrout I, Greb D, Ben Abdelghaffar H, Hassene H, Fekih L, Smadhi H, Megdiche MA, Ksouri J, Kasdalli H, Hayder A, Gattoussi M, Chérif L, Ben Saida F, Gueldich M, Ben Jemaa H, Dammak A, Frikha I, Saidani A, Ben Amar J, Aissi W, Chatti AB, Naceur I, Ben Achour T, Said F, Khanfir M, Lamloum M, Ben Ghorbel I, Houman M, Cherif T, Ben Mansour A, Daghfous H, Slim A, Ben Saad S, Tritar F, Naffeti W, Abdellatif J, Ben Fredj M, Selmi M, Kbir GH, Maatouk M, Jedidi L, Taamallah F, Ben Moussa M, Halouani L, Rejeb S, Khalffalah N, Ben Ammar J, Hedhli S, Azouz MM, Chatti S, Athimni Z, Bouhoula M, Elmaalel O, Mrizak N, Maalej M, Kammoun R, Gargouri F, Sallemi S, Haddar A, Masmoudi K, Oussaifi A, Sahli A, Bhouri M, Hmaissi R, Friha M, Cherif H, Baya C, Triki M, Yangui F, Charfi MR, Ben Hamida HY, Karoui S, Aouini F, Hajlaoui A, Jlassi H, Sabbah M, Fendri MN, Kammoun N, Fehri S, Nouagui H, Harzalli A, Snène H, Belakhal S, Ben Hassine L, Labbene I, Jouini M, Kalboussi S, Ayedi Y, Harizi C, Skhiri A, Fakhfakh R, Jelleli B, Belkahla A, Fejjeri M, Zeddini M, Mahjoub S, Nouira M, Frih N, Debiche S, Blibech H, Belhaj S, Mehiri N, Ben Salah N, Louzir B, Kooli J, Bahri R, Chaka A, Abdenneji S, Majdoub Fehri S, Hammadi J, Dorgham D, Hriz N, Kwas H, Issaoui N, Jaafoura S, Bellali H, Shimi M, Belhaj Mabrouk E, Sellami R, Ketata I, Medi W, Mahjoub M, Ben Yacoub S, Ben Chaabene A, Touil E, Ben Ayed H, Ben Miled S, El Zine E, Khouni H, Ben Kadhi S, Maatoug J, Boulma R, Rezgui R, Boudokhane M, Jomni T, Chamekh S, Aissa S, Touhiri E, Jlaiel N, Oueslati B, Maaroufi N, Aouadi S, Belkhir S, Daghfous H, Merhaben S, Dhaouadi N, Ounaes Y, Chaker K, Yaich S, Marrak M, Bibi M, Mrad Dali K, Sellami A, Nouira Y, Sellami S, Anane I, Trabelsi H, Ennaifer R, Benzarti Z, Bouchabou B, Hemdani N, Nakhli A, Cherif Y, Abdelkef M, Derbel K, Barkous B, Yahiaoui A, Sayhi A, Guezguez F, Rouatbi S, Racil H, Ksouri C, Znegui T, Maazaoui S, Touil A, Habibech S, Chaouech N, Ben Hmid O, Ismail S, Chouaieb H, Chatti M, Guediri N, Belhadj Mohamed M, Bennasrallah C, Bouzid Y, Zaouali F, Toumia M, El Khemiri N, El Khemiri A, Sfar H, Farhati S, Ben Chehida F, Yamoun R, Braham N, Hamdi Y, Ben Mansour A, Mtir M, Ayari M, Toumia M, Rouis S, Sakly H, Nakhli R, Ben Garouia H, Chebil D, Hannachi H, Merzougui L, Samet S, Hrairi A, Mnif I, Hentati O, Bouzgarrou L, Souissi D, Boujdaria R, Kadoussi R, Rejeb H, Ben Limem I, Ben Salah I, Greb D, Ben Abdelghaffar H, Smadhi H, Laatiri H, Manoubi SA, Gharbaoui M, Hmandi O, Zhioua M, Taboubi F, Hamza Y, Hannach W, Jaziri H, Gharbi R, Hammami A, Dahmani W, Ben Ameur W, Ksiaa M, Ben Slama A, Brahem A, Elleuch N, Jmaa A, Kort I, Jlass S, Benabderrahim S, Turki E, Belhaj A, Kebsi D, Ben Khelil M, Rmadi N, Gamaoun H, Alaya Youzbechi F, Brahim T, Boujnah S, Abid N, Gader N, Kalboussi S, Ben Sassi S, Loukil M, Ghrairi H, Ben Said N, Mrad O, Ferjaoui M, Hedhli L, Ben Kaab B, Berriche A, Charfi R, Mourali O, Smichi I, Bel Haj Kacem L, Ksentini M, Aloui R, Ferchichi L, Nasraoui H, Maoua M, Chérif F, Belil Y, Ayed MA, Alloulou Y, Belhadj S, Daghfous J, Mehiri N, Louzir B, Abbes A, Ghrab A, Chermiti A, Akacha A, Mejri O, Debbiche A, Yahiaoui C, Binous M, Tissaoui A, Mekni K, El Fekih C, Said MA, Chtioui S, Mestiri S, Smaoui H, Ben Hamida S, Haddar A, Mrizek N, Gares N, Zaibi A, Bouazizi N, Gallas S, Lachhab A, Belhadj M, Hadj Salem N, Garrouch A, Mezgar Z, Khrouf M, Abbassi H, Souissi D, Hamra I, Ben Mustapha N, Abessi I, Boubaker F, Bouchareb S, ElOmma Mrabet H, Touil I, Boussoffara L, Knani J, Boudawara N, Alaya W, Sfar MH, Fekih S, Snène H, Boudawara N, Gargouri I, Benzarti W, Knaz A, Abdelghani A, Aissa S, Hayouni A, Mejri I, Kacem M, Mhamdi S, Daboussi S, Aichaouia C, Moatemri Z, Chaachou A, Fsili R, Ben Ghezala H, Ben Jazia A, Brahmi N. 2022 TUNISIAN NATIONAL CONGRESS OF MEDICINE ABSTRACTS. Tunis Med 2023; 101:62-64. [PMID: 37682263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Indexed: 09/09/2023]
|
18
|
Setti Boubaker N, Gurtner A, Trabelsi N, Manni I, Blel A, Saadi A, Chakroun M, Naimi Z, Zaghbib S, Ksontini M, Meddeb K, Rammeh S, Ayed H, Chebil M, Piaggio G, Ouerhani S. An insight into the diagnostic and prognostic value of
HOX A13
’s expression in non‐muscle invasive bladder cancer. J Clin Lab Anal 2022; 36:e24606. [PMID: 35853090 PMCID: PMC9459288 DOI: 10.1002/jcla.24606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/23/2022] [Accepted: 06/14/2022] [Indexed: 11/15/2022] Open
Abstract
Background Several studies have interrogated the molecular pathways and their interacting genes underlying bladder cancer (BCa) tumorigenesis, yet, the role of homeobox genes is still poorly understood. Specifically, HOXA13, which plays an important role as a major actor in the urogenital tract's development. Methods Immunohistochemical (IHC) staining was performed to inspect the differential expression of HOXA13 protein in non‐muscle‐invasive bladder cancer (NMIBC) and non‐tumoral tissues. A semiquantitative scoring system was adopted to evaluate the IHC labeling. Correlation to clinical parameters was performed by descriptive statistics. Overall survival was estimated by the Kaplan–Meier method and Cox regression model. The functional HOX A13 protein association networks (PPI) were obtained using String 11.0 database. Results HOX A13 exhibited cytoplasmic and nuclear staining. Its expression levels were lower in high‐grade NMIBC (HG NMIBC) compared to low‐grade ones (LG NMIBC). The expression of HOX A13 was correlated to tumor grade (LG/HG) (p = 0.036) and stage (TA/T1) (p = 0.036). Nevertheless, its expression was not correlated to clinical parameters and was not able to predict the overall survival of patients with HG NMIBC. Finally, PPI analysis revealed that HOX A13 seems to be a part of a molecular network holding mainly PBX1, MEIS, ALDH1A2, HOX A10, and HOX A11. Conclusion The deregulation of HOX A13 is not associated with the prognosis of BCa. It seems to be rather implicated in the early initiation of urothelial tumorigenesis and thus may serve as a diagnostic marker in patients with NMIBC. Further experimentations on larger validation sets are mandatory.
