[Intracavernous injections of vasoactive drugs. Contribution to the study of their value in erectile impotence]. / Les injections intracaverneuses de drogues vasoactives. Contribution à l'étude de leur valeur dans l'impuissance érectile.

The obtention of an artificial erection with a single intracavernous injection (ICI) of vasoactive drugs, has upset our conceptions about erection and the approach for erectile failure. If this pharmacologic stimulation increases the reliability of some erection tests, their diagnosis value is still questioned. The complexity of both erection and vasomotricity pharmacology, make difficult the understanding of the mechanisms of these ICI. Their therapeutic value is reduced to the method by self injections, new treatment for impotence, even if it concerns only few impotent patients. Finally, the experimental feature and the unquestionable morbidity of these ICI, mainly priapism, impede their large diffusion. However, in spite of these doubts, this intracavernous pharmacology is a real progress for erection and its troubles.

[Intracavernosa injections of drugs in erection disorders. Their clinical value apropos of 100 cases]. / Les injections intracaverneuses de drogues dans les dysérections. Leur intérêt clinique à propos de 100 cas.

Several centers of interest have been stimulated by the true progress represented by the use of intracavernous injections (ICI) for disorders of erection. First, we have become conscious of our uncertainties concerning the physiology of erection. Second, they serve to orