[Evaluation of radiofrequency (TUNA) in the outpatient treatment of benign prostatic hyperplasia]. / Evaluation de la radiofréquence (TUNA) dans le traitement de l'hypertrophie bénigne de prostate en chirurgie ambulatoire.

OBJECTIVE: Evaluating the effectiveness and feasibility of transurethral needle ablation (TUNA) for young patients with symptomatic benign hyperplasia (BPH) in outpatient care. MATERIAL AND METHODS: From 2004 to 2005, 9 patients (mean age: 59.7 years) were treated with the TUNA device. The urinary function using the IPSS (International Prostate Symptom Score), the quality of life score (QOL-UR), the uroflowmetry, and the post-void residue, and the sexual function using the International Index of Erectile Function score (IIEF-5) were assessed. RESULTS: Prior to thermotherapy, the mean IIEF-5 was 20.2. The mean preoperative IPSS and QOL-UR scores were respectively 25.2 and 5,6. Regarding uroflowmetry, the mean pre-treatment maximal urinary flow was 6 ml/s and the mean post-void residue was 167.1 mL. Patients' follow-up was at intervals of 3 months. With a mean follow-up of 9.5 months, 8 patients have achieved a better urinary status with a mean IPSS and QOL-UR score of 9.5 and 1.6 respectively (p<0.05). The mean maximal flow rate was improved (14 ml/s, p< 0,05). The post-void residue decreased but had no statistical significance. The IIEF-5 score remained unchanged. Only 4 complications including 3 urinary retentions and 1 prostatitis were revealed for 3 patients. No failure with radiofrequency thermal therapy was observed. CONCLUSION: TUNA as a mini-invasive outpatient treatment for symptomatic BPH proved reliable and reproducible for young patients with preserved sexual function.

[Bladder perforation during transurethral resection of bladder tumour: a review]. / Perforations vésicales au cours d'une résection trans-uréthrale de tumeur de vessie.

Transurethral resection of bladder tumour is a common procedure (10,711 new cases of bladder tumour diagnosed in France in 2000), associated with a certain morbidity. Intra- or extraperitoneal perforation of the bladder wall is a possible complication. The diagnosis is generally established intraoperatively and cystography can be performed in the operating room to demonstrate the diameter of the perforation. Most cases of extraperitoneal perforation can be treated conservatively by simple bladder drainage. Intraperitoneal perforations may require surgical repair Laparoscopy is currently tending to replace open surgery for this repair. One of the risks of perforation is also tumour seeding outside of the bladder However metastases related to perforation appear to be rare and occur rapidly requiring close surveillance.