Collapse
Affiliation(s)
- Nouha Setti Boubaker
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP‐MB) INSAT University of Tunis Carthage Tunis Tunisia
- UOSD SAFU Department of Research, Diagnosis and Innovative Technologies IRCCS‐Regina Elena National Cancer Institute Rome Italy
- Urology Department Faculty of Medicine Charles Nicolle Hospital University of Tunis‐El Manar Tunis Tunisia
| | - Aymone Gurtner
- UOSD SAFU Department of Research, Diagnosis and Innovative Technologies IRCCS‐Regina Elena National Cancer Institute Rome Italy
- Institute of Translational Pharmacology (IFT) National Research Council (CNR) Rome Italy
| | - Nesrine Trabelsi
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP‐MB) INSAT University of Tunis Carthage Tunis Tunisia
| | - Isabella Manni
- UOSD SAFU Department of Research, Diagnosis and Innovative Technologies IRCCS‐Regina Elena National Cancer Institute Rome Italy
| | - Ahlem Blel
- Pathology Department Faculty of Medicine Charles Nicolle Hospital University of Tunis El Manar Tunis Tunisia
| | - Ahmed Saadi
- Urology Department Faculty of Medicine Charles Nicolle Hospital University of Tunis‐El Manar Tunis Tunisia
| | - Marouene Chakroun
- Urology Department Faculty of Medicine Charles Nicolle Hospital University of Tunis‐El Manar Tunis Tunisia
| | - Zeineb Naimi
- Medical Oncology Department Faculty of Medicine Salah Azaiez Institute University of Tunis‐El Manar Tunis Tunisia
| | - Selim Zaghbib
- Urology Department Faculty of Medicine Charles Nicolle Hospital University of Tunis‐El Manar Tunis Tunisia
| | - Meriam Ksontini
- Pathology Department Faculty of Medicine Charles Nicolle Hospital University of Tunis El Manar Tunis Tunisia
| | - Khedija Meddeb
- Medical Oncology Department Faculty of Medicine Salah Azaiez Institute University of Tunis‐El Manar Tunis Tunisia
| | - Soumaya Rammeh
- Pathology Department Faculty of Medicine Charles Nicolle Hospital University of Tunis El Manar Tunis Tunisia
| | - Haroun Ayed
- Urology Department Faculty of Medicine Charles Nicolle Hospital University of Tunis‐El Manar Tunis Tunisia
| | - Mohamed Chebil
- Urology Department Faculty of Medicine Charles Nicolle Hospital University of Tunis‐El Manar Tunis Tunisia
| | - Giulia Piaggio
- UOSD SAFU Department of Research, Diagnosis and Innovative Technologies IRCCS‐Regina Elena National Cancer Institute Rome Italy
| | - Slah Ouerhani
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP‐MB) INSAT University of Tunis Carthage Tunis Tunisia
| |
Collapse
|
19
|
Zaghbib S, Chakroun M, Saadi A, Boussaffa H, Bouzouita A, Derouiche A, Ben Slama R, Bacha M, Abdallah Taieb B, Ayed H, Chebil M. MO967: Lymphocele After Renal Transplantation: Management, Risk Factors and Impact on Transplant Survival. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac087.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Lymphocele after renal transplantation remains a common complication, despite all the technical precautions taken, in particular the ligation of lymphatic vessels. Its incidence varies according to the series, depending on the diagnostic methodology, and whether or not it is systematically screened.
This study aims to investigate the risk factors for lymphocele and its impact on transplant survival.
METHOD
We performed a retrospective longitudinal descriptive study including all patients who had a kidney transplant in a Urology department from 1986 to 2017. Clinical presentation and management of lymphocele were studied. Then, the characteristics of patients who presented a lymphocele were compared with those of the rest of the population including characteristics related to the recipient, the donor, the transplant and the procedure to identify risk factors. The impact of lymphocele on patient and transplant survival was then studied.
RESULTS
A total of 720 patients were included with a mean age of 32.7 years. The transplant was from a living donor in 79% and a brain-dead donor in 21%. Lymphocele occurred in 51 patients (7.1%). The lymphocele was asymptomatic in 80%, and clinical manifestations were related to the compression of the transplant or its important size, requiring active treatment, most often percutaneous (13.7%). The lymphocele did not require treatment in 42 cases (82.4%) with disappearance in 90.5%. Revision surgery for a lymphocele was necessary in two cases.
The risk factors for lymphocele were a cadaveric donor (P = 0.003) and an advanced age of the recipient (P < 0.001). No predictive factors related to the transplant (vascular anatomy), or procedure (location and type of anastomoses, ischemia time) were identified.
Transplant survival was 77.9% at 5 years, with a median survival of 15.9 years. The occurrence of a lymphocele did not influence the survival of the transplant (P = 0.25) (Figure 1).
CONCLUSION
Our study showed that lymphocele is usually asymptomatic, not requiring a specific treatment in most cases with a high rate of spontaneous disappearance with no impact on transplant survival. Risk factors were a cadaveric donor which may reflect the absence of careful ligation of the transplant's lymphatic vessels in the context of urgent, sometimes multi-organ, cadaveric procurement and advanced recipient age.
