[A bifid ureter with a blind branch. Apropos of a case]. / L'uretère bifide à branche borgne. A propos d'un cas.

A case of bifid ureter with a blind branch exhibiting no parenchymal connections is reported. Diagnosis was established by excretory urography. Less than twenty cases diagnosed in this way have been reported previously, the embryogenesis of the normal and bifid ureter is reviewed. Symptoms, which are inconsistently present, are described. Excision of the blind branch is required and should be accompanied with antireflux reimplantation of the normal ureter if called for.

[The limits of conventional imagery in urology: the prostate and the kidney]. / Les limites de l'imagerie conventionnelle en urologie: prostate et rein.

Despite the progress in conventional medical imaging it retains certain limitations particularly in two areas: 1) the detection of prostatic cancer: the specificity and sensitivity of transrectal ultrasonography are too poor to justify the use of this modality for screening or for diagnosis. 2) Small renal tumours, which are detected increasingly frequently on ultrasound examinations. Computed tomography is the most reliable examination for determining the benign or malignant nature of the lesion. The other modalities are disappointing and an excessive repetition of medical imaging should be avoided.

[Internal urethrotomy. Resection of urethral stricture (over 5 years follow-up)]. / L'urétrotomie interne. Résection des rétrécissements urétraux (greater than 5 ans de recul).

Since 1980, in addition to internal urethrotomy, the authors have used urethrotomy combined with endoscopic resection of the stricture. This method consists of a classical first stage of section of the stricture, but only at 11 o'clock and at 1 o'clock to leave a rail of midline fibrosis. The second stage consists of resection of this rail. The value of this approach consists of more effective excision of the fibro-inflammatory callus. Thirty-four patients treated by this method have a follow-up exceeding 5 years. This series was compared with a series of patients treated by internal urethrotomy alone (39 patients with a follow-up greater than 5 years). Very good results were obtained in 55% of cases versus 28% with internal urethrotomy alone. Poor results were obtained in 32% of cases versus 43%. Internal urethrotomy therefore appears to be more rapidly and more completely effective.

[Rigid ureteroscopy: a reliable, non-aggressive technic. Apropos of 51 cases treated for ureteral lithiasis]. / Urétéroscopie rigide: une technique fiable et peu agressive. A propos de cinquante et une observations de traitement de lithiases urétérales.

The authors obtained 82% good results by using rigid ureteroscopy to treat a total of 55 calculi in a series of 51 patients and they propose the following therapeutic approach: calculi in the lumbar ureter are frequently difficult to reach (54% failures). There is no harm in gently trying to remove the stone by ureteroscopy which, in the event of failure, can be followed by percutaneous surgery or posterolumbar incision. Rigid ureteroscopy is easier and more reliable in the case of calculi in the iliac or pelvic ureter (7% failures) and the indications can be extended.

[Infected cystic malformations of a seminal vesicle with ipsilateral uretero-renal agenesis. Description and discussion of the surgical approach]. / Malformations kystiques infectées d'une vésicule séminale avec agénésie urétéro-rénale ipsi-latérale. Description, discussion de la voie d'abord chirurgicale.

The author reports a case of rare malformation affecting all of the elements derived from the Wolffian duct, the embryology of which is briefly reviewed. The clinical picture, as in the majority of previously published cases, was initially suggestive of acute prostatitis, but clinical, radiological and ultrasonographic examination revealed the malformation. The treatment is surgical and most authors prefer an intra-peritoneal transvesical approach.

[Total prostatocystectomy followed by enterocystoplasty in the treatment of bladder neoplasms]. / Prostato-cystectomie totale suivie d'entérocystoplastie dans le traitement des tumeurs de vessie.

Bladder replacement enterocystoplasty in the treatment of bladder tumors provides the patient with maximum mictional comfort, and better protection of the kidneys than in the case of cutaneous urinary diversion. The remote carcinological results are satisfactory at over 60% nowadays at three years, against only 20%, seventeen years ago. The functional impact on continence is very good during the day but not yet satisfactory at night, but a sometimes lengthy re-education can help. The result on the upper urinary tract is still the delicate point in this technique, with the hope of an attenuation of the renal insufficiency thanks to the setting up of an antireflux process. However, the indications for this brilliant technique may be limited by the extension of the tumor and the fragility of the diasthesis.

[Value of an ostomy club for patient followup after total cystectomy]. / Intérêt d'un club d'urostomisés pour le suivi des malades après cystectomies totales.

Patients using stoma appliances after a total cystectomy undergo a considerable psychological shock. The creation of groups of ostomates helps in the dissemination of information concerning the use of stomal appliances and in the building up of user confidence, thereby facilitating a return to a normal everyday life. Our main aim is to organize regular meetings of stoma appliance users, with frequent visits from former cystectomy patients. The usefulness of these clubs has been amply demonstrated by the introduction of the training of enterostomal therapists, the collaboration offered by the appliance manufacturers and the interest manifested by surgeons and urologists.

[Primary vesico-uretero-renal reflux in adults: therapeutic outcome. Apropos of 68 cases]. / Reflux vésico-urétéro-rénal primitif de l'adulte: évolution thérapeutique. A propos de soixante-huit observations.

The authors compare two series of adult patients presenting with primary vesico-uretero-renal reflux. The first series was treated before 1974, and the second, over the past ten years. The salient feature of this comparison is the reduction in the number of renal failures. More systematic investigation of the reflux highlights a greater number of cases which will evolve without further impairment of renal function. This point has a considerable bearing on operative indications.

[Incomplete duplication of the urethra with intra-rectal opening of the posterior chanel (author's transl)]. / Bifidité urèthrale avec abouchement intra rectal de l'un des canaux. A propos de deux cas sans anomalie ano-rectale

We have described two cases of urethro-rectal fistulae: outstanding by their absence of anorectal abnormality. This type of malformation must be separated from the fistula observed in imperforated anus. We consider it as an incomplete duplication of the urethra; the posterior part ending in the rectum: this is a very rare abnormality. The treatment involves a separation of the posterior urethra from the rectum to bring it up to the preneum then continue as in an hypospadias usig the Duplay and Leveuf (Cecil) techniques. Seemingly normal urethra is hypoplastic in part or entirely.