[Inguinal lymphadenectomy in cancer of the penis: surgical techniques and indications].

Lymph node invasion is one of the major prognostic factors of cancer of the penis. However, as it is difficult to evaluate clinically and by means of complementary investigations, inguinal or even ilioinguinal lymph node dissection is still indicated. As this surgery carries a certain morbidity (necrosis of skin edges, infection, lymphorrhoea and subsequent lymphoedema), the indications are presented according to the presence or absence of palpable inguinal lymph nodes and the stage of the primary tumour.

[Penile injuries].

Penile trauma is uncommon, but can be serious due to its urinary and sexual complications. After reviewing the literature, the authors examined three types of trauma of particular interest because of the specificity of the lesions induced and their treatment. The circumstances of onset, the various lesions observed, the complementary investigations required, and the therapeutic modalities are studied for each type of trauma.

[Wermer syndrome associated with a bilateral renal tumor].

Wermer's syndrome is a polyendocrinopathy characterized by neoplasia of the parathyroidis, pancreas and the pituitary. We report a case, unique in our knowledge, of an unusual association of a bilateral renal tumors and Wermer's syndrome. The originality of this case is: Bilateral renal blow.

[Urethroplasty in 2 stages using skin grafts].

Objective: To present the technique and results of 2-stage mesh-graft urethroplasty, as described by Schreiter in 1984.

Methods: 11 patients with a stricture of the anterior urethra were treated according to this urethroplasty (pedicle skin flap). The site of the stricture was penile in 4 cases and perineoscrotal in 7 cases, and the mean length was 7.

[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.

[Lymphangiomyomatosis: an exceptional cause of chyluria. Report of a case].

A rare case of lymphangiomatosis without pulmonary involvement is reported. The diagnosis was based on the presence of multifocal lesions and histological examination. Retroperitoneal lesions were responsible for chyluria, which was treated surgically.

[Cancer of the penis: the value of systematic biopsy of the superficial inguinal lymph nodes in clinical N0 stage patients].

From 1985 to 1991, bilateral surgical biopsy of the superomedial group of superficial inguinal lymph nodes, considered to be the first draining nodes, was performed in 24 patients with clinical stage T1-3 N0 M0 squamous cell carcinoma of the penis at the same time as surgical treatment of the primary. This procedure was technically successful in every case, but no lymph node metastases were detected. As bilateral biopsy was negative in these 24 patients, clinical surveillance was implemented: review every 2 months for 2 years and self-palpation by the patient.

[Treatment of interstitial cystitis with sub-trigonal cystectomy and enterocystoplasty].

Eight patients with interstitial cystitis were treated by supratrigonal cystectomy and enterocystoplasty. The indications for this procedure are functionally disabling interstitial cystitis refractory to conservative treatment and associated with severely altered cystomanometric parameters. 6 patients obtained an excellent functional result and 2 patients obtained a poor result, due to sphincter hypotonia responsible for total incontinence in one case.

[Achieving urinary continence].

Development of urinary continence, which is necessary for species survival and comfort of human being, begins with the organization of vesico-sphincteric automatism, as part of nervous system growth. Micturitional reflex are successively integrated inside the ganglionic plexuses in the foetus, the sacral spinal cord in the newborn and the pontine center in the child. Voluntary control of this automatism needs, at first, feeling an sensitive information about the bladder fullness, that is to say a "desire of urinate".

[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.

[Incidence of graft rejection after pancreas and kidney transplantation].

The possibility of an immunological follow-up of the pancreas through the renal transplant after simultaneous pancreaticorenal transplantation (S.P.R.

Vesicoureteral reflux in the renal transplantation candidate.

The incidence and severity of urinary tract infection episodes were evaluated in two groups of renal transplantation patients. Group 1 consisted of 11 patients transplanted following successful surgical correction of a noninfected vesicoureteral reflux in native kidneys, and group 2 of 28 patients transplanted with a noninfected vesicoureteral reflux. An increased incidence of acute urinary tract infection episodes was noted in group 2 as compared to group 1 (42.

[Kidney transplantation after 60 years of age. Survival of patients and functional results].

Between January 1, 1984 and October 1, 1988, 36 cadaveric kidney transplantations were performed in 60 to 66 years' old patients (mean: 62.4 years). Induction immunosuppression consisted of rabbit antithymocyte globulins for 10 days or 33B3.

[Wadding of the axilla in the conservative treatment of cancer of the breast. Prevention of lymphocele].

A randomized prospective study was carried out on 53 consecutive female breast cancer cases hospitalized at the Centre René Gauducheau, In Nantes (France), with the intent of investigating whether surgical wadding of the axillary fossa with the use of proximate muscular tissue can prevent lymphocele from occurring, and avoid placement of suction drains usually required in conservative management of breast cancer. Results have been significant regarding the incidence of lymphocele (p less than 0.001), as well as the mean puncture volume and the total number of punctures needed (p less than 0.

[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.

Interleukin 2 receptor in rat heart allograft rejection.

Soluble interleukin 2 receptors (S-R-IL-2) of truncated Tac chain, produced in vitro during T lymphocyte activation, may represent an in vivo marker of an alloimmune reaction. We analyzed serum S-R-IL-2 production during acute heart allograft rejection and compared soluble and membranous Tac chain (blood lymphocytes and graft invading cells) regulation during rejection. Serum S-R-IL-2 was tested in an immunoradiometric assay, with a combination of two mouse IgG1 anti-IL2-R mAbs (ART18 and OX39).