[Modified Nesbit's operation in the treatment of incurvations of the penis. Apropos of 26 cases]. / L'opération de Nesbit modifiée dans le traitement des incurvations de la verge. A propos de 26 cas.

Distortion of the penis can be an obstacle to normal sexual intercourse and can lead to psychological problems. Nesbit first described an operation for the correction of three cases of congenital incurvation of the penis. Several authors later proposed modifications of the original procedure, but the principle technique relies on folding the corpus cavernosum on the side opposite the deviation. We have treated 26 cases with distorted penis: 14 congenital, 3 postsurgical, 1 post-trauma and 8 due to la Peyronie's disease. Our functional results have been excellent. The risk of postoperative retraction is considerably reduced when the fold is created without removing the albugin patches. The quality of the results is directly related to rigorous patient selection.

[Urinary diversion by ureteral endoprosthesis during pregnancy]. / Dérivation urinaire par endoprothèse urétérale au cours de la grossesse.

Dilatation of the renoureteral cavities during pregnancy is a common occurrence, especially on the right side. Though generally asymptomatic, this dilatation can be unfrequently complicated by pain and/or urinary infections that may cause severe infectious and obstetrical complications. In such cases, drainage of the renal cavities may be indicated in very selected cases. The authors review their experience with renal bypass through an endoureteral prosthesis during pregnancy, and specify the technical aspects and the indications of this type of bypass.

[Resection of a pyelonephritic small kidney by celiosurgery]. / Exérèse par coelio-chirurgie d'un petit rein pyélonéphritique.

The authors report about the exeresis of a pyelonephrictic left small kidney with laparoscopic surgery. First a ureteral tube was inserted to facilitate detection of the ureter by laparoscopy possible after reclining the colon. Dissection of the ureter was taken up to the hilum and pedicle, which was severed between rows of clamps by means of the endoscopic GIA stafler. The operation lasted 4 hours and 30 minutes. The blood loss was minimal and the stay in hospital was of three days.

[Morbidity of radical prostatectomy for localized cancer of the prostate. Apropos of 100 cases]. / Morbidité de la prostatectomie radicale pour cancer localisé de la prostate. A propos de 100 cas.

Adenocarcinoma of the prostate is the most frequent cancer of male over 60 years of age. Radical prostatectomy is one of the preferred modes of treatment for localized stages. Surgical morbidity decreases with experience and consists mainly in bleeding and rectal injury. Delayed morbidity comprises loss of erection, anastomosis stricture, incontinence. A retrospective study of 100 patients is reported.

BCG therapy in superficial bladder tumours--complications and precautions.

Bacillus Calmette-Guérin (BCG) immunotherapy represents a valuable treatment in the management of superficial bladder cancer, but the therapy is not without its risks. A total of 220 patients have been included in a review of local and systemic side effects associated with BCG immunotherapy. The majority of side effects are mild and self limiting, but potentially life threatening complications can arise with BCG immunotherapy. These systemic side effects include pneumonitis/hepatitis and systemic BCG infection. Recommendations are given for the use and administration of BCG, and if these rules are correctly applied, BCG may be administered safely, and with confidence.

Genitourinary tumors and HIV1 infection.

4 patients with solid genitourinary tumors and HIV1 infection have been treated in our institution over the last 2 years. Two patients had seminoma, 1 renal adenocarcinoma and 1 renal angiosarcoma. All had deeply impaired immunity with a low CD4 level. 3 had or developed a true AIDS syndrome according to the WHO and CDC criterias of 1988. The remaining patient was seropositive and died less than 3 months following the diagnosis of renal angiosarcoma. He is the first reported case of renal sarcoma in a patient infected with HIV1. 2 patients were homosexuals, and the 2 others were drug addicts. Along with other reported cases, our cases underline the association between the depression of immunity due to HIV and the onset of solid genitourinary tumors.

[Treatment of epidermoid carcinoma of the penis]. / Traitement du cancer épidermoïde de la verge.

