[Repair of female urinary incontinence with prolene "TVT": preliminary results of a multicenter and prospective survey]. / Cure d'incontinence urinaire féminine par bandelette de prolène "TVT": résultats préliminaires d'une enquête multicentrique et prospective.

OBJECTIVES: A multicentre, prospective study (6 private centres, 1 general hospital and 1 teaching hospital) was conducted to evaluate the perioperative morbidity and short-term functional results of the TVT procedure in the treatment of the female urinary stress incontinence. PATIENTS AND METHODS: From November 1996 to September 1999, 120 patients with a mean age of 65.2 years (range: 37-91) were operated according to the tension-free vaginal tape (TVT) technique for isolated urinary stress incontinence (stage 2 or 3) in 94 cases and associated with pelvic tone disorder in 26 cases. 59 patients (49.2%) presented recurrence of urinary incontinence that had already been operated between 1 and 4 times. Physical examination demonstrated hypermobility of the urethra in 73 cases (60.8%), isolated clinical sphincter incompetence in 47 cases (39.2%) and pelvic tone disorders in 31 cases. Urodynamic studies, performed in 113 patients, demonstrated sphincter incompetence in 65 cases (57.5%) with a mean maximum urethral closure pressure of 18 cmH2O (range: 5-29). RESULTS: The operation, performed under spinal anaesthesia in 97 cases (80.8%), general anaesthesia in 16 cases (13.3%) and local anaesthesia in 7 cases (5.8%) lasted an average of 28.7 min (range: 15-60) for insertion of the TVT. Perioperative complications consisted of twelve bladder injuries (10%) and two pelvic haematomas (1.7%). No cases of infection, erosion or migration of the tape were reported. In the group of 94 patients operated exclusively by TVT, the mean hospital stay was 2.6 days (range: 1-7). Twelve patients (10%) required self-catheterization for 2 to 30 days. With a mean follow-up of 15.2 months (range: 36-6), continence was restored in 104 patients, corresponding to a cure rate of 86.7%. A marked improvement was obtained in 11 cases (9.2%) and five cases (4.2%) were considered to be failures. CONCLUSION: The TVT procedure is a new approach to the treatment of female urinary stress incontinence. Its advantages are its simplicity, the rapidity of the technical procedure and the short-term efficacy on continence. A longer follow-up is essential to assess to the functional outcome and the long-term urethral tolerance.

[Renal hemangiopericytoma. Review of the literature apropos of a case]. / Hémangiopéricytome rénal. Revue de la littérature à propos d'un cas.

Regard to a new case of renal hemangiopericytoma, the authors have reviewed the literature, in order to specify the main features of this uncommon entity. Because of the lack of correlation between the clinical behavior and the histologic pattern, hemangiopericytomas should be treated as potential low grade malignancies and followed carefully. Surgery seems to be actually the only form of treatment to propose.

[Piezoelectric extracorporeal lithotripsy. Report of 1-year's experience (350 treatments)]. / La lithotripsie extra-corporelle piézo-électrique. Rapport d'une année d'expérience (360 traitements).

Over the period of one year, 356 extracorporeal lithotripsies were performed in 303 patients with the EDAP piezoelectric lithotripter. The success rate, depending on the frequency (1.2 to 40 Hz) was between 75 and 80%. The treatment was repeated for 13 to 22% of the patients and 15% underwent an auxiliary manoeuvre preoperatively. Morbidity remains low with less than 5% of ureteral obstruction. For simple or small calculi (less than 1 cm), the use of low frequencies (1.2 to 5 Hz) is preferred, making it possible to carry out the treatment without anaesthesia and without hospitalization. For complex or bigger calculi, the use of higher frequencies (10-20 Hz), under neuroleptic analgesia, seems to be more efficient with a shorter time of treatment and a lower complication rate.

[Intracavernous injection of papaverine. Diagnostic value]. / Injection intracaverneuse de papavérine. Valeur diagnostique.

The authors use the intracavernous injection of papaverine (ICP) as a diagnostic test in order to differentiate between organic and psychogenic erectile impotence. Comparison of the results of this test with those of nocturnal penile plethysmography and Doppler studies of the penile vessels demonstrated a good correlation. However, the ICP test cannot be used alone to confirm the organic or psychogenic nature of erectile impotence.

[Peyronie's disease. Therapeutic difficulties]. / La maladie de la Peyronie. Difficultés thérapeutiques.

The authors report their experience of the treatment of Peyronie's disease on the basis of 27 cases. In the light of their results and the data reported in the literature, they study the place of infiltrations, plication of the corpora cavernosa and implants in the treatment of this disease.

[Treatment of renal calculi with extracorporeal lithotripsy. Experience of the Urology Service at Rennes. Preliminary report on 134 patients]. / Traitement des calculs rénaux par lithotripsie extra-corporelle. Expérience du Service d'Urologie de Rennes. Rapport préliminaire à propos de 134 patients.

The results of 134 patients who underwent 150 treatments with the EDAP lithotriptor are reported. The first patients were treated with a frequency of 150 Hz under general anesthesia, with a success rate of 64%. In order to decrease the pain induced by the shocks waves, the frequency was lowered (20 Hz and 10 Hz), so that treatment could be performed under neuroleptic analgesia. The success rate was respectively 84% and 90%. A second treatment was required in 11% of the patients and 9% have undergone auxiliary endoscopic manoeuvres preoperatively. Morbidity was extremely low with only 3% of ureteral obstruction. The gradual reduction of anesthesia constitutes an advance in lowered morbidity and costs; in addition, the possibility to repeat the treatments makes the management of complex lithiasis easier.