[Experience of day case robotic prostatectomy. About thirty-two patients]. / Expérience de la prostatectomie totale robot-assistée ambulatoire. À propos de 32 cas.

OBJECTIVE: To report a monocentric experience of outpatient management of robot-assisted radical prostatectomy using a rapid recovery protocol. PATIENTS AND METHODS: In this retrospective observational study, thirty-two patients underwent a prostatectomy by the same surgeon between February 2017 and September 2018 as part of an outpatient hospitalization. The surgery was a transperitoneal robot-assisted prostatectomy with a urinary catheter duration of 7 days. A satisfaction questionnaire on outpatient care and functional results was sent to all patient during follow-up. RESULTS: Of the thirty-two patients initially planned for ambulatory care, two patients remained hospitalized overnight: the first at the request of his wife, the second because of severe nausea. Of the thirty ambulatory patients, nine (30%) required emergency attention in the days following their discharge, including one with Clavien complication IV. Seven patients would have preferred to be hospitalized one night, but twenty-six patients would recommend ambulatory care to one of their relatives, should they undergo prostatectomy. Oncological findings and functional are comparable to conventional hospitalization. CONCLUSION: Radical prostatectomy can be performed routinely in an outpatient setting with no increase in morbidity or decrease in functional and oncological results, with a high patient-family satisfaction rate. LEVEL OF EVIDENCE: 4.

[Contribution of urodynamic examinations in the exploration of micturition disorders in patients with Parkinson disease]. / Apport des examens urodynamiques dans l'exploration des troubles mictionnels des patients parkinsoniens.

24 men (mean age 71.2 years) with micturition disorders and parkinson disease have been studied: irritative symptoms are present in 62.5%. Urodynamics were specially usefull when obstructive symptoms (37.5%). In these cases, 3/4 had a mechanical obstruction to be treated by surgery. 3 men had a neurologic bladder and needed a pharmacological treatment. In this high risk population, urodynamics seemed to be necessary.

[A rare renal tumor: cavernous hemangioma. Apropos of a case]. / Une tumeur rénale rare: l'hémangiome caverneux. A propos d'un cas.

The authors report a case of cavernous hemangioma of the kidney, a rare benign tumor. The interest of this case is probably to be the only one reported with MRI: an high signal intensity T2 in weight sequence could represent in the future a good information for the diagnosis. Endoscopic methods are useful for the diagnosis, but cannot be used for therapy. The treatment is surgical. Selective embolisation could be a good alternative in the future.

[Retrograde endopyelotomy in the treatment of iterative stenoses of the pyeloureteral junction]. / Endopyélotomie par voie rétrograde dans le traitement des sténoses itératives de la jonction pyélo-urétérale.

This work is a report on our preliminary experience with the treatment of iterative stenosis of the pyeloureteral junction (JPU) through a retrograde endoscopic approach. From June, 1991, to June, 1992, we used this method to operate 6 cases of failed surgical pyeloplasty due to abnormalities of the JPU. The success of this operation depends, on one hand, on the systematic dilatation of the intramural portion of the ureter, and on the other hand, on the possible installation of a double pigtail stent a few weeks before endopyelotomy. We have noted no complication. The stay in hospital lasted 3 days in average (2 to 5 days). Clinical and radiological results include: 4 successes, 1 improvement and 1 failure. The average time elapsed is of 9 months (6 to 18 months). This technique, which has a proven feasibility, is a good alternative for this indication, in the absence of associated calculi and particularly in women. Its efficacy remains to be demonstrated by larger series with a longer follow-up.

Localized hyperthermia versus the sham procedure in obstructive benign hyperplasia of the prostate: a prospective randomized study.

Hyperthermia was shown to cause improvement in 50 to 60% of the patients with benign prostatic hyperplasia (BPH) without considering placebo effects. We studied 68 patients randomly assigned to a treatment group (38) and a sham group (30) who underwent the same manipulation but without applying radio frequency power. The Biodan Prostathermer was used. Criteria for inclusion were based on objective and subjective symptoms. Treatment was performed 6 times at 43 +/- 0.5C for the treatment group. Followup evaluation was performed at 3 months, and the same objective and subjective symptoms were recorded. We observed a statistically significant subjective improvement in the sham group (33%) that was not accompanied by any significant objective improvement. In the treatment group the subjective response was significantly better regarding number of patients (68%) and response rate, and was substantiated by a significant improvement in all objective symptoms (53% of the patients) except voided volume. Therefore, hyperthermia treatment had a definite therapeutic effect on BPH in excess of placebo.

[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.

[Localized transrectal hyperthermia in the treatment of obstructive manifestations of prostatic adenoma. Review of the literature and personal experience]. / Hyperthermie transrectale localisée dans le traitement des manifestations obstructives de l'adénome prostatique. Revue de la littérature et expérience personnelle.

For about the last 10 years, transrectal hyperthermia has been used to treat obstructive manifestations of adenoma of prostate. This procedure induces interstitial edema and acts preferentially on the fibrous elements of the prostate. Several therapeutic regimens have been used successively by different teams, after objective and subjective inclusion screening programmes. Results published up to the present show about 45% of objective responders (against 3% in a placebo group) with improvement sustained in 3 out of 4 cases. Morbidity rate (infection and urinary retention) was 3%. Data from a retrospective study of a series of personally treated patients was w used to determine those with the greatest chance of a successful outcome, even though this is never comparable with that of surgical treatment.

[Treatment of calculi of the lumbar ureter. Apropos of a series of 118 patients]. / Traitement des calculs de l'uretère lombaire. A propos d'une série de 118 patients.

118 patients suffering from a calculus in the lumbar ureter were treated from January, 1987 to January, 1990. The treatment of 91 patients combined an initial internal ureteral drainage, followed by extracorporeal lithotrity (ECL): 40 calculi were driven back into the kidney and 51 were treated within the ureter. 69 patients (76%) no longer have any calculus; 17 (19%) retain residual fragments smaller than or equal to 3 mm in the lower calyces. We therefore count 5 failures, including 3 in which a second-intention surgical ureterotomy was performed. The ascent of the probe failed in 9 cases at the beginning of the series (6 ureterotomies and 3 percutaneous nephrostomies + ECL). 11 patients were treated with probeless in situ ECL. The others were treated with ureteroscopy (4), percutaneous nephrostomy + ECL (1) and nephrectomy (2). There is not one single treatment for the calculi of the lumbar ureter, and they require associating several therapeutic procedures.

[Low pressure bladder replacement after total cysto-prostatectomy. Apropos of a series of 40 patients]. / Iléocystoplastie de remplacement à basse pression après cystoprostatectomie totale. A propos d'une série de 40 patients.

The results of 40 consecutive patients who underwent bladder replacement following cystoprostatectomy for invasive bladder cancer are reported. A 30 cm detubularized ileal segment was used to make the neobladder. Mean follow-up was 19 months (over 2 years in 17 patients). All patients achieved diurnal continence. Nocturnal continence was obtained in 70.5% of patients: 41% had no leakage and nocturia less than 2, while 29.5% had some occasional leakage. Urodynamic evaluation showed the average peak flow to be at 18.3 ml/s and an average neobladder capacity of 410 ml. Six patients had spontaneous contractions of the enteric bladder of greater than 40 cm H20, always associated with elevated urethral pressure. Post-void residue was smaller than 100 cc in all cases. This procedure is simple to do, and led to an excellent diurnal continence, although it cannot assure nocturnal continence in every single patient.