[Show abstract][Hide abstract] ABSTRACT: Spinal dural arteriovenous fistula (DAVF) with epidural drainage is infrequent: 22 cases of the 194 reported DAVF. In the case reviewed, DAVF is associated with a complete urinary retention and its somatic neurologic features are moderate. Such spinal arteriovenous fistula clinical picture is rare and occurs in only 4 to 5% cases. Urological diagnosis approach is interesting because of a patient presenting with a benign prostatic hypertrophy.
No preview · Article · Jan 1996 · Progrès en Urologie
[Show abstract][Hide abstract] ABSTRACT: The term gangrene of the male external genital organs is applied to two different entities : Primary gangrene of the external genital organs (5% of cases), also called Fournier's disease, first described in 1883 : gangrene of the integument of the external genital organs in the absence of a local cause, according to an unknown mechanism and with inevitable progression towards a specific distribution of necrosis, regardless of treatment. "Secondary" gangrene of the external genital organs (95% of cases) related to a local, cutaneous, urogenital or gastrointestinal cause, whose course can be modified by early application of appropriate treatment. An early diagnosis is essential : in true Fournier's disease to avoid the systemic complications of this necrosis, and in secondary gangrene to limit the local extension and to prevent systemic complications. In view of the galloping course of the disease and in order to very rapidly reach the diagnosis, many authors recommend : local aspiration, biopsy or search for subcutaneous gas by ultrasound or radiology. Treatment consists of : Antibiotic therapy using two or three antibiotics to cover the usually mixed bacterial flora (Gram positive cocci, Gram negative bacilly and anaerobes). Surgical debridement as required, possibly repeated to excise necrotic zones, to drain collections and for irrigation of cavities. Hyperbaric oxygen therapy. Urinary diversion (cystostomy) or gastrointestinal diversion (colostomy) may be required when either of these two tracts are responsible for the infection, or when diversion facilitates management. Surgical reconstruction (grafts or flaps) as required. The mortality is high, of the order of 20% : < 10% in young patients with a good general condition who are correctly treated after an early diagnosis; > 50% in elderly patients with other concomitant diseases, when diagnosis and treatment are delayed.
No preview · Article · Dec 1995 · Progrès en Urologie
[Show abstract][Hide abstract] ABSTRACT: Bladder retraction is a rare complication of contact chemotherapy with mitomycin C in the treatment of superficial bladder cancer. The clinical and histological features and pathophysiology of this lesion are discussed in the light of a recent case.
No preview · Article · Oct 1995 · Progrès en Urologie
[Show abstract][Hide abstract] ABSTRACT: Between 1987 and 1992, we operated on 15 patients with tubulopapillary tumours (TPT) of the kidney, corresponding to 10% of all renal cancers operated during this 5-year period, which brings the total number of published cases to 418. TPT differ from non-tubulopapillary tumours in several ways. The medical imaging findings may differ when the tumour is not necrotic (20 to 30% of cases). The histology differs not only in terms of the tumour architecture, but also by the frequent association (9/15 cases) with other ipsilateral or contralateral renal anomalies: 2 bilateral tumours, 3 tumours associated with multiple cysts and 4 multifocal tumours. These characteristics, combined with the finding of 12 familial cases suggest a genetic origin for TPT, especially as the genetic abnormalities detected (tri-or tetrasomy 17) differ from the anomalies usually detected in non-tubulopapillary tumours (anomalies of 3p and 5q). This study is the first to report familial cases of TPT. The prognosis of these tumours, generally better than that of non-tubulopapillary tumours, suggests the possibility of conservative surgery when the diagnosis can be established preoperative or at operation.
No preview · Article · Jan 1995 · Progrès en Urologie
[Show abstract][Hide abstract] ABSTRACT: Retrocaval ureter is a rare malformation occasionally associated with other urological or nonurological abnormalities. We report an exceptional case of retrocaval ureter associated with contralateral pelvic ectopic kidney in a 22 year old man. The anomalies associated with the retrocaval ureter and the embryological mechanisms are described. Abdominal computed tomography with 3D reconstruction provided a new perspective of this malformation, but its clinical value remains unclear.
No preview · Article · May 1994 · Progrès en Urologie