Collapse
Affiliation(s)
| | | | - Ahmed Saadi
- Charles Nicolle Hospital, Urology, Tunis, Tunisia
| | | | | | | | | | - Mongi Bacha
- Charles Nicolle Hospital, Nephrology, Tunisia
| | | | - Haroun Ayed
- Charles Nicolle Hospital, Urology, Tunis, Tunisia
| | | |
Collapse
|
20
|
Zaghbib S, Chakroun M, Saadi A, Boussaffa H, Bouzouita A, Derouiche A, Ben Slama R, Bacha M, Abdallah Taieb B, Ayed H, Chebil M. MO968: Vascular Complications of Renal Transplantation: Risk Factors and Impact on Graft Survival. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac087.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Despite the progress made in renal transplantation, vascular complications can occur, jeopardizing the prognosis of the transplant.
This study aims to investigate the risk factors of vascular complications and their impact on transplant survival.
METHOD
We performed a retrospective longitudinal descriptive study including all patients who had a kidney transplant in a Urology department from 1986 to 2017. Transplant Vascular complications included: Arterial thrombosis (AT), Venous thrombosis (VT), hemorrhagic complications (hemorrhage and hematoma) and arterial stenosis (AS). The potential risk factors for vascular complications that were investigated included characteristics related to the recipient, the donor, the transplant and the procedure. The impact of vascular complications on transplant survival was then studied.
RESULTS
A total of 720 patients were included with a mean age of 32.7 years. The transplant was from a living donor in 79% and a brain-dead donor in 21%.
AT occurred in 15 patients (2.1%) and VT occurred in 10 patients (1.4%). Risk factors for vascular thrombosis were recipient age >35 years (P = 0.001; OR = 10.78), recipient smoking (P = 0.005; OR = 1.8), multiple arteries (P < 0.001; OR = 1.45) and prolonged warm ischemia (P = 0.02). Perirenal hematoma occurred in 11 patients (1.5%) and hemorrhage occurred in six patients (0.8%). The risk factors for bleeding complications were a prolonged pre-transplantation dialysis time (P = 0.03; OR = 1.35), and prolonged warm ischemia (P = 0.02; OR = 1.26). AS was the most frequent vascular complication, occurring in 20 cases (2.8%) and no risk factors were identified.
Transplant survival was 77.9% at 5 years, with a median survival of 15.9 years. Vascular thrombosis led to the loss of the transplant in all cases, and externalized hemorrhage significantly reduced transplant survival (P < 0.001). Perirenal hematoma (P = 0.42) and transplant artery stenosis (P = 0.25) had no impact on transplant survival (Figure 1).
CONCLUSION
Our study showed that the vascular complications impacted the survival of the transplant and that they were related to factors related to the recipient, the transplant and the procedure insisting on a multidisciplinary and personalized management for each case.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Mongi Bacha
- Charles Nicolle Hospital, Nephrology, Tunisia
| | | | | | | |
Collapse
|
21
|
Zaghbib S, Chakroun M, Boussaffa H, Saadi A, Ayed H, Chebil M. Ejaculatory duct reflux revealed by chronic scrotal swelling in an adult. Urol Case Rep 2022; 42:101992. [PMID: 35059297 PMCID: PMC8760482 DOI: 10.1016/j.eucr.2022.101992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/06/2022] [Indexed: 11/18/2022] Open
Abstract
Ejaculatory duct reflux is rare and few investigations have focused on this entity, which is usually described in children. This study reports a new case of unilateral ejaculatory reflux in a 32-year-old patient, with a history of urethroplasty at the age of 5 for hypospadias, who presented for right chronic scrotal swelling. Urethrocystscopy showed an anterior urethral stricture and a gaping opening of the right ejaculatory duct. CT scan with opacification through the right ejaculatory duct, showed a dilated right seminal vesicle, associated to a reflux in the right deferent vas and epididymis, which was dilated explaining the scrotal swelling.
Collapse
Affiliation(s)
- Selim Zaghbib
- Corresponding author. Charles Nicolle Hospital, Boulevard du 9 Avril, Tunis, Tunisia.
| | | | | | | | | | | |
Collapse
|
22
|
Zouari S, Saadi A, Chakroun M, Zaghbib S, Setti Boubaker N, Boussaffa H, Bouzouita A, Derouiche A, Ben Slama R, Ayed H, Chebil M. Predictive factors of recurrence of urethral strictures after a first internal uretrotomy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00935-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
23
|
Zouari S, Saadi A, Htira Y, Ben Nacef I, Chakroun M, Zaghbib S, Boussaffa H, Bouzouita A, Derouiche A, Ben Slama R, Khiari K, Ayed H, Chebil M. Management aspects of urinary tract infection in diabetic patients: A national survey among different specialties. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00206-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
24
|
Hemissi I, Boussetta S, Dallali H, Hellal F, Durand G, Voegele C, Ayed H, Zaghbib S, Naimi Z, Ayadi M, Chebil M, Mckay J, Le Calvez-Kelm F, Ouerhani S. Development of a custom next-generation sequencing panel for the determination of bladder cancer risk in a Tunisian cohort. Mol Biol Rep 2022; 49:1233-1258. [PMID: 34854013 DOI: 10.1007/s11033-021-06951-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/09/2021] [Indexed: 12/24/2022]
Abstract
BACKGOUND Bladder cancer (BCa) is a heterogeneous disease caused by the interaction between environmental and genetic risk factors. The goal of this case-control study was to evaluate the implication of a selected SNP panel in the risk of BCa development in a Tunisian cohort. We were also interested in studying the interaction between this predictive panel and environmental risk factors. METHODS The case/control cohort was composed with 249 BCa cases and 255 controls. The designed Bladder cancer hereditary panel (BCHP) was composed of 139 selected variants. These variants were genotyped by an amplification-based targeted Next-Generation Sequencing (NGS) on the Ion Torrent Proton sequencer (Life Technologies, Ion Torrent technology). RESULTS We have found that rs162555, rs2228000, rs10936599, rs710521, rs3752645, rs804276, rs4639, rs4881400 and rs288980 were significantly associated with decreased risk of bladder cancer. However the homozygous genotypes for VPS37C (rs7104333, A/A), MPG (rs1013358, C/C) genes or the heterozygous genotype for ARNT gene (rs1889740, rs2228099, rs2256355, rs2864873), GSTA4 (rs17614751) and APOBR/IL27 (rs17855750) were significantly associated with increased risk of bladder cancer development compared to reference group (OR 2.53, 2.34, 1.99, 2.00, 2.00, 1.47, 1.96 and 2.27 respectively). We have also found that non-smokers patients harboring heterozygous genotypes for ARNT/rs2864873 (A > G), ARNT/ rs1889740 (C > T) or GSTA4/rs17614751 (G-A) were respectively at 2.775, 3.069 and 6.608-fold increased risk of Bca development compared to non-smokers controls with wild genotypes. Moreover the ARNT CT (rs1889740), ARNT CG (rs2228099), ARNT TC (rs2864873) and GSS GA genotypes were associated with an increased risk of BCa even in absence of professional risk factors. Finally the decision-tree analysis produced a three major BCa classes. These three classes were essentially characterized by an intensity of tobacco use more than 20 pack years (PY) and the CYP1A2 (rs762551) genotype. CONCLUSIONS The determined association between environmental factors, genetic variations and the risk of Bca development may provide additional information to urologists that may help them for clinical assessment and treatment decisions. Nevertheless, the underlying mechanisms through which these genes or SNPs affect the clinical behavior of BCas require further studies.
