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Médecine et Maladies Infectieuses 04/2011; 41(8):443-5. · 0.72 Impact Factor
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ABSTRACT: The nephrectomy of a dialyzed renal insufficient patient is a frequent operation. Nevertheless, the vascular complication risks are increased for these patients. We report the case of a patient who had presented a mesenteric ischemia after a left nephrectomy. The cause of this ischemia was plurifactorial with, on one hand, a splanchnic hypoperfusion due to post-procedure hypovolemia caused by an important depletion during the dialysis as well as the use of vasoactive amines and, on the other hand, the peripheral mesenteric microvascularisation occlusion due to a kayexalate crystal deposit.
Progrès en Urologie 07/2010; 20(7):542-4. · 0.58 Impact Factor
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Progrès en Urologie 01/2009; 18(12):837-40. · 0.58 Impact Factor
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ABSTRACT: Preparation for the national entrance examination is a major concern for hospital medical students. Many teaching materials are available to prepare for the urology module: faculty photocopies and general urology texts. The objective of this study was to determine the selection criteria used by medical students to choose their urology teaching materials, in preparation for the national entrance examination.
A questionnaire was distributed to 200 medical students (4th and 6th year students) preparing for the national entrance examination. This questionnaire comprised three parts: (1) information about the student (medical school, attendance of lectures, participation in intern conferences); (2) student's level of satisfaction with the teaching material provided;(3) criteria of choice (18 items) of the photocopies used.
Out of the 200 students completing the questionnaire, only 32% used teaching material provided by the university and 22% reported that their medical school did not provide Urology teaching material. Fifty-nine percent of students thought that this teaching material was "moderately" to "not at all adapted" to the national entrance examination programme and 70% considered that they were "moderately" to "not at all" prepared for the national entrance examination. We noted that 83.5% of students thought that intern conferences were "useful" to "very useful" to prepare the urology module of the national entrance examination and 85% thought that photocopies were "useful" to "very useful" to prepare the national entrance examination. The College of urology photocopies were the most widely used teaching material: 38% of students. The four most important criteria of choices were "their peers' opinion", "the style of presentation and writing" and "advice from interns". "The author" and "price" were only rated in 11th and 12th positions.
In this study, students appeared to consider that the material provided by medical schools was insufficient and poorly adapted to prepare for the national entrance examination in Urology. In contrast, College of urology photocopies appeared to be a satisfactory study tool, in terms of presentation and writing.
Progrès en Urologie 11/2008; 18(9):608-12. · 0.58 Impact Factor
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ABSTRACT: To review the various clinical forms of female urethral cancer in the light of three clinical cases with a review of the corresponding treatment guidelines.
The authors report three cases of female urethral cancer. Case 1 consisted of squamous cell carcinoma in a 56-year-old woman with no particular history. Case 2 was a urothelial tumour arising in a urethral diverticulum in a 60-year-old smoker. Case 3 was a 69-year-old woman patient with invasive urothelial carcinoma.
Case 1 was treated by segmental urethrectomy with no adjuvant therapy and a favourable course. Case 2 was treated by anterior pelvic exenteration with no adjuvant therapy. This patient relapsed in the form of peritoneal carcinomatosis two years later and died. Case 3 was initially treated by anterior pelvic exenteration followed by a chemoradiotherapy combination after local recurrence with a favourable course.
There are many clinical presentations and histological forms of female urethral cancer. Localized distal lesions can be treated by simple circumferential resection. The treatment of other lesions comprises anterior pelvic exenteration and platinum- or M-VAC-based chemoradiotherapy. The main prognostic factors for these tumours are their size, histological type, site and the presence of pelvic lymph node extension.
Progrès en Urologie 06/2008; 18(5):318-22. · 0.58 Impact Factor
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ABSTRACT: Blood supply in pelvic kidney presents with more anatomic variations than in a normal positioned lumbar kidney. We report a patient with a right pelvic kidney and a particularly atypic vascularisation. In addition we present a review of the literature with all possible pelvic arterial variations and their frequency.
Morphologie 05/2004; 88(280):24-6.
