Penile calciphylaxis is a rare and highly morbid condition mainly affecting diabetic patients with chronic renal failure (CRF). It is characterized by ischemic skin ulceration and necrosis secondary to dystrophic calcification of the subcutaneous penile tissue and penile arterioles. We report a 52-year-old male with a 6-year history of diabetes mellitus and CRF on hemodialysis, who presented with a painful penile necrotic lesion in the last three weeks. He firstly treated with medical treatment, which was failed. Then underwent total penectomy. The histopathology result confirmed the diagnosis of penile calciphylaxis. Unfortunately, he passed away due to septic shock and multisystem organ failure ten days after surgery. In conclusion, the diagnosis of penile calciphylaxis must be evoked in the presence of any minimal necrotic penile lesion in a patient with CRF; this will initiate quick medical and/or minimally invasive surgical treatment to improve the patient's prognosis and avoid serious complications.
Leiomyosarcoma of the prostate is an extremely rare neoplasm. It represents less than 0.1% of all prostate malignancies. It is considered to have a poor prognosis, an aggressive nature, and high metastatic potential. Additionally, the relationship between radiation exposure for the treatment of primary prostatic cancer and the occurrence of leiomyosarcoma as second cancer at the irradiated site is rare, with unknown etiology. We reported a 72-year-old male known case of prostate adenocarcinoma with radio-hormonotherapy for six years who presented with acute urinary retention. Magnetic resonance imaging revealed a large malignant obstructive prostate with direct invasion of surrounding organs and multiple metastases. Trans-urethral resection of the prostate was performed, and the histopathology result showed high-grade leiomyosarcoma. The patient passed away after four months due to multiorgan failure. In conclusion, there may be a causal relationship between radiation therapy to the prostate and the development of prostate leiomyosarcoma.
Objective: The rational of the surgical treatment of female stress urinary incontinence has changed over the past few years. The techniques of colposuspension have been replaced by the suburethral slings, retropubic initially with the TVT and then, the suburethral transobturator tape (TOT), introduced to reduce the complications of the TVT. It is thus difficult to currently have an objective idea of the effectiveness of the TOT compared to the TVT, even if the first impressions, with respect to the TOT, are rather favourable. The objective of this study is to present the feasibility, short-and long-term results of the surgical treatment of stress urinary incontinence by TOT tape.
Materials and methods:This retrospective study involved all patients who were surgically treated for incontinence by TOT tape according to the OUT-IN method, based on polypropylene monofilament sling.Results: Two hundred patients were involved. All patients were urodynamically diagnosed with stress urinary incontinence. Renal and bladder ultrasound was systematically requested in order to avoid any anomalies of the lower urinary tract. The mean duration of intervention is 25 minutes, and a duration of hospitalization between 3 and 5 days. 82% of patients regained normal continence with no evidence of urgency with improvement of quality of life. Only 15 cases of dysuria were reported that regressed spontaneously, 11 cases of vaginal erosion and only two cases of de novo-urge.
Conclusion:The TOT is an excellent procedure for the definitive surgical treatment, given that the results are satisfactory, whether anatomically or functionally.
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