The urachus is a fibrous cord, a remnant of the duct, which in the embryo, connects the bladder with the allantois duct [1]. The urachus can be the site of two types of lesions: on the one hand, congenital anomalies resulting from a defect in the obliteration of the allantois duct (diverticula, fistulas, cysts, sinus), and on the other hand, acquired lesions, essentially of a tumoral nature and most often malignant (urachus carcinoma) [2]. We report the clinical picture of a 28-year-old patient, with a history of uropathology since childhood (hypospadias), chronic renal failure since 2017 under dialysis, neobladder type Mitrofanoff since 2009, admitted for the management of an umbilical abscessed collection. Abdominal MRI revealed a superinfected urachus sinus. The treatment consisted of complete open excision of the sinus (Figure 1) from the umbilicus to the urinary bladder. The postoperative course was simple. Figure 1: The resected specimen (urachal sinus (black arrow), bladder wall (white arrow). A purulent umbilical discharge is often indicative of the presence of a urachus sinus; ultrasound and fistulography are sufficient for the diagnosis [3]. Excision of the urachus sinus by surgery is the standard treatment in this clinical situation [4].

Upper Urinary Tract Urothelial Carcinoma (UTUC) remain rare. Radical Nephroureterectomy (RNU) is the Gold standard for management of these tumours. We are reporting a clinical image of a 45-year-old patient admitted in emergency for left lumbar pain (nephritic colic). The checkups requested computed tomography scanner showed a nephromegaly and left hydronephrosis upstream of a suspicious parietal thickening of the lumbar ureter with cortical and functional repercussion, neighborhood infiltration, and atypical lateral-aortic ganglia. Left lower calicial lithiasis of stasis, pancreatic nodular lesion and the left adrenal gland. The patient was a candidate for an open Radical Left Nephroureterectomy (RNU) (Figure 1). Figure 1: Radical Nephroureterectomy (RNU) picture U (Ureter) R (Renal). There are prognostic factors of tumors of the upper urinary excretory tract, which are the patient’s status, the preoperative, the operation and the anatomopathology [1]. According to current literature data, the oncology outcomes of radical nephrouretrectomy by laparoscopic are lower than those of open RNU surgery [2].

The management of giant stones of the upper urinary tract remains a challenge for the urologist because of the potential risk of treatment-related complications [1]. We report as a clinical picture the case of a 42-year-old patient received for chronic right lumbar pain in whom the CT scan performed revealed the presence of a giant pyelic stone (Figure 1a and 1b) whose dimensions on the sagittal plane are 43.1mmx41.5mm. The patient underwent an open pyelolithotomy in our department, which allowed the extraction of a giant pyelic calculus of 12cm (Figure 1c). The postoperative course was simple.