ObjectiveTo evaluate the management and outcomes of patients who presented with torsion of an undescended testis and review the reported series in the literature.MethodsThe case records of 13 patients operated for testicular torsion involving undescended testis were retrospectively reviewed. The medical records included age at presentation, medical history, physical examination, operative findings and the results of follow-up. The diagnosis of torsion of undescended testis was made clinically and confirmed by inguinal exploration.ResultsIn six cases the testis was preserved and orchiopexy was performed, while in seven cases orchidectomy was performed due to testicular gangrene in six patients and testicular tumor discovered peroperatively in one case. Mean duration of symptoms at time of surgery in the orchiopexy group was 6.5 h and in the orchidectomy group was 21.2 h. From six patients treated by orchiopexy, two patients suffered from testicular atrophy at a mean of 24 months.ConclusionTesticular torsion in undescended testis is still diagnosed with delay which may affect testicular salvage. The importance of examination of external genital organs is highlighted which should be routinely included by emergency physicians in physical examination for abdominal or groin pain.

Les lésions urétérales iatrogènes peuvent succéder à toute chirurgie pelvienne. Elles sont graves pouvant mettre en jeu le pronostic fonctionnel du rein et même le pronostic vital. But du travail: est de préciser les aspects cliniques et les modalités thérapeutiques de cet accident. Il s’agit d’une étude rétrospective sur six observations de lésion urétérale iatrogène, après chirurgie gynécologique ou obstétricale, colligées dans le service d’urologie de Kairouan sur une période de 4 ans (2012-2016). L’âge moyen de nos patientes est de 46 ans. Elles sont toutes des multipares. La symptomatologie clinique est variable selon le type lésionnel. L’urographie intraveineuse demeure très utile au diagnostic, nous l’avons pratiqué dans 4 cas revenues toutes anormales. Le traitement a consisté en une montée de sonde dans un cas et 5 réimplantations urétéro-vésicales. Les suites opératoires sont émaillées par une néphrectomie. Les lésions urétérales iatrogènes sont devenues rares. Elles sont corrélées au degré de médicalisation du pays. La chirurgie gynécologique ou obstétricale est la plus grande pourvoyeuse. Leur pronostic est conditionné par la précocité du diagnostic et l’état anatomique de l’uretère.

RésuméBut : La cryptorchidie est une pathologie assez fréquente en urologie. Elle est associée à un risque élevé d'infertilité et de dégé-nérescence. Elle semble aussi être associée à un risque important de torsion. Cette entité est très peu abordée dans la littérature. Nous rapportons tous les cas de torsion sur testicule cryptorchide observés à notre service dans le but de mieux caractériser cette pathologie et de réduire ainsi le taux d'orchidectomies. AbstractPurpose: Cryptorchidism is a rather frequent pathology in urology. It is associated with a high risk of infertility and degeneration. It also seems to be associated with a high risk of torsion. This entity is poorly studied in the literature. We studied the cases of torsion on cryptorchid testicles hospitalized at our service, to better characterize this pathology and reduce the rate of orchidectomy. Methods: We underwent a retrospective study of all the cases of torsion on a cryptorchid testicle hospitalized in our service of urology between 1999 and 2007. Results: The age of patients was between 7 months and 39 years. Torsion touched the right testicle in 53% of the cases. Patients experienced a brutal pain of the inguinal area with an under cutaneous mass inflammatory and a painful and empty homolateral scrotum. In 60% of the cases, the diagnosis was late and an orchidectomy was carried out. In the other cases, a lowering of the testicle was done with the controlateral orchidopexy. Conclusion: Even though torsions on a cryptorchid testicle are rare, we should not ignore them. The early diagnosis will make it possible to save and lower the testicle, and track a possible degeneration.

HighlightsPolyorchidism is a rare congenital abnormality. To the best of our knowledge, this is the first report of leiomyoma in supranumerary testis (SNT).Most cases of polyorchidism are found incidentally during surgery for inguinal hernia, undescended testes, torsion or testicular tumor.There is no consensus regarding the management of SNT. If the SNT is scrotal, most authors recommend conservative management.If nonscrotal SNT is found incidentally during surgery, orchiectomy could be performed because of increased risk of malignancy.Treatment of intratubular germ cell neoplasia includes surveillance, orchiectomy, or low-dose external radiation.

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