Sertoli cell barrier dysfunction and spermatogenetic cycle breakdown in the human testis: a lanthanum tracer investigation.

The introduction of nitrate of lanthanum in fixative solutions for testicular biopsies improves ultrastructural observations of the blood-testis barrier. In complete (normal) spermatogenesis, junctional specializations impede the diffusion of lanthanum into the adluminal compartment. They clearly exhibit a three-storied disposition in orthogonal sections. In maturation arrest, lanthanum passes easily through the junctional specializations surrounding the germ cells and up to the lumen. In irregular hypospermatogenesis, the Sertoli cell barrier is permeable, but diffusion of the tracer is less significant and variable. Unexpectedly, in germ cell aplasia, the barrier remains efficient

[Congenital megaureter (MU) in the adult. A series of 55 patients presenting 64 megaureters]. / Le mégauretère (MU) congénital chez l'adulte. Une série de 55 malades représentant 64 mégauretères.

Analysis of series of 64 instances of MU in 55 patients leads the authors to the following conclusions: --MU is fairly rare in adults since it is usually discovered at an earlier age; --adult MU shows little activity, even when it is complicated by lithiasis; --renal involvement frequently bears no strict relationship to the magnitude of the MU and is not always obviously improved by surgery; --surgical treatment of MU (anti-reflux ureterovesical reimplantation, with or without ureteral modelling) gives reliable results (14 successes, 2 failures, and 1 patient lost to follow up), comparable to those obtained in children); --the main operating indications consist of: infection, associated urinary, youth, and the possibility of pregnancy; --the problem of associated lithiasis must be dealt with before or during surgical treatment of MU, never after, because of the risk of postoperative lithic migration. Treatment of associated lithiasis has been appreciably simplified by endoscopic methods, and particularly by extracorporeal litholapaxy.

[Merits of interureteral anastomosis in the treatment of unilateral extensive non-neoplastic lesions of the pelvic ureter in adults]. / Intérêt de l'anastomose inter-urétérale (AIU) dans le traitement des lésions étendues unilatérales non néoplasiques de l'uretère pelvien chez l'adulte.

The authors intend to set out the merits of interureteral anastomosis for unilateral extensive lesions of the pelvic ureter. In order to achieve a good homogeneity on one hand and a greater distance in time (8 and 12 years in two cases) on the other hand, they decided to confine their study to the non-neoplastic lesions of adult patients, which are most often iatrogenic. This brief analysis shows that interureteral anastomosis is simpler than ureteroileoplasty when ureterovesical plasty is impossible (psoic, bladder tubulization). Contrary to a widespread opinion, itl does not seriously jeopardize the receiving, ie. normal, urinary tract. The chances of salvage of the initially threatened upper urinary tract are considerable (at least 75 to 80%). The production of an ureteroureteral reflux is a negligible risk, as is the spread of an infection towards the normal kidney. Of course, these good results can be achieved only with an accurate, minutious procedure, of which the authors describe the essential features. The stability of the results is confirmed by the long period elapsed in some cases.

[A case of hydronephrosis disclosed after traumatic rupture of the kidney pelvis]. / A propos d'un cas d'hydronéphrose découverte lors de rupture traumatique de bassinet.

We report a typical case of traumatic ruptured hydronephrosis (moderate trauma, unknown hydronephrosis). Conservative treatment with pyeloplasty appears to be the best solution in these cases when as is frequently the case the major lesions affect the renal pelvis.

[A case of auto-emasculation]. / A propos d'une observation d'autoémasculation.

We present a case of genital self emasculation in a non-psychotic patient. We discuss here the few problems (surgical, psychiatric, legal and sociologic) that this rare case suggest.