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Introduction. Splenogonadal fusion is a rare congenital anomaly, defined by the presence of ectopic splenic tissue caused by an abnormal connection between the spleen and the gonad or mesonephrotic derivatives during the embryonic period. Materials and Methods. By reporting an observational case and performing a review of the literature according to the CARE guidelines (using the PubMed database and guidelines from urology, general surgery, and pediatric learned societies), we present the embryological genesis of the splenogonadal fusion, the associated anatomical anomalies, and the diagnostic procedure. Observation. We report the case of a patient aged 45, with no notable history, reporting left testicular pain. A small nodule on the upper pole of the left testicular was clinically palpable. Tumor markers were normal, and scrotal ultrasound depicted a hypoechoic hypervascular nodule measuring 8∗6∗8 mm. After validation in a multidisciplinary oncology consultation meeting and opinion from a uro-andrologist expert, the patient underwent an inguinal lumpectomy with an extemporaneous examination which did not objectify any signs of malignancy. Ultimately, it is a normal spleen tissue in the testicular ectopic position. Discussion. Splenogonadal fusion corresponds to a rare congenital malformation; less than 200 cases have been published in the literature, most often affecting boys, with a sex ratio of 15/1. Two types are described, depending on the continuity of the link between the orthotopic spleen and the gonad: the continuous and discontinuous forms. In a third of the cases, there are associated congenital malformations and particularly in the continuous forms (44 to 50% of the cases): anomalies of the limbs, micrognathia, microgyria, and hepatic and digestive abnormalities. Cryptorchidism is associated with the continuous form in 31% of cases. The preoperative diagnosis remains difficult because of its morphological and clinical characteristics suggesting a tumor process.

Introduction: To assess the framework of Multidisciplinary Neuro-Urologic Meeting (MNUM) after 5 years of experience. The quality criterion was the concordance to national and International Guidelines. The secondary objective was to assess participants’ satisfaction, and thus the added value brought by health professionals involved in neuro-urology. Finally, to analyze and propose concrete changes including a formal operational charter. Material and method: Urologists, neurologists and physiatrists participate to the MNUM, in order to offer a personalized and adequate care for each patient. A scientific basis was done by a comprehensive research of neurourology references from PubMed, Embase, Cochrane and Google Scholar. A satisfaction questionnaire was developed and diffused using Google Forms. A positive advisory opinion from a medical ethics committee was obtained on the 04.19.2016 (CECIC Rhône-Alpes Auvergne, Clermont-Ferrand, IRB 5891). Results: Between March 2011 and December 2015, 179 cases were presented in 20 meetings. Decisions were consistent with guidelines in 69.9 % of cases. Over the 5 years, 92.4 % of operated patients were followed up by an urologist. Surgical and medical decisions are influenced by the specialist who presents the medical record (p = 0.046 and p = 0.004, respectively). On average, 12 cases per meeting were presented. The average number of participants per meeting was 10. The overall rate of achievement of decisions was 85.5 %, with an evolution of 10.5% over the 5 years. The French baselines are very extensive in recommendations according to the type of pathology and have an own specificity with the guardianship of the AFU. A quorum composed of 2 physiatrists, 2 urologists, and 2 neurologists was achieved in 20 % of the meetings. A strong interest in this MNUM was reported for 66.6 % of participants. Conclusion: This synthesis of improvement outlook is the first conducted in our center, and in the field of neurourology to our knowledge. This MNUM will formalize and ensure a consensual care for patients with chronic diseases, such as neurogenic bladder.; Introduction : Évaluer le dispositif de Réunion de Concertation Pluridisciplinaire de Neuro-Urologie (RCPNU) après 5 années d’expérience. Le critère de qualité était la concordance aux référentiels nationaux et internationaux. L’objectif secondaire était d’évaluer la satisfaction des participants, et donc la plus-value apportée pour les professionnels de santé impliqués en neuro-urologie. Enfin, analyser et proposer des évolutions concrètes avec notamment une charte formelle de fonctionnement. Matériel et méthode : Chirurgiens urologues, médecins spécialisés en médecine physique et de réadaptation (MPR) et neurologues participent aux RCPNU, afin de proposer une prise en charge personnalisée et adéquate pour chaque patient. Une assise scientifique a été faite par une recherche exhaustive des référentiels de neuro-urologie à partir de PubMed, Embase, Cochrane et Google Scholar. Un questionnaire de satisfaction a été élaboré puis diffusé via Google Forms. Un avis éthique consultatif favorable a été obtenu le 19/04/2016 (CECIC Rhône-Alpes Auvergne, Clermont-Ferrand, IRB 5891). Résultats : Entre mars 2011 et décembre 2015, 179 dossiers ont été traités sur 20 réunions. Les décisions prises étaient conformes aux recommandations dans 69,9% des cas. Sur les 5 ans, 92,4% des patients opérés ont fait l’objet d’un suivi par un urologue. Les décisions chirurgicales et médicales sont influencées par le spécialiste qui présente le dossier (p=0,046 et p=0,004 respectivement). En moyenne, 12 dossiers par réunion étaient présentés. Le nombre moyen de participants par réunion était de 10. Un taux global de réalisation des décisions prises était de 85,5 % avec une évolution de 10,5% sur les 5 ans. Les référentiels français sont très fournis en recommandations par type de pathologie et présentent une spécificité propre avec la tutelle de l’AFU. Un Quorum composé de 2 MPR, 2 urologues, et de 2 neurologues était atteint dans 20% des réunions. Un intérêt fort pour cette RCPNU était déclaré pour 66,6% des participants. Conclusion : Cette synthèse des perspectives d’amélioration est le premier réalisé dans notre centre et dans le domaine de la neuro-urologie à notre connaissance. Cette RCPNU permet de formaliser et de garantir une prise en charge consensuelle pour les patients atteints de maladie chronique, comme les vessies neurologiques.