Collapse
Affiliation(s)
- Imen Hemissi
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), INSAT, National Institute of Applied Sciences and Technology of Tunis, University of Carthage, Tunis, Tunisia
| | - Sami Boussetta
- Laboratory of Genetics, Immunology and Human Pathology, Faculty of Sciences of Tunis, Tunis, Tunisia
| | | | - Faycel Hellal
- National Institute of Applied Sciences and Technology of Tunis, University of Carthage, Tunis, Tunisia
| | - Geoffroy Durand
- Centre International de Recherche sur le Cancer CIRC/International Agency for Research on Cancer IARC, Lyon, France
| | - Catherine Voegele
- Centre International de Recherche sur le Cancer CIRC/International Agency for Research on Cancer IARC, Lyon, France
| | - Haroun Ayed
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Selim Zaghbib
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Zeineb Naimi
- Medical Oncology Department, Saleh Azaiez Institute, Tunis, Tunisia
| | - Mouna Ayadi
- Medical Oncology Department, Saleh Azaiez Institute, Tunis, Tunisia
| | - Mohamed Chebil
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - James Mckay
- Centre International de Recherche sur le Cancer CIRC/International Agency for Research on Cancer IARC, Lyon, France
| | - Florence Le Calvez-Kelm
- Centre International de Recherche sur le Cancer CIRC/International Agency for Research on Cancer IARC, Lyon, France
| | - Slah Ouerhani
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), INSAT, National Institute of Applied Sciences and Technology of Tunis, University of Carthage, Tunis, Tunisia.
| |
Collapse
|
25
|
Hemissi I, Boussetta S, Dallali H, Hellal F, Durand G, Voegele C, Ayed H, Zaghbib S, Naimi Z, Ayadi M, Chebil M, Mckay J, Le Calvez-Kelm F, Ouerhani S. Correction to: Development of a custom next-generation sequencing panel for the determination of bladder cancer risk in a Tunisian cohort. Mol Biol Rep 2022; 49:1259. [PMID: 34977990 DOI: 10.1007/s11033-021-07052-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Imen Hemissi
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), INSAT, National Institute of Applied Sciences and Technology of Tunis, University of Carthage, Tunis, Tunisia
| | - Sami Boussetta
- Laboratory of Genetics, Immunology and Human Pathology, Faculty of Sciences of Tunis, Tunis, Tunisia
| | | | - Faycel Hellal
- National Institute of Applied Sciences and Technology of Tunis, University of Carthage, Tunis, Tunisia
| | - Geoffroy Durand
- Centre International de Recherche sur le Cancer CIRC/International Agency for Research on Cancer IARC, Lyon, France
| | - Catherine Voegele
- Centre International de Recherche sur le Cancer CIRC/International Agency for Research on Cancer IARC, Lyon, France
| | - Haroun Ayed
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Selim Zaghbib
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Zeineb Naimi
- Medical Oncology Department, Saleh Azaiez Institute, Tunis, Tunisia
| | - Mouna Ayadi
- Medical Oncology Department, Saleh Azaiez Institute, Tunis, Tunisia
| | - Mohamed Chebil
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - James Mckay
- Centre International de Recherche sur le Cancer CIRC/International Agency for Research on Cancer IARC, Lyon, France
| | - Florence Le Calvez-Kelm
- Centre International de Recherche sur le Cancer CIRC/International Agency for Research on Cancer IARC, Lyon, France
| | - Slah Ouerhani
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), INSAT, National Institute of Applied Sciences and Technology of Tunis, University of Carthage, Tunis, Tunisia.
| |
Collapse
|
26
|
Sahnoun W, Chakroun M, Zaghbib S, Saadi A, Blel A, Rammeh S, Ayed H, Chebil M. Management and prognosis of liposarcomas of the spermatic cord: an experience with six cases. J Surg Case Rep 2022; 2022:rjab621. [PMID: 35070268 PMCID: PMC8769886 DOI: 10.1093/jscr/rjab621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/20/2021] [Indexed: 11/14/2022] Open
Abstract
Liposarcoma of the spermatic cord (LSC) is a rare tumor with no consensus on therapeutic management. This study reports six new cases of LSC. The patients’ age ranged from 56 to 80 years. All patients presented with a scrotal mass, and it was ultrasound that oriented the diagnosis. The initial treatment consisted of an inguinal orchiectomy. Anatomopathological study coupled with immunohistochemistry using the anti-MDM2 antibody confirmed that the tumors were well-differentiated LSC in four cases and dedifferentiated LSC in the other two cases. Adjuvant radiotherapy was performed in two patients. No recurrence was noted in these two patients at 14 and 34 months of follow-up. The only recurrence we had was local and occurred at 44 months of follow-up in a patient who had a dedifferentiated form ofLSC.
Collapse
Affiliation(s)
- Wajih Sahnoun
- Correspondence address. Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia. Tel: 0021655663392; E-mail:
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Said R, Jenni R, Boussetta S, Ammous F, Zouari S, Zaghbib S, Chakroun M, Derouiche A, Chebil M, Ouerhani S. Association of a common genetic variant (insertion/deletion) in ACE gene with prostate cancer susceptibility in a Tunisian population. J Clin Lab Anal 2021; 36:e24129. [PMID: 34799866 PMCID: PMC8761439 DOI: 10.1002/jcla.24129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 01/11/2023] Open
Abstract
Background Angiotensin‐converting enzyme (ACE) plays a pivotal role in several pathologies including cancers. The association of insertion/deletion (I/D) polymorphism of the ACE gene with prostate cancer (PC) risk remains controversial. We aimed to investigate for the first time, to our Knowledge, in North Africa the potential relationship between ACE I/D polymorphism with PC susceptibility and clinical outcomes of PC patients. Methods This case‐control study included 143 healthy individuals and 124 patients diagnosed with PC. Using genomic DNA, the samples were genotyped for ACE I/D polymorphism by polymerase chain reaction (PCR). Results We found that The D allele is significantly associated with an increased risk of PC and D/D + D/I genotypes were at 3 times increased risk of PC ([p = 0.005], OR = 2.95, IC 95% = 1.26–7.09) compared with I/I genotype (p = 0.003, OR = 0.3, IC 95% = 0.12–0.74). We observed an association between D/D and D/I genotypes with advanced age (≥70 years) (p = 0.014; r2 = 0.22). Furthermore, there is a significant prediction of advanced Gleason score ≥8 based on epidemiological parameters and ACE genotype (p = 0.000; R2 = 0.349), although no significant association was observed with stage and metastasis. Conclusion The ACE I/D polymorphism is likely to predispose to PC and could play a role in PC progression and aggressiveness.
