[Primary tumors of the upper urinary tract. Apropos of 49 cases and a review of the literature]. / Les tumeurs primitives de la voie excrétrice urinaire supérieure. A propos de quarante-neuf observations et revue de la littérature.

We report 49 tumors of the upper urinary tract treated between 1980 and 1988. Intravenous pyelography with direct opacification technics gave the diagnosis in 83.7% of patients. Ultrasonography and computed tomography were only reliable for tumors of renal pelvis. Urinary cytology gave good results only in high grade invasive transitional cell carcinoma. Nephro-ureterectomy is always recommended.

[Results of the surgical treatment of impotence due to venous leakage by insertion of a prosthetic venous tourniquet. 26 patients reviewed with a 1-year follow-up]. / Résultats du traitement chirurgical de l'impuissance par fuite veineuse par mise en place d'un garrot veineux prothétique. Vingt-six malades revus avec un an de recul.

Twenty-six patients have been operated by pericavernoplasty with a band of synthetic material. After 1 year, 61.6% had a good result. Venous leaking is certainly a disease of the corpora cavernosa.

[Female vesical instability: etiologic problems in 209 cases]. / Instabilité vésicale féminine: problémes étiologiques. A propos de 209 cas.

Based on a series of 209 cases, the authors investigate the aetiological factors responsible for vesical instability in adult females. Fifty five p. cent of patients suffered from incontinence due to isolated urgency. These patients presented a history of neurological disturbances in 21 cases, total hysterectomy in 22 cases and surgery for incontinence in 54 cases. Sixty p. cent of cases presented with genital prolapse. There were 7 cases of urinary tract infection, 2 cases of renal stones and 2 bladder tumours. Urodynamic studies revealed 60 dysuric syndromes. The responsibility of urinary tract infection or genital prolapse in the development of vesical instability is questionable. Nevertheless, the frequency of genital prolapse in the present series argues in favour of deficiency of the perineal musculature which decreases the capacity for inhibition of the detrusor. Lastly, 40% of patients did not have any neurological causes or any vesical or adjacent pathology. These cases were described as idiopathic vesical instability for which the aetiopathogenesis remains unknown.

[Artificial urinary sphincter in the treatment of neurogenic bladder in children]. / Le sphincter artificiel urinaire dans le traitement des vessies neurologiques de l'enfant.

Over a two years period, the model AS 800 artificial urinary sphincter was implanted in 10 children (mean 14 years old) with incontinence due to a neurogenic bladder (7 spina bifida; 3 sacral agenesis). Goal of continence was achieved in 100% of 7 boys and 3 girls with a follow up between 6-32 months (mean 17 months). Patients selection was rigid and incontinence have failed to response at pharmaceutic manipulation (6) intermittent catheterisation (5) and previous classical surgery enterocystoplasty (2), Young-Dees procedure (1). Age minimum was 8 years. All sphincters were implanted around the bladder neck. Associated surgical techniques were performed in 4 cases: 2 detubularized enterocystoplasties, 1 Teflon injection for vesico ureteral reflux, 1 closure of previous cystostomy. Sphincterotomy was never done. 5 patients are submitted post implantation to intermittent catheterisation without any problem. 2 patients required one revision. Nocturnal desactivation is used in 2 cases. Authors focus on the necessity of correcting previously or at the time of implantation bladder compliance and vesico ureteral reflux.