[The prevention of the recurrence of stage pTa bladder tumors using intravesical instillation of BCG].

45 patients were included in a retrospective study designed to assess the long-term efficacy and tolerance of immunotherapy by intravesical BCG instillation in the treatment of stage pTa bladder tumours (mean follow-up 52.7 months, range: 12-87 months). 41 patients (91% responded to immunotherapy: 24 (53%) did not develop anu recurrences with a mean follow-up of 49.

[Autosomal dominant polycystic kidney disease: urologic complications and results of kidney transplantation: 217 patients].

The authors report a retrospective series of 217 cases of autosomal dominant renal polycystic disease collected over a period of 30 years in the urology and nephrology departments of Nantes university hospital. They study the incidence of urological complications, observed in 87 patients (40%), consisting of calculi (15%), infection (22%, with 4 deaths), intracystic haemorrhages (3.5%) and urinary tract compression (2%).

[Acquired phimosis, or preputial sclero-atrophic lichen in children].

From 1979 to 1988, 8 cases of balanitis xerotica obliterans were histologically demonstrated in children at Nantes University Hospital. In 6 of these 8 patients, whose average age at the time of consultation was 9.4 years, the phimosis was obviously acquired or recurrent, and the prepuce was sclerous, thick, and produced a tight distal phimosis.

[Post-traumatic stenosis of the membranous urethra].

Secondary urethral stricture is the most serious complication of traumatic rupture of the membranous urethra, directly related to the treatment of the rupture. In a series of 45 patients treated for urethral rupture with a minimal follow-up of 5 years, 30 developed stricture (66%). An urethral guide, inserted in 31 cases, was responsible for the stricture in 26 of these cases (84%).

[Electrocoagulation of the paraurethral glands (Reiser's operation) in women with urethro-cystalgia].

One hundred nineteen cases of women with chronic urethrocystalgia were reviewed. The symptoms were dominated by urethral burning (83%) and pollakiuria (75%). Electrosection of the paraurethral glands according to Rieser's technique and resection of the urethral floor (100% of cases) were combined with hymeneoplasty in 9% of cases.

[Prevention of complications in inguinal lymphadenectomy].

Inguinal lymphadenectomy, as indicated in the treatment of metastases of carcinoma of the penis and of malignant melanoma in the inguinal lymph nodes, involves considerable mortality and morbidity. From February, 1988, to January, 1990, we performed 15 inguinal lymphadenectomies in 10 patients with an average age 51.9 +/- 5.

Clinical experience with leuprorelin acetate before radiotherapy for prostatic cancer.

A total of 40 patients with stages A2 to C prostatic cancer were treated with leuprorelin acetate depot once a month for 2 months before being treated by pelvic irradiation or radical prostatectomy. In the 32 patients who were evaluable, seven (22%) were classified as minor responders after leuprorelin treatment and 23 (72%) as major responders when assessed by rectal examination. Prostate-specific antigens also returned to normal concentrations (5 ng/ml) in 26/31 (84%) patients.

[Varicocele in children and adolescents. Is surgery justified?].

Varicocele, a disease essentially observed in adults, is under-estimated in children and adolescents, in whom, for the majority of authors, the therapeutic management is surgical although the benefits in terms of fertility are unknown. Forty-eight children and adolescents, seen between 1978 and 1983, were followed by clinical examination and subsequent sperm count with a mean follow-up of 5.20 years.

[Injuries of the posterior urethra. Apropos of 57 patients excluding iatrogenic injuries].

Between 1973 and 1986, 57 patients presented with a fracture of the pelvis with rupture of the posterior urethra. All of these patients were treated as an emergency and were then followed periodically with a minimal follow-up of 2 years. There were 4 cases of rupture of the prostatic urethra and 53 cases of rupture of the membranous urethra, including 32 complete ruptures and 21 partial ruptures.

[Varicocele in children and adolescents. Is surgical treatment justified?].

Varicocele , a disease essentially observed in adults, is underestimated der-estimated in children and adolescents, in whom, for the majority of authors, , the therapeutic management is surgical although the benefits in terms of fertility are unknown. Forty-eight children and adolescents, seen between 1978 and 1983, were followed by clinical examination and subsequent sperm count with a mean follow-up of 5.20 years.

[Emphysematous pyelonephritis and perinephritis].

The authors report an eighth case of emphysematous perinephritis and a new case of emphysematous pyelonephritis. The general features of these two diseases and their similarities are described: middle aged diabetic women, clinical picture of sepsis, gas images projected over the renal area with delayed excretion on intravenous pyelography, computed tomography reveals the exact site of the emphysematous images (perinephritic and or intraparenchymal). Emphysematous perinephritis may be an early form of emphysematous pyelonephritis.

Management of regional lymph nodes in carcinoma of the penis.

In the management of carcinoma of the penis, standard treatment of the primary tumor is by radiotherapy for small lesions (Tis, T1, T2 located in the glans) and by amputation in other cases (T2 with invasion of the shaft). The diagnosis and treatment of regional lymph nodes are thus the essential problems with this cancer. In our series of 45 patients with a minimum 5-year follow-up, clinical assessment was incorrect in 22.

[Sterility and tumors of the testis. Study of late exocrine and endocrine functions in stage I or IIA tumors].

Spermatogenesis and plasma hormone levels (testosterone, follicle stimulating hormone and 17 beta estradiol) were studied in patients presenting stage I or IIA testicular tumors. Patients with a previous history of cryptorchidism or varicocele, and those who had received combined chemotherapy, were excluded. In 22 patients (10 seminomas and 12 non-seminoma tumors) a spermogram was obtained at the time of orchidectomy, before the procedure in 9 cases and immediately afterwards in 13.

[Linitis plastica extending through the entire digestive tract. A case report].

A 43-year-old man who presented a perplexing diagnostic challenge, had diffuse linitis plastica involving the entire gastrointestinal tract (autopsy). Although the usual primary site is the stomach in case of linitis plastica, invasion of the large and small bowel is rarely seen, but must be searched with proctoscopic exam and barium enema. We review the literature and discuss the pathogeny of this disorder.

[Long-term evaluation of urinary diversion using a rectal bladder].

The long term assessment of urinary diversion by rectal bladder was studied in 18 subjects with a follow-up between 10 and 26 years (mean follow-up: 20 years). The results were evaluated by means of a triple survey: clinical, radiological and laboratory tests. The functional state of the sphincters was assessed, revealing excellent or good results in 13/17 cases for continence of urine during the day, although a lower score was obtained at night, and 14 excellent or good results for continence of faeces.

[Congenital superior mesenteric arteriovenous malformations].

An arteriovenous aneurysm in the region supplied by the superior mesenteric artery was detected fortuitously during abdominal arteriography. The absence of a previous history of injury or operation suggested a congenital origin for this infrequently observed lesion. Logical therapy whenever possible is resection of mesentery and the neighbouring intestine.

[Preoperative vascular loading. A guide for the management of volume expansion in the surgery of pheochromocytoma].

The most acurate fluid replacement is needed for the operative management of patients with pheochromocytoma. Pulmonary capillary wedge pressure monitoring must be incorporated into routine practice for assessing left ventricular filling pressure because discrepancies between central venous pressure and left-sided filling pressure may occur, even in patients apparently free of cardiopulmonary dysfunction. The response to preoperative acute volume loading was used in 11 patients--to detect preoperatively patients in whom fluid infusion was associated with a dangerous increase in pulmonary wedge pressure without improvement in forward flow and--to provide a guide for intraoperative volume replacement.

[A case of acquired occlusion of the upper ureter by ampullary hernia of the renal hilus].

The authors report the documented observation of a 59 year old woman admitted to hospital for recent pains in the left flank caused by acute hydronephrosis. Surgical exploration revealed a surprising loss of continuity in the ureter resulting from an ischemic occlusion of the upper ureter. The occlusion was in turn due to compression from a hernia of the renal hilum.

[A rare complication of disk surgery: ureteral fistula. Apropos of a case following counter-lateral laminectomy].

The authors report a new case (to be added to the 10 already published in the literature) of damage to the ureter during surgical treatment of a herniated disc. Instruments seeking the hernia perforate the prevertebral ligament and damage the ureter. The diagnosis should have been made rapidly in the light of a difficult postoperative course, the discovery of a pre and laterovertebral effusion by echography and the presence of haematuria and pyuria.

[Three cases of regressive hypertension after renal trauma. (author's transl)].

Three cases of post-renal contusion hypertension are reported. The treatment was conservative in the three cases, and we think it had no incidence on return to normal arterial pressure. There was a good correlation between arterial pressure and renal vein renin activity.

[Left renal vein thrombosis with exception diagnostic circumstances. Success of an unusual surgical treatment].

The presentation of cystitis associated with lumbago in a young woman lead to the discovery on IVU of left pyelitic irregularities. Ultrasound demonstrated a non-homogeneous lateral pyelitic mass. Because we suspected a vascular aetiology, we performed arteriography: arteries were normal, the renal vein was not visualized, but opacities caused by peripyelitic varices being drained by a much dilated lumbo-ovarian vein which gave a normal intramyometrial phlebographic picture, were seen.