Collapse
Affiliation(s)
- Rahma Said
- Laboratory of Protein Engineering and Bio-active Molecules, National Institute of Applied Science and Technology - University of Carthage, Tunis, Tunisia
| | - Rim Jenni
- Laboratory of Protein Engineering and Bio-active Molecules, National Institute of Applied Science and Technology - University of Carthage, Tunis, Tunisia
| | - Sami Boussetta
- Laboratory of Genetics, Immunology, and Human Pathology, Faculty of Sciences of Tunis
| | - Feryel Ammous
- Laboratory of Genetics, Immunology, and Human Pathology, Faculty of Sciences of Tunis
| | - Skander Zouari
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Selim Zaghbib
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Amine Derouiche
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Chebil
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Slah Ouerhani
- Laboratory of Protein Engineering and Bio-active Molecules, National Institute of Applied Science and Technology - University of Carthage, Tunis, Tunisia
| |
Collapse
|
28
|
Zouari S, Saadi A, Marouene C, Zaghbib S, Htira Y, Boussaffa H, Bouzouita A, Derouiche A, Ben slama R, Ben mami F, Ayed H, Chebil M. Diététique des patients porteurs de lithiase urinaire : point de vue du médecin généraliste. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
29
|
Hemissi I, Ayed H, Naimi Z, Meddeb K, Ayadi M, Zouari S, Zaghbib S, Talbi E, Chebil M, Ouerhani S. Polymorphisms in NQO1 and MPO genes and risk for bladder cancer in Tunisian population. Mol Genet Genomic Med 2021; 9:e1819. [PMID: 34549902 PMCID: PMC8606214 DOI: 10.1002/mgg3.1819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND NAD (P) H: quinone oxidoreductase (1) (NQO1-HGNC: 2874) and myeloperoxidase (MPO-HGNC: 7218) are two enzymes involved in phase II of the xenobiotic metabolism pathway. METHODS In this study, a case-control analysis was conducted to investigate the relationship between genetic variations in the NQO1 (C609T, rs1800566; IVS1-27 C >G, rs689452) and MPO (G463A, rs2333227) genes and the risk for bladder cancer among Tunisian population. RESULTS We have found that the MPO 463GA genotype was associated with a decreased risk of developing bladder cancer (p = 0.049; OR = 0.696; 95% CI 0.484-0.999). In contrast, we have found that the NQO1 609CT genotype could increase the risk of bladder cancer patients (p = 0.0039; OR = 1.454; 95% CI = 1.017-2.078). Moreover, patients with "NQO1 609 CT/IVS1-27 CG" genotype show a 2.180-fold increasing risk for developing bladder cancer in comparison to the control group with wild genotype. This OR is estimated at 5.6-fold in smokers patients with "NQO1 609 CT/IVS1-27 CG" genotype. Lastly, study findings suggest that the NQO1 IVS-27 *CG genotype (rs689452) is associated with a risk of progression to muscle invasive bladder cancer. CONCLUSION Our study suggests that environmental risk factors in association to NQO1 genotypes (NQO1 609 CT/IVS1-27 CG) play an important role in the development of bladder cancer in Tunisian population.
Collapse
Affiliation(s)
- Imen Hemissi
- Laboratory of Protein Engineering and Bio‐active MoleculesNational Institute of Applied Science and Technology ‐ University of CarthageTunisTunisia
| | - Haroun Ayed
- Urology DepartmentCharles Nicolle HospitalTunisTunisia
| | - Zeineb Naimi
- Medical oncology department Salah AzaiezTunisTunisia
| | | | - Mouna Ayadi
- Medical oncology department Salah AzaiezTunisTunisia
| | | | - Selim Zaghbib
- Urology DepartmentCharles Nicolle HospitalTunisTunisia
| | - Emna Talbi
- Biochemistry DepartmentCharles Nicolle HospitalTunisTunisia
| | | | - Slah Ouerhani
- Laboratory of Protein Engineering and Bio‐active MoleculesNational Institute of Applied Science and Technology ‐ University of CarthageTunisTunisia
| |
Collapse
|
30
|
Setti Boubaker N, Gurtner A, Trabelsi N, Manni I, Ayed H, Saadi A, Zaghbib S, Naimi Z, Sahraoui G, Zouari S, Meddeb K, Mrad K, Chebil M, Piaggio G, Ouerhani S. The diagnostic applicability of A-type Lamin in non-muscle invasive bladder cancer. Ann Diagn Pathol 2021; 54:151808. [PMID: 34438192 DOI: 10.1016/j.anndiagpath.2021.151808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/04/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Lamin A is a major component of the nuclear lamina maintaining nuclear integrity, regulation of gene expression, cell proliferation, and apoptosis. Its deregulation in cancer has been recently reported to be associated with its prognosis. However, its clinical significance in non-muscle invasive bladder cancer (NMIBC) remains to be defined. MATERIAL/METHODS Immunohistochemical staining and RT-qPCR were performed to screen the expression patterns of Lamin A/C protein and Lamin A mRNA respectively in 58 high and low grade NMIBC specimens. RESULTS Lamin A/C protein was expressed only in the nucleus and less exhibited in NMIBC tissues compared to non-tumoral ones. On the other side, Lamin A mRNA was up-regulated in NMIBC compared to controls. Nevertheless, both expression patterns (protein and mRNA) were not correlated to clinical prognosis factors and were not able to predict the overall survival of patients with high-grade NMIBC. CONCLUSIONS The deregulation of A-type Lamin is not associated with the prognosis of NMIBC, but it could serve as a diagnostic biomarker distinguishing NMIBC patients from healthy subjects suggesting its involvement as an initiator event of tumorigenesis in our cohort.
