Introduction: The dilatation of the upper urinary tract, signs in the vast majority of cases the presence of a ureteral obstacle. The etiologies are diverse. Mali is a country where urinary schistosomiasis is endemic. Repeated infestation may result in long-term ureteropelastic dilatation secondary to stenotic sequelae. The objective is to study the causes of dilatations of the upper urinary tract. Materials and Methods: This is a prospective study of 12 months, from October 2010 to September 2011, performed in the urology department of Gabriel Toure University Hospital in Bamako. The parameters studied were: age, sex, reason for consultation, medical history, urinary analysis, etiological diagnosis, management, evaluation of renal failure. Result: In 12 months, we collected 50 cases of dilatations of the upper urinary tract representing 0.66% of all consultations. The average age of our patients was 35 years old. The sex ratio was 2.13 in favor of men. A history of urinary schistosomiasis was found in 25 patients or 50%. Low back pain was the most common reason for consultation, 76%. The renal and bladder ultrasonography performed in all 50 patients in our series found bilateral dilatation in 68% of patients and unilateral dilation in 32% of cases. Urinary tract infection with Escherichia coli was found in 53% of cases. Ureterovesical reimplantation was performed in 40% of cases. Conclusion: The dilatation of the upper urinary tract, consequence of an anatomical or functional obstruction, constitutes a rather frequent pathology and constituted 10% of the surgical acts of our service. Etiologies are diverse: congenital and acquired. Open surgery gives good results, but the introduction of innovative minimally invasive surgical technique is necessary.

Testicular cancers are tumours of the young adult (15-35 years), and it is a rather rare pathology in African black. However, the risk of developing these cancers becomes higher if the testicle does not descend. In our context, these undescended testicles often go unnoticed, which poses the problem of surveillance. We report a case in a patient of 24 years who consulted for pain plus hypogastric mass, in whom at the end of the clinical, paraclinical and surgical investigations we retained the diagnosis of seminoma of the right testicle. This is the first case in our daily practice. Conclusion: The rarity of tumours on the undescended testicle should not cause their diagnosis to be misunderstood because of the seriousness of cases diagnosed late.

Introduction: Complete cervico-urethral transection is a vesicovaginal fistula characterized by total disinsertion of the urethra from the bladder. It is a fistula of the cervico-urethral intersection threatening the mechanism of continence. The aim of this study was to describe the epidemiological and therapeutic aspects of this type of fistula. Patients and Methods: This was a descriptive retrospective study on patients who have had surgery for cervico-urethral transection from June 01, 2012 to June 01, 2015. Results: Cervico-urethral transections (n = 76) accounted for 33.77% of all urogenital fistulas admitted to our department of surgery during the study period. The average age was 25.02 ± 8, 6 years. Married patients accounted for 85.58%, 72.36% had not received any classical education. Fistulas less than one year old made up 56.58% of cases, associated lesions were perineal tears 25.0%, vaginal sclerosis, 21.05%, vaginal straps, 13.15%, rectovaginal fistula, 2.63% and the shortness of the urethra less than 2.5 cm in 42.10% of cases. All surgeries were performed vaginally with a 98.68% fistula closure rate and an average of 1.68 surgeries per patient. After closure of the fistula, 10.67% of patients presented a residual urinary incontinence. Conclusion: Complete cervico-urethral transection is a frequent vesicovaginal fistula. She sometimes exposes to urinary incontinence after closing the fistula. The results of his surgery are often good at the cost of multiple intervention.

Introduction: Penile skin flap urethroplasty is a technique for replacing or enlarging an obstructed urethra. We aim to report our experience in the practice of this surgical technique. Patients and method: This was a prospective and descriptive study of penile skin flap urethroplasty indicated for urethral stenosis between January 2014 and December 2019. Results: A total of 21 penile skin flap urethroplasties for urethral stenosis were performed. The average age was 38.6 years old. The stenosis was of sclero-inflammatory origin in 15 cases (71.43%). It was of bulbo-perineal, penile, and penile-bulbar topography in about a third each. A history of urethral surgery was reported in 80.95% of the cases. The average length of the stenosis was 6.8 cm. Mundy circular skin flap urethroplasty about 15 cases (71.43%), and Quartey rectangular skin penile flap urethroplasty about 6 cases (28.57%) were the surgical techniques performed. The postoperative follow-up was favorable in 19 cases (90.48%). Two cases of urethral fistula (9.52%) underwent the 2 nd urethroplasty. Urination at 1 year was satisfactory. No relapse has been reported to date. However, 4 patients (19.04%) reported asthenic ejaculation, and 1 patient (4.76%) a marked decrease in sexual pleasure. Conclusion:

Testicular ectopia is a rare genital malformation belonging to the spectrum of testicular migration abnormalities. Renal agenesis can be unilateral or bilateral, isolated or associated with other malformations (1/4 of renal agenesis is accompanied by genital malformations, and more often affects the left kidney. Few cases are reported in the literature. We report a case in a 28-year-old patient with ectopia of the right testicle in the suprapubic position associated with agenesis of the left kidney, and surgical management consisted of an orchiectomy, with good surgical results.