PIRADS 3 MRI lesions: are biopsies still necessary?

Introduction: A significant proportion of newly diagnosed prostate cancer (PCa) cases are slow growing with a low risk of metastatic progression. There is a lack of data concerning the optimal biopsy regimen for improving diagnosis yield in PI-RADS3 lesions. This study aimed to assess the diagnostic value of current biopsy regimens in PI-RADS 3 lesions and identify clinical predictors to improve clinically significant PCa (csPCa) detection.

Modified holmium laser enucleation for benign prostatic obstruction to preserve sexual and ejaculatory function.

Introduction: To report ejaculatory and urinary results in patients who underwent holmium laser enucleation of the prostate (HoLEP) with selective laser enucleation of the median lobe (MLHoLEP).

Methods: Patients with lower urinary tract symptoms (LUTS)/benign prostatic obstruction (BPO) who underwent MLHoLEP to preserve ejaculatory function in a single center were retrospectively identified. Urinary function was assessed using International Prostate Score Symptom (IPSS), IPSS-Quality of Life index (IPSS-QoL), peak urinary flow (Qmax) and postvoid residual (PVR).

Challenges and opportunities for reducing anthelmintic use in ruminant livestock systems: Insights from a sheep farmer survey in France.

Today's level of anthelmintic use in livestock production is a major threat to both the livestock industry and the environment. In this context, the research community is looking for ways to equip farmers with preventive and treatment strategies that can decrease livestock-industry dependence on anthelmintics. Production practices for a sustainable control of parasites have been advocated for almost forty years, but farmers' uptake of these practices has been too slow to address the issues at stake.

New perspectives on metabolic imaging in the management of prostate cancer in 2022: A focus on radiolabeled PSMA‑PET/CT (Review).

Nuclear medicine is an essential part of prostate cancer management concerning initial staging, patient follow-up and even therapy. Prostate-specific membrane antigen (PSMA) is a glutamate carboxypeptidase II transmembrane glycoprotein expressed by 80% of prostatic cells. The interest in this protein is due to its specificity for prostatic tissue.

Implant breakage and revision factors for modular fluted tapered stems in revision total hip arthroplasty.

Purpose: Modular stems in revision total hip arthroplasties allow diaphyseal fixation and optimal restoration of the architecture of the proximal femur. Several studies report metaphyseal implant breakage having a negative impact on survivorship. The aim of the study was to evaluate the outcome of an uncemented modular fluted tapered stem (MFT) in revision surgery.

[Management of testicular torsion by a general surgeon isolated in Africa].

The onset of sudden and intense scrotal pain exposes to several problems when it occurs in a young man in Africa. Among the possible etiologies, testicular torsion is the surgical emergency to rule out, because beyond 6 hours of evolution the functional prognosis of the testicle is concerned. The septic evolution towards a purulent melting, in case of exceeded torsion, is also possible.

Dislocation fracture of the femoral head in adult.

The smaller the head fragment, the more likely it is located at the bottom and in front of the femoral head, which then determines the most suitable approach. A CT scan is essential after reduction and before resumption of weight-bearing to verify the size and congruence of the fragments and whether there are foreign bodies and/or a fracture of the posterior wall. Classifications should include the size of the fragment and whether or not there is an associated fracture of the acetabulum or femoral neck (historical 'Pipkin', modernised 'Chiron').

[Place of preperitoneal pelvic packing in severe pelvic traumatisms: 20 cases in a French level 1 trauma center].

Background: The overall mortality of hemodynamically unstable patients with pelvic trauma is high. Their management is controversial concerning places of arterioembolization and pelvic packing associated with pelvic stabilization. The aim of this study was to collect the pre-peritoneal pelvic packing (PPP) performed in our institution over 10years in order to propose a management algorithm.

Network flow and flood routing model for water resources optimization.

Real-time management of hydraulic systems composed of multi-reservoir involves conflicting objectives. Its representation requires complex variables to consider all the systems dynamics. Interfacing simulation model with optimization algorithm permits to integrate flow routing into reservoir operation decisions and consists in solving separately hydraulic and operational constraints, but it requires that the water resource management model is based on an evolutionary algorithm.

Laser-Induced Ocular Lesions with Thulium Fiber Laser in Endourology: An Study.

The thulium fiber (Tm-F) laser is currently studied as an alternative to the holmium: yttrium-aluminum-garnet (Ho:YAG) laser, the gold standard for endocorporeal laser lithotripsy. We aimed to evaluate the effects of an accidental Tm-F laser exposure on bovine eyes and to test the protective action of different eyeglasses in preventing eye lesions in case of an accident. A 50-W TFL generator (IPG Photonics, Russia) with a wavelength of 1940 nm and 200-μm core diameter fibers (CDFs) were used.

[Late complications after blunt renal trauma: A French multicenter study].

Introduction: Among genitourinary traumas, blunt trauma to the kidney are the most frequent: their initial management has been well studied but their development at a distance is poorly documented. The objective of this study was to assess the late complications of blunt renal trauma, and to investigate their predictive factors for occurrence.

Materials And Methods: A retrospective observational study of the TraumAFUF project was conducted, including, between 2005 and 2018, all blunt renal trauma treated in 18 French hospitals and followed for more than 3 months.

Atypical Presentation of Testicular Adrenal Rest Tumor (TART) Leading to Bilateral Partial Orchiectomy in a 31-Year-Old Adult Revealing Primary Adrenal Insufficiency with Deficiency.