Collapse
Affiliation(s)
- Nouha Setti Boubaker
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), INSAT, University of Tunis Carthage, Tunis, Tunisia; UOSD SAFU, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy.
| | - Aymone Gurtner
- UOSD SAFU, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy; Institute of Translational Pharmacology, National Research Council, Rome, Italy.
| | - Nesrine Trabelsi
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), INSAT, University of Tunis Carthage, Tunis, Tunisia.
| | - Isabella Manni
- UOSD SAFU, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy.
| | - Haroun Ayed
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis-El Manar, Tunis, Tunisia.
| | - Ahmed Saadi
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis-El Manar, Tunis, Tunisia.
| | - Selim Zaghbib
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis-El Manar, Tunis, Tunisia.
| | - Zeineb Naimi
- Medical Oncology Department, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis-El Manar, Tunis, Tunisia.
| | - Ghada Sahraoui
- Pathology Department, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis-El Manar, Tunis, Tunisia.
| | - Skander Zouari
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis-El Manar, Tunis, Tunisia.
| | - Khedija Meddeb
- Medical Oncology Department, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis-El Manar, Tunis, Tunisia.
| | - Karima Mrad
- Pathology Department, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis-El Manar, Tunis, Tunisia.
| | - Mohamed Chebil
- Urology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis-El Manar, Tunis, Tunisia.
| | - Giulia Piaggio
- UOSD SAFU, Department of Research, Diagnosis and Innovative Technologies, IRCCS-Regina Elena National Cancer Institute, Rome, Italy.
| | - Slah Ouerhani
- Laboratory of Proteins Engineering and Bioactive Molecules (LIP-MB), INSAT, University of Tunis Carthage, Tunis, Tunisia.
| |
Collapse
|
31
|
Saidani B, Chakroun M, Saadi A, Zaghbib S, Bouzouita A, Derouiche A, Ben Slama M, Ayed H, Chebil M. Interest of FGSI and LRINEC prognostic scores in the management of Fournier gangrene. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00563-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
32
|
Zaghbib S, Chakroun M, Saadi A, Boussaffa H, Znaidi N, Rammeh S, Ayed H, Chebil M. Isolated bladder metastasis from lung adenocarcinoma: a case report. J Surg Case Rep 2021; 2021:rjab195. [PMID: 34055288 PMCID: PMC8159194 DOI: 10.1093/jscr/rjab195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/14/2021] [Accepted: 04/18/2021] [Indexed: 11/12/2022] Open
Abstract
Cancers of extra bladder origin represent between 2 and 12% of bladder neoplasms and are most often secondary to contiguous bladder invasion. Metastasis from distant organs is exceptional, especially from pulmonary adenocarcinoma with <10 cases identified over the last 20 years. We report here a new case of a 55-year-old patient with a recently diagnosed pulmonary adenocarcinoma referred to the urology department for macroscopic hematuria. Computed tomography scan showed, in addition to the lung mass of the right lower lobe with a right mediastinal adenopathy, a thickening of the right lateral bladder wall. Cystoscopy showed inflammatory lesions on the bladder mucosa, which biopsy with immunohistochemical examination revealed to be tumoral proliferation in the lamina propria realizing the same immunohistochemical profile of the primary lung tumor (CK7+/TTF1+/CK20-/PSA-). The patient was treated with palliative platinum-based chemotherapy and unfortunately died 5 months after diagnosis.
Collapse
Affiliation(s)
- Selim Zaghbib
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Ahmed Saadi
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Hamza Boussaffa
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Nadia Znaidi
- Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Soumaya Rammeh
- Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Haroun Ayed
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Chebil
- Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
33
|
Zaghbib S, Chakroun M, Saadi A, Mrad Dali K, Zouari S, Bouzouita A, Ben Rhouma S, Derouiche A, Ben Slama M, Nouira Y, Ayed H, Chebil M. Oncologic results of radical prostatectomy for high-risk prostate cancer and prognostic factors for recurrence and progression-free survival. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36209-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
34
|
Boussaffa H, Chakroun M, Saadi A, Zaghbib S, Meddeb K, Ayedi M, Bouzouita A, Derouiche A, Ben Slama M, Mezlini A, Ayed H, Chebil M. Is the percentage of teratoma in the orchiectomy specimen predictive of teratoma in retroperitoneal residual masses after chemotherapy in nonseminomatous germ cell tumors? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36273-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
35
|
Zaghbib S, Saadi A, Chakroun M, Oueslati A, Bouzouita A, Derouiche A, Ben Slama M, Mahjoubi K, Naimi Z, Nasr C, Mezlini A, Ayedi M, Meddeb K, Ayed H, Chebil M. Enquête nationale sur la pratique de la surveillance active pour cancer de la prostate en Tunisie. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
36
|
Oueslati A, Saadi A, Chakroun M, Zaghbib S, Bouzouita A, Derouiche A, Slama MRB, Ayed H, Chebil M. Endoscopic meatotomy in the treatment of ureterocele: results in adult patients. Pan Afr Med J 2020; 36:243. [PMID: 33014239 PMCID: PMC7519792 DOI: 10.11604/pamj.2020.36.243.24941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 07/20/2020] [Indexed: 11/12/2022] Open
Abstract
To evaluate the efficacy of endoscopic meatotomy in the treatment of ureterocele in adults. A retrospective study of adult patients with ureterocele, treated between January 1987 and December 2014. In 47 patients, 55 intravesical ureteroceles were diagnosed and classified as 18 right, 21 left and eight bilateral (38%, 44% and 17% respectively). According to the Bruézière classification, 41 (75%) ureteroceles were type A and 14 (25%) others were type C. These ureteroceles were complicated by calculus formation in 22 cases, moderately dilated excretory pathways in 16 cases and both complications in a total of 9 cases. Four patients had a complicated ureterocele with pyelonephritis, one of which was emphysematous. The endoscopic treatment was performed in cases of complicated and/or symptomatic ureteroceles. Fifty one cases were treated by a “smiling mouth” meatotomy consisting in a transverse horizontal incision, with the treatment of any associated complication. The mean operative time was 35 minutes (10-90). The operative follow-up was uneventful in 42 patients and complications occurred in 5 patients (2 urinary retentions, 2 infectious complications and one hematuria). The mean duration of postoperative stay was 1-2 days. The mean follow-up was 15 months. Four patients developed vesicoureteral reflux and no stenosis was noted. The endoscopic incision of the ureteroceles seems today, after reviewing the results, to be a good treatment of adult ureterocele. It is a simple, minimally invasive and has a low morbidity rate.
