[Pharmacologic treatment of urinary dysfunctions].

After reviewing the nervous control of the lower urinary tract, the author defines the action of various drugs on the bladder, bladder neck, urethra (smooth and striated sphincter). The drugs are classified according to their stimulant or blocking effect on the sympathetic and parasympathetic nervous systems and alpha and betadrenergic receptors. Drugs acting on smooth and striated muscle fibres are then studied and the iatrogenic adverse effects of these drugs are mentioned.

[Retro-iliac ureter. A new pathogenetic hypothesis. Proposal of an anatomic classification. A study from a review of the literature].

Rétroiliac ureter is a rare congenital anomaly. The authors propose a new pathogenic hypothesis and an anatomical staging and present an analysis of this rare disease based on a review of the world literature.

[Neurotransmission and the lower urinary system].

Various substances, called neurotransmitters, act as a chemical relay between the nervous and the tissue of the lower urinary tract. Some play also a role inside the muscle cell modulating the activity of the myofibrils. To allow a better pharmacochemical approach, these substances are described, their activity analyzed, with the purpose of helping specialists concerned by investigation or treatment of the lower urinary tract, to be able to act on their activity or change their pathologic abnormalities.

[Neurophysiopathology of spinal lesions, evaluation of the 80s. Post-injury assessment and treatment of the neurogenic bladder in the acute period].

This introductory presentation deals with the recent pathophysiological aspects of the post-traumatic spinal cord lesion and the population concerned. The neurophysiology of the bladder and its sphincters is summarized so as to try and explain some disturbances occurring during the acute phase following a spinal cord injury; their clinical and urological aspects and the methods of bladder drainage.

[Cockett's syndrome and retro-iliac ureter. A previously unknown and original association apropos of a case and review of the literature].

The authors report a case of Cockett's syndrome discovered by ilio--cava angiography at a patient who was operated on a bilateral retro-iliac ureter which occasioned an important renal insufficiency. After a review of the literature, it appears it is the first case published with such a pathologic association mentioned.

[Neurotransmission and the lower urinary tract].

The neurotransmitter activity in the lower urinary tract is very complex. This paper reviews the main substances, known today, their agonists, antagonists, metabolic pathways and their action and discusses the site of action of neuropharmacological substances. The existence of a non-adrenergic, non-cholinergic pathway, in parallel with the sympathetic adrenergic and the parasympathetic cholinergic pathways is thus clearly admitted.

Surgical treatment of the static perineal modifications in spinal cord or cauda equina lesions.

Severe dysuria, due to insufficiency of the perineal floor associated during micturition with a posterior tilting of the prostate-bladder block in lower or in associated upper and lower motor neuron lesions, can be treated surgically by a prostato cytso pexy. Since 1971, eight patients with post-traumatic conus and/or cauda equina lesions have been treated by this intervention. On the follow-up the satisfactory results appear to remain stable.

[The silent kidney. Evolving ultrasonic picture of emphysematous pyelonephritis: the vanishing kidney. Apropos of a case].

The authors report the progressive disappearing of the sonographical image of a previously visualized kidney in a case of emphysematous pyelonephritis. They have called the sonographic vanishing kidney "the sign of the Deaf Kidney". The non-visualisation of a kidney with advanced emphysematous pyelonephritis is due to the infiltration of the perirenal environment by a gas envelope and the filling of the excretory cavities by gas.

[Renal obstruction during pregnancy. Internal drainage using the JJ ureteral probe].

The advantage of using JJ ureteral stent during pregnancy in case of ureteral obstruction is shown two clinical observations. We use ultrasonography to control the site of this catheter during the operation and for the follow-up of the patients.

[Medical treatment of metastatic cancer of the kidney with a combination of vinblastine and recombinant interferon alpha IIa. Result of a phase I-II trial].

Usual treatments of metastatic renal cell carcinoma are not efficient. Phase II trials using Interferon alpha showed a low response rate (10 to 15%). We have conducted a phase I-II trial using a combination of Vinblastine and Recombinant alpha 2 A Interferon in 21 patients.

[Anuria due to bilateral ureteral blockage by the iliac pedicles (retro-iliac ureters)].

The authors report a case of bilateral retro-iliac ureter with renal failure. The transvascular segments of the ureters were eliminated, and the two ureters were reanastomosed in front of the iliac vessels.

[Fielding's intervention in vesico-ureteral reflux and its limits].

Vesico-ureteric reflux in adult patients with normal and dilated ureters (88 ureters) was treated surgically by Fielding's procedure. The authors describe this technique with their own modifications, and discuss the results.

Paraganglioma of urinary bladder.

The literature is reviewed and 2 new cases of paraganglioma of the urinary bladder, 1 malignant and 1 benign, are presented. One patient had no classic symptoms of vesical paraganglioma, and diagnosis was made postoperatively by means of light and electron microscopy. Differentiation between malignant and benign endocrine tumor cannot be made histopathologically and biochemically.

Elongation of the active anterior wall of the uro-genital pelvic diaphragm, a late unusual complication of paraplegia.

The situation of the usual bladder, prostate, membranous urethra channel, can vary, according to the morphology of the perineum which can be overstretched. A case of a young man with a T10 complete upper motor neurone lesion is presented. The normal anterior angulation at the prostate and membranous urethra junction was reduced anteriorly and pushed backwards, thus causing an added indirect factor of dysuria.

Our surgical approach towards the treatment of urethrocele and urethral fistula.

A new technique, described in the text, has been elaborated inspired by that of Monseur (1968) for urethral techniques. It has been performed with success in three paraplegics and in one incomplete tetraparesis. The plastic reconstruction of the diseased part of the urethra after excision of the stenosis and a fistula or diverticula by rotation and fixation to the subcavernal groove creates, in fact, an enlarged neo-urethra rendering the recurrence of the primary lesion practically impossible.

Impairment of erection after external sphincter resection.

Two cases of temporary loss of reflex erectile activity after transurethral bladder-neck and external sphincter resection are reported in two tetraplegics. Only recently such occurrences have been reported in the literature associated with external sphincterotomy. The reasons are discussed and most likely direct damage to erectile tissues is the cause of such a complication.