Adrenogenital syndrome is commonly associated with a deficiency in 21-hydroxylase but can be present in other rare enzymatic blocks. We report here the case of a 31-year-old man who presented with bilateral painful testicle lesions leading to bilateral partial orchiectomy as they were suspected for malignancy. These lesions were finally identified as benign testicle adrenal rest tumors (TARTs), and the patient was actually belatedly diagnosed with primary adrenal insufficiency due to 2 mutations of the gene encoding the cholesterol side-chain cleavage enzyme (P450scc); the mutations were 940G > A (p.

[The urologist confronted with a mass killing].

Introduction: Following the Paris attacks in 2015, the French hospital system has had to organize itself in mass casualties of serious injuries, especially hemorrhagic shock. Recent experience shows that the first flow of casualties is spontaneously directed to the structure closest to the events, whether it is suitable or not. Any surgeon can face such a crisis regardless of their practice structure, because terrorist attacks are unpredictable.

[Non-infectious emergencies of the lower urinary tract and genitals].

Introduction: The objective of this narrative review was to report the most relevant data on the contemporary management of the main non-infectious emergencies of the lower urinary tract and genital organs.

Methods: A narrative synthesis of the articles (French, English) available on the Pubmed database was carried out in June 2021. A request to the health surveillance network for emergencies and deaths (SurSaUD®, Santé Publique France) revealed original data on the epidemiology of non-infectious lower urinary tract and genital organs emergencies.

Outcomes of acute versus delayed total hip arthroplasty following acetabular fracture.

Purpose: Post-traumatic arthritis is known complication following acetabular fracture. The aim was to compare mid- to long-term outcomes of acute THA (aTHA) for acetabular fracture and delayed THA (dTHA) following failure of ORIF or conservative management.

Methods: We retrospectively analysed 60 THA (21 aTHA; 39 dTHA) performed for acetabular fracture between 2004 and 2014 in 60 patients with a mean age of 59 years (20-94).

Comparative study of total hip arthroplasties with dual mobility cups versus hemiarthroplasties in management of femoral neck fractures: Survival and dislocation rate at 5 years of follow-up?

Background: Instability after hip arthroplasty, whether it is a total (THA) or intermediate (HA), poses a major risk, however arthroplasty is the standard treatment for displaced intracapsular fractures of the femoral neck of the elderly. Three types of arthroplasties can be proposed: total prostheses with or without a dual mobility cup (DM THA) reducing the risk of dislocation, and hemiarthroplasties. In the absence of clear recommendations regarding the type of implant to be used and the scarcity of studies comparing HA and DM THA, we conducted a monocentric comparative retrospective study using the propensity score method to compare DM THA versus HA on recently displaced femoral neck fractures: (1) survival and risk of dislocation, (2) functional results, (3) mortality.

[Rare emergencies in urology].

Introduction: The aim of this article was to cite rare but sometimes serious emergencies that may be encountered by any urologist during their practice, and to outline the main principles of their management.

Material And Method: A systematic review of the literature using PubMed, Embase and Google Scholar was carried out between January 2000 and June 2021. The articles obtained were selected according to their age and type.

Does augmented core decompression decrease the rate of collapse and improve survival of femoral head avascular necrosis? Case-control study comparing 184 augmented core decompressions to 79 standard core decompressions with a minimum 2 years' follow-up.

Introduction: Avascular necrosis of the femoral head often progresses to femoral head collapse if not treated. Conservative treatment yields highly variable results and is not standardised, mainly because it is typically evaluated in small patient populations. This led us to conduct a large retrospective comparative study with the goals of 1) analysing survival and functional outcomes, 2) looking for differences in survival between core decompression techniques (standard versus augmented), and 3) studying the risk factors for femoral head collapse and revision by arthroplasty.

Periprosthetic joint infection in aseptic total hip arthroplasty revision.

Purpose: There is no consensus regarding systematic screening for infection in aseptic revision total hip arthroplasty (THA). The rationale for systematic intra-operative samples is to increase the sensitivity of latent infections detection, which may require specific treatment. However, the incidence of occult infection in revision THAs is not precisely known.

Patient Participation During Anterior Cruciate Ligament Reconstruction Improves Comprehension, Satisfaction, and Functional Outcomes: A Simple Way to Improve Our Practices.

Background: It is estimated that 28% of patients are dissatisfied after anterior cruciate ligament (ACL) reconstruction, in part because they do not understand the procedure well enough.

Purpose: To assess the postoperative comprehension, satisfaction, and functional outcomes of 2 patient groups: 1 undergoing a standard surgical procedure (standard group) and 1 involved in their surgery (participation group).

Study Design: Cohort study; Level of evidence, 2.

The Delta of Correction: a novel, more reliable variable than limb-length discrepancy at predicting outcome after total hip arthroplasty.

Background: Leg-length discrepancy (LLD) is a frequent and recurring issue after total hip arthroplasty (THA). It can lead to discomfort and litigation due to the patient's perception of this inequality.

Purpose: The aim of this study was to evaluate the functional impact of postoperative LLD and length correction in patients after primary THA.

Ho:YAG laser lithotripsy in non-contact mode: optimization of fiber to stone working distance to improve ablation efficiency.

Purpose: To evaluate how variable working distances between the laser fiber and the stone influence ablation volume.

Methods: A laser fiber was fixed on a robotic arm perpendicular to an artificial stone. A single laser pulse was triggered at different working distances (0-2.

Determination of normal KOOS and WOMAC values in a healthy population.

Purpose: The KOOS questionnaire is used to assess the symptoms and function of patients with traumatic or degenerative knee pathology. The WOMAC score has been validated mainly in the context of knee osteoarthritis. The distribution of these scores in a non-diseased population is not known.