Collapse
Affiliation(s)
- Amine Oueslati
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ahmed Saadi
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Selim Zaghbib
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Amine Derouiche
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Haroun Ayed
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Chebil
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
37
|
Zaghbib S, Ouanes Y, Ayari Y, Chaker K, Mrad Dali K, Bibi M, Sellami A, Ben Rhouma S, Nouira Y. Facteurs prédictifs d’échec du traitement conservateur d’une pyélonéphrite emphysémateuse. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
38
|
Zaghbib S, Chakroun M, Saadi A, Zouari S, Bouzouita A, Ayed H, Chebil M, Ferjani A, Boutiba I. Caractéristiques épidémiologiques et cliniques des infections à entérobactéries productrices de carbapénémases en urologie. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
39
|
Zaghbib S, Saadi A, Chakroun M, Chaker K, Bouzouita A, Ferjani A, Boutiba I, Ayed H, Chebil M. Détection du portage digestif d’Entérobactéries résistantes aux fluoroquinolones avant biopsie prostatique et intérêt de la prophylaxie ciblée selon la culture rectale. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
40
|
Zouari S, Chakroun M, Saadi A, Zaghbib S, Bouzouita A, Ayed H, Chebil M, Ferjani A, Boutiba I. Caractéristiques épidémiologiques et bactériologiques des pyélonéphrites aiguës lithiasiques. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
41
|
Karray O, Ayed H, Saadi A, Zaghbib S, Henchir S, Cherif A, Ben Miled A, Chakroun M, Bouzouita A, Derouiche A, Ben Slama R, Chebil M. Is imagery distinctive in papillary renal cell carcinoma subtypes? Tunis Med 2020; 98:131-137. [PMID: 32395802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The subdivision into two entities of papillary renal cell carcinoma (PRCC) was established on histological criteria. It's in fact possible to distinguish the two subtypes by the means of radiological and progressive data. The subtype 1 is associated with the favorable profile. The ultrasound and especially CT urography ensure an accurate diagnostic approach with substantial therapeutic and prognostic involvement. The aim of the study is to define the radiological features that distinguish the two subtypes of renal papillary carcinoma, and to study the radiological predictive factors of locoregional recurrence, metastases free survival and specific survival. METHODS It's about a monocentric, retrospective study led between January 2005 and June 2017, gathering 49 cases of operated PRCC. The study concerned patients over the age of 18, who were diagnosed after anatomopathological examination of the operative specimen (enlarged nephrectomy or conservative surgery). Cases in which diagnosis was made by renal biopsy were excluded. The comparative study concerned ultrasound and CT scan data. Univariate and multivariate analysis were performed to determine factors having a prognostic value in terms of locoregional recurrence, metastases-free and specific survival. RESULTS On the ultrasound, the subtype 1 tumors were significantly homogenous with regular contours. Tumors were globally spontaneously hypodense and hypo vascular in 97,8% of cases. Enhancement was significantly more heterogonous for subtype 2 (p=0,01). Intratumoral necrosis and adenomegalies were associated with subtype 2 (p=0,0001 and 0,005). The predictive factors of locoregional recurrence, metastases-free survival and specific survival in univariate analysis were the contours' aspect, moderate enhancement and the presence of adenomegalies. On multivariate analysis, only the irregular contours were retained for locoregional recurrence-free survival and specific survival. CONCLUSIONS Significant differences between the PRCC subtypes were observed when studying the radiological data. Irregular contours, adenomegalies and enhancement degree seemed to predict the progression of PRCC after curative surgery.
Collapse
|
42
|
Zaghbib S, Ouanes Y, Bibi M, Chaker K, Ben Chehida M, Sellami A, Ben Rhouma S, Nouira Y. Facteurs déterminants de la fonction sexuelle postopératoire après fracture de la verge. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
43
|
Zaghbib S, Ouanes Y, Bibi M, Chaker K, Ben Chehida M, Sellami A, Ben Rhouma S, Nouira Y. Résultat oncologique d’une résection simultanée d’une tumeur vésicale et d’une hypertrophie prostatique par rapport à une résection d’une tumeur vésicale seule. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
44
|
Chaker K, Ouanes Y, Ben Chehida M, Zaghbib S, Sellami A, Abid K, Ben Rhouma S, Nouira Y. Signification pronostique du rapport préopératoire neutrophiles-lymphocytes dans les tumeurs vésicales infiltrant le muscle non métastatique. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
45
|
Zaghbib S, Chakroun M, Saadi A, Boussaffa H, Bouzouita A, Derouiche A, Ben Slama MR, Ayed H, Chebil M. Severe penile injury due to condom catheter fixed by a rubber band: A case report. Int J Surg Case Rep 2019; 64:120-122. [PMID: 31634783 PMCID: PMC6806461 DOI: 10.1016/j.ijscr.2019.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/01/2019] [Accepted: 10/06/2019] [Indexed: 12/11/2022] Open
Abstract
Condom catheter is frequently used to manage male urinary incontinence but should not be used carelessly or overlooked. Even if they are rare, penile strangulation and gangrene may occur and are severe complications. Treatment is based on debridement, broad-spectrum antibiotics and skin grafting. It may result in partial or total penectomy. Proper care and routine maintenance of condom catheters are mandatory in order to prevent devastating complications. Appropriate care is necessary, especially in debilitated and psychiatric populations.
Introduction Condom catheters are considered as a safe tool in the management of male urinary incontinence, yet complications may occur, especially in debilitated patients, with psychiatric disorders. Presentation of case A 58-year-old paraplegic man, suffering from schizophrenia, who had been using condom urinary catheters, was referred to our department for “penile injury”. Interrogation revealed that he was placing a rubber band tightly around his penis to maintain the condom. Examination showed a 4 cm defect interesting the proximal portion of the penis including the corpus spongiosum and the urethra. A surgical repair was performed, consisting in covering the defect using the surrounding tissue. Unfortunately, the patient developed penile gangrene four weeks after surgery. A partial penectomy was performed. Discussion Condom catheters are known as a safe tool to manage urinary incontinence in male patients, providing an adequate care. Long-term use may result in complications including urinary tract infection (40%) and skin injuries ranging from inflammation to gangrene. Gangrene, secondary to strangulation of the penis, is however uncommon. These complications are more common in debilitated patients with poor medical care or psychiatric disorders. In case of necrosis, debridement should be performed, which may result in a partial or a total penectomy if necessary. Conclusion Condom catheter is frequently used to manage male urinary incontinence but it should not be used carelessly or overlooked as it can cause severe complications such as penile strangulation and penile gangrene.
Collapse
Affiliation(s)
- Selim Zaghbib
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia.
| | | | - Ahmed Saadi
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Hamza Boussaffa
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Amine Derouiche
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | | | - Haroun Ayed
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Chebil
- Departement of Urology, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
46
|
Taktak T, Boussaffa H, Ouanes Y, Zaghbib S, Sellami A, Ghorbel Z, Chelly I, Rhouma SB, Nouira Y. Unexpected skin lesions secondary to metastasis of urothelial carcinoma. Int J Surg Case Rep 2019; 64:177-179. [PMID: 31670145 PMCID: PMC6831817 DOI: 10.1016/j.ijscr.2019.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/05/2019] [Indexed: 11/28/2022] Open
Abstract
Skin metastases of urothelial bladder carcinoma are rare. The inflammatory presentation, as seen in our case, is exceptional. Diagnosis requires immunohistochemical study of a skin biopsy. The prognosis after the appearance of cutaneous metastasis is poor.