Epidermoid carcinoma of the penis is a rare type of cancer. Treatment of the primary lesion consists of amputation, although curietherapy can be effective in some cases as a conservative treatment. The prognosis is determined by the presence of absence of lymph node invasion, but the therapeutic strategy to be used when invaded lymph nodes are present remains controversial. Lymph node dissection is the only effective treatment of metastatic adenopathy, but its high morbidity rate limits its indications.

[Does rectal examination modify the blood level of specific prostatic antigen? A study of 40 cases]. / Le toucher rectal modifie-t-il le taux sérique de l'antigène prostatique spécifique? Etude sur quarante cas.

Prostatic specific antigen has become an essential laboratory parameter in prostatic cancer; it may rise transiently after various manipulations of prostatic tissue. We decided to investigate a possible modification in PSA after rectal examination. The PSA level, studied before and after rectal examination in 40 patients, confirmed the almost constant rise in PSA after thorough rectal examination. The biokinetic features of PSA are also discussed as they are important to determine the time of PSA assay after a transient rise.

[Urogenital tumors and HIV-1 infection]. / Tumeur urogénitale et infection à HIV 1.

Four patients with solid genito-urinary tumors and HIV 1 infection have been treated in our institution over the last 2 years, including 2 with seminoma, 1 with renal adenocarcinoma and 1 with renal angiosarcoma. All had severely impaired immunity with a low CD4 level. Three had or developed a true AIDS syndrome according to the WHO and CDC criteria (1988). The remaining patient was seropositive and died less than 3 months following the diagnosis of renal angiosarcoma, he is the first reported case of renal sarcoma in a patient infected with HIV 1. Two patients were homosexuals and the other 2 were drug addicts. Along with other reported cases, our cases may underline the association between depression of immunity due to HIV and onset of solid genito-urinary tumors.

[Infiltrating tumors of the bladder. Local response to systemic platinum-based chemotherapy]. / Tumeurs infiltrantes de vessie. Réponse locale à la chimiothérapie systémique a base de platine.

16 patients with invasive bladder cancer were treated primarily "bladder in place", with chemotherapy. (M-VAC, CDDP + MTX). There were 11 with T1 to T4, N+, M0, M+, 5 with T1, T2, N0, M0. The aim of the study was to evaluate the response of bladder lesions to chemotherapy. 2 had complete response (CR), 6 partial response (PR) and 8 no-response (NR). Patients with complete responses and partial responses were found to have complete resection before chemotherapy. Unresectable lesions were associated with NR patients. The results did not show a significant improvement and they question the role of neo-adjuvant chemotherapy.

Delayed nonurothelial metastatic lesions to the penis: a report of two cases.

Metastatic lesions to the penis are uncommon and originate most often from other genitourinary primaries. Diagnosis is usually easy, as the primary is already known in most cases. The metastases can very rarely be isolated and delayed for several years after the treatment of the primary tumor. We report two cases of penile metastases from nonurothelial primary lesions. A sigmoid adenocarcinoma was the primary in one case, a renal adenocarcinoma in the other. These two cases were distinctly unusual, as the metastases were delayed for several years after the treatment of the primary. Treatment was palliative with early death in both cases.

["Someone stepped on the catheter". Apropos of a case report of periprostatic arteriovenous fistula treated with embolization]. / "On a marché sur la sonde". A propos d'une observation de fistule artério-veineuse périprostatique traitée par embolisation.

Intractable bleeding occurred in patient who has his inflated balloon catheter accidentally torn out. Treatment by bilateral transcatheter embolization of the hypogastric arteries was successful. The indications, technical requirements and complications of this method are reviewed.

[Priapism induced by heparin. A more serious prognosis?]. / Priapisme induit par l'héparine. Un pronostic plus sombre?

Between 1973 and 1985, 31 patients were treated in the Urology Department of La Pitié hospital for priapism. Analysis of the aetiologies, determined in 25 cases, revealed a particularly high incidence of heparin as an aetiological factor for priapism. Surgical treatment was proposed in 28 patients. Independently of the type of surgical treatment performed and with a comparative preoperative delay, priapism as a complication of heparin therapy appears to be functionally more severe than priapism due to other aetiologies. Although the frequency, mechanism and prognosis of this complication of heparin therapy remain poorly understood, analysis of the 10 cases in this series and a review of the literature nevertheless provide certain answers.