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ABSTRACT: Haemorrhagic cystitis consists of acute or insidious diffuse bleeding from the bladder mucosa. Although the aetiology of haemorrhagic cystitis is varied, the two predominant causes are chemical and irradiation. The chemical compounds most frequently responsible for haemorrhagic cystitis are oxaphosphorines (cyclophosphamide, ifosfamide). Haemorrhagic cystitis may also be due to toxic or infectious causes (bacterial, fungal, parasitic or viral). Finally, haemorrhagic cystitis can occur in the context of a systemic disease or may be isolated and idiopathic. Prevention of haemorrhagic cystitis, based on general measures and specific measures, is essential, but is not always effective. In the case of proven haemorrhagic cystitis, various treatment options are available, including and can associate clot extraction, continuous bladder irrigation, bladder instillations of haemostatic factors, formalin, hyperbaric oxygen therapy, arterial embolization or salvage surgery. Although therapeutic management is usually effective, it can sometimes be difficult due to the severity of the bleeding and its repercussions on the patient's general state. Deaths are not exceptional, emphasizing the seriousness of haemorrhagic cystitis. Based on a review of the literature, the authors review the aetiology and treatment of haemorrhagic cystitis.
Progrès en Urologie 10/2001; 11(4):591-601. · 0.58 Impact Factor
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ABSTRACT: The authors report a case of trocar site metastasis, one year after laparoscopic retroperitoneal lymphadenectomy. This is the seventh published case of trocar site metastasis in laparoscopic urological surgery. The lymph node resection procedure and the histological type of the tumour appear to be risk factors for the development of wall metastases.
Progrès en Urologie 05/2001; 11(2):307-9. · 0.58 Impact Factor
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ABSTRACT: Hemorrhagic cystitis (HC) is a common complication following allogeneic stem cell transplantation (SCT). In rare cases, it can be severe, inducing kidney failure and sepsis, and become life-threatening.
We report three cases of severe HC in stem cell transplant recipients. Risk factors and the management of these patients were studied, as well as severe HC cases reported in the literature.
All three patients received high-dose cyclophosphamide in addition to total body irradiation or busulfan in their preparative regimen. They underwent allogeneic SCT, one of them from unrelated cord blood. BK viruria was detected in two cases at the onset of hematuria. HC lasted for more than 3 months, resulting in urinary tract obstruction and sepsis. Ultimately, cystectomy was the last therapeutic procedure available to treat this life-threatening complication.
We describe three patients, among a total of more than 1300 patients treated in our unit by allogeneic bone marrow transplantation, in whom HC was severe and long lasting enough to require cystectomy as a life-saving procedure.
Transplantation 01/2001; 70(12):1807-11. · 4.00 Impact Factor
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ABSTRACT: Erection is a rare event during lower urinary tract surgery. When it is extremely refractory, endoscopy is impossible and the lower urinary tract surgery may need to be deferred. The development of erection during spinal anaesthesia is due to manipulations before complete installation of sensory block or incomplete blockade of sacral segments (S2 to S4) supplying the nervi erigentes. The mechanism of erection during general anaesthesia remains poorly elucidated. General anaesthesia may suppress central or peripheral sympathetic control of flaccidity. The peripheral target could be the smooth muscle of the cavernous tissue, either by a direct action or via alpha-adrenergic receptors. Psychogenic and reflexogenic stimuli have also been proposed, possibly facilitated by amplification of sensations during stage II anaesthesia. The various treatments are based on experience acquired in the field of priapism. Systemic treatments such as ketamine an beta 2 mimetics or benzodiazepines are not always effective and are associated with considerable adverse effects. Intracavernous injections of alpha-adrenergic drugs constitute the treatment of choice. Phenylephrine and etilefrine are preferred because of their rapid efficacy and particularly their only moderate cardiovascular adverse effects.
Progrès en Urologie 05/2000; 10(2):303-9. · 0.58 Impact Factor
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ABSTRACT: The authors report a case of unilateral epididymitis with caseous abscess after BCG-therapy for superficial bladder tumour. The severity of the lesions required orchidectomy, followed by four-agent tuberculostatic therapy.
Progrès en Urologie 03/2000; 10(1):99-100. · 0.58 Impact Factor
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ABSTRACT: The authors describe a case of sarcomatoid carcinoma of the bladder, in which the stroma presented marked calcified bone metaplasia. Mechanical lithotripsy of the tumor was necessary to allow transurethral resection.
Progrès en Urologie 01/1999; 8(6):1051-3. · 0.58 Impact Factor
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ABSTRACT: The nephrectomy of a dialyzed renal insufficient patient is a frequent operation. Nevertheless, the vascular complication risks are increased for these patients. We report the case of a patient who had presented a mesenteric ischemia after a left nephrectomy. The cause of this ischemia was plurifactorial with, on one hand, a splanchnic hypoperfusion due to post-procedure hypovolemia caused by an important depletion during the dialysis as well as the use of vasoactive amines and, on the other hand, the peripheral mesenteric microvascularisation occlusion due to a kayexalate crystal deposit.
Progrès en Urologie. 20(7):542-544.