Introduction Metastatic spread of urothelial bladder carcinoma (UBC) rarely involves the skin which is associated with a poor prognosis. We present a rare case of UBC with cutaneous metastases which is exceptional by its inflammatory clinical form. Presentation of case A 62-year-old male was diagnosed with a non-metastatic muscle invasive transitional cell bladder carcinoma invading the anterior wall of the rectum. Cisplatin-based chemotherapy was indicated but refused by the patient. Three months later, he developed cutaneous lesions in the left axilla and the right inguinal fold. These lesions were budding, nodular and inflammatory corresponding to carcinomatous metastasis on skin biopsy which urothelial origin was confirmed by immunohistochemical analysis. The patient died four weeks later after multi-organ failure. Discussion Skin metastasis of transitional cell carcinoma of the bladder are uncommon, representing 0.84% of all cutaneous metastases. The inflammatory presentation, as seen in our case, is rarer than the other types and is usually due to a lymphatic extension. The clinical appearance of cutaneous metastases might mimic other common dermatologic disorders; Thus, diagnosis requires histological confirmation by microscopic examination and immunohistochemical study of a skin biopsy. The prognosis after the appearance of cutaneous metastases is generally poor with a median disease-specific survival of less than 12 months Treatment is palliative and is principally based on chemotherapy, analgesics and psychological support. Conclusion Cutaneous metastases secondary to urothelial bladder carcinoma are exceptional especially in its inflammatory presentation. Diagnosis is based on immunohistochemical study. Treatment is based on chemotherapy and the prognosis is poor.
Collapse
Affiliation(s)
- Tarek Taktak
- Urology Department, La Rabta Teaching Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Hamza Boussaffa
- Urology Department, La Rabta Teaching Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
| | - Yassine Ouanes
- Urology Department, La Rabta Teaching Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Selim Zaghbib
- Urology Department, La Rabta Teaching Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Ahmed Sellami
- Urology Department, La Rabta Teaching Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Zinet Ghorbel
- Department of Anatomopathology, La Rabta Teaching Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Ines Chelly
- Department of Anatomopathology, La Rabta Teaching Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sami Ben Rhouma
- Urology Department, La Rabta Teaching Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Yassine Nouira
- Urology Department, La Rabta Teaching Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| |
Collapse
|
47
|
Mrad Daly K, Ben Rhouma S, Zaghbib S, Oueslati A, Gharbi M, Nouira Y. Infected urachal cyst in an adult: A case report. Urol Case Rep 2019; 26:100976. [PMID: 31380223 PMCID: PMC6661533 DOI: 10.1016/j.eucr.2019.100976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 11/30/2022] Open
Abstract
The urachus is an embryologic remnant which degenerates after the birth. An infected urachal cyst is one of a spectrum of presentations of urachal pathology, all of which are rare in adulthood. Infected urachal cyst is a rare pathology in adult women and it should be considered in the differential diagnosis of acute abdomen. We report here a case of a 50-year-old women with an infected urachal cyst reveled by an acute abdomen.
Collapse
Affiliation(s)
| | | | - Selim Zaghbib
- Department of Urology, La Rabta Hospital, Tunis, Tunisia
| | - Amine Oueslati
- Department of Urology, La Rabta Hospital, Tunis, Tunisia
| | - Maroua Gharbi
- Department of Urology, La Rabta Hospital, Tunis, Tunisia
| | - Yassine Nouira
- Department of Urology, La Rabta Hospital, Tunis, Tunisia
| |
Collapse
|
48
|
Gharbi M, Chakroun M, Chaker K, Zaghbib S, Saadi A, Bouzouita A, Ayed H, Slama MB, Derouiche A, Chebil M. Évaluation de la prescription des carbapénèmes au cours des pyélonéphrites aiguës obstructives. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
49
|
Yonli DS, Chakroun M, Zaghbib S, Ye D, Bouzouita A, Derouiche A, Slama MRB, Ayed H, Cherif M, Chebil M. Bilateral duplex collecting system with bilateral vesicoureteral reflux: a case report. J Med Case Rep 2019; 13:128. [PMID: 31053166 PMCID: PMC6500020 DOI: 10.1186/s13256-019-2058-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 03/18/2019] [Indexed: 02/06/2023] Open
Abstract
Background A bilateral duplex collecting system is an unusual renal tract abnormality. Vesicoureteral reflux may be associated. We describe a rare case of bilateral duplex collecting system with bilateral vesicoureteral reflux in which the refluxing ureter on the left side drains the upper pole moiety contrary to what is often found. Case presentation A 24-year-old married Arab woman presented with ascending left-sided flank pain during micturition. She complained of recurrent urinary tract infections. A physical examination and laboratory tests were normal. Voiding cystourethrography and computed tomography scan detected bilateral duplex collecting system, grade IV vesicoureteral reflux on the left side, and grade I vesicoureteral reflux on the right. She underwent left heminephrectomy and dextranomer/hyaluronic acid injections on the right side. After a year of follow-up, a clinical examination and imaging findings were unremarkable. Conclusions A bilateral duplex collecting system with refluxing upper pole moiety ureter is a very rare entity. The diagnosis should be suspected when exploring any flank pain with recurrent urinary tract infections to avoid subsequent renal impairment. Furthermore, this case shows how some common symptoms may lead to finding an unexpected urinary tract abnormality.
Collapse
Affiliation(s)
- Diataga Sylvestre Yonli
- Department of Urology, Yalgado Ouedraogo University Hospital of Ouagadougou, Ouagadougou 03, 03 BP 7022, Burkina Faso.
| | - Marouene Chakroun
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Selim Zaghbib
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Delphine Ye
- Department of Urology, Yalgado Ouedraogo University Hospital of Ouagadougou, Ouagadougou 03, 03 BP 7022, Burkina Faso
| | - Abderrazak Bouzouita
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Amine Derouiche
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Mohamed Riadh Ben Slama
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Haroun Ayed
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Mohamed Cherif
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| | - Mohamed Chebil
- Department of Urology, Charles Nicolle University Hospital of Tunis, Boulevard du 9 Avril 1938, 1006, Tunis, Tunisia
| |
Collapse
|
50
|
Zaghbib S, Ouanes Y, Chaker K, Ben Chehida MA, Daly KM, Nouira Y. Urethral self-inserted sewing needle in a 14-year-old boy for autoerotic stimulation. Urol Case Rep 2019; 25:100894. [PMID: 31049290 PMCID: PMC6484282 DOI: 10.1016/j.eucr.2019.100894] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 04/18/2019] [Indexed: 11/18/2022] Open
Abstract
Urethral foreign bodies are rare in daily practice, especially in adolescents with no evident history of mental illness. The presentation is usually delayed and a wide variety of objects may be implicated. Treatment by minimally invasive procedures (endoscopy), if possible, is preferred to minimize bladder and urethral injuries and psychiatric evaluation is mandatory to detect an underlying mental disorder. Despite the available literature on self-inserted urethral foreign bodies; the case we report here of urethral self-insertion of a sewing needle in a 14 year-old boy for autoerotic stimulation is very rare.
Collapse
|