The simultaneous presence of primary carcinomas in the same patient is uncommon and synchronous primary tumors involving the kidney and pancreas are extremely rare. There are a few reports in the English literature of synchronous primary malignancies of the kidney and pancreas. We present a 62-year-old man who had weight loss of 9 kg and epigastric pain. Findings showed a Furhman grade II renal papillary carcinoma confined to the kidney and a synchronous well differentiated pancreatic ductal adenocarcinoma.

ObjectivesTo report a technique of percutaneous endoscopic nephropexy, using a polyglactin suture passed through the kidney, in patients with nephroptosis.Patients and methodsFour women presenting with symptomatic right nephroptosis underwent a percutaneous endoscopic nephropexy. An upper-pole calyx was accessed percutaneously and a 24-F working sheath was placed. Another needle access was made through a lower-pole calyx and a #2 polyglactin suture was passed into the renal pelvis. It was then pulled out through the upper-pole tract using the nephroscope. A retroperitoneoscopy was performed and the tip of the nephroscope was used to cause nephrolysis. After inserting the nephrostomy tube the polyglactin suture was passed into the subcutaneous tissue and then tied without too much tension, to avoid cutting the parenchyma.ResultsThe operative duration was 33 min and the hospital stay after surgery was 3.5 days. The nephrostomy catheter was removed 5 days after surgery. There were no complications, especially no haemorrhagic, infectious, lithiasic or thoracic complications. The four patients were relieved of their initial symptoms, with a mean follow-up of 28 months. Ultrasonography and/or intravenous urography showed the kidney at a higher location with the patient standing.ConclusionsThis technique combines the nephrostomy tract used in percutaneous techniques with the suture and nephrolysis used in laparoscopic techniques. Moreover, this procedure seems to be safe, with satisfactory anatomical and clinical results and a lower morbidity. However, a larger series will be necessary to establish its long-term morbidity and success rate.

Introduction: Undescended testis is a genital pathology of pediatric age. But it is not rare that the diagnosis of this pathology is made in adults, especially in low income countries with management problems as Benin Republic. The purpose of this study was to describe the epidemiology and therapeutic aspects of this congenital malformation in adults, in HKM University Teaching Hospital of Cotonou. Material and Method: It was a retrospective, crosssectional and descriptive study, conducted from January 1, 2007 to December 31, 2016. Patient files served as data collecting support. All the patients aged 16 years and older were included in this study, treated and followed in the urology clinic department for undescended testis. Results: Twenty-three files were selected. The most represented age group was 16 to 20 years of age. The average consultation time from the observation of the anomaly was 213.6 months. The vacuity of the scrotum was the main reason for consultation. The absence of an intra-scrotal testis was the most clinical finding. The testis was found in the inguinal canal in 15 patients. Surgical re-positioning testis in scrotal location had been conducted for all patients and the open surgery was the only modality. Orchiectomy was performed in presence of atrophic testis. Any complication was reported in postoperative time. Later, two retractions of the testis and two testicular hypotrophies were seen. Semen control (spermograms) revealed persistence of azoospermia in three patients and astheno-zoospermia in another. Conclusion: Cryptorchidism is a pathology of the child but can still be seen in adults in our context. The main reason for consultation is the vacuity of scrotum but also paternity desire. Surgical lowering is the rule. In adults, its main purpose is the surveillance for the easy and early detection of a testicular tumor.

Objective: To evaluate the effects of varicocele on sperm characteristics, on testicles and its responsibility in male fertility. Patients and Methods: The study took place in the National University Teaching Hospital Hubert Koutoukou Maga of Cotonou. It was a prospective study, from December 2015 to July 2016, which concerned 45 patients affected by the varicocele and seen for infertility. The duration of the infertility was 12 months or more, according to the definition. The studied parameters were the age, the profession, the deadline of the infertility, the type and the rank of the varicocele, the data of the ultrasound and the spermogram. Results: The average age of our patients was 35 years with a range of 20 and 56 years. The average duration of infertility was 3 years and 5 months. The pattern of consultation was a desire of paternity in 71.1% of cases. The testicular hypotrophy was found in 93.3% of cases at the right side and in 97.8% at the left side. The varicocele was bilateral at 82.2% of cases. The most frequent sperm abnormality was the oligoasthenoteratozoospermia found in 31.1% of cases. Conclusion: The varicocele is a male subject pathology. Its consequences on fertility are bad as well as on the volume and the capacity of the testicles to play its endocrine and exocrine function. The better choice is to start the treatment just when it is found in a man. The surgery seems to be the best solution to that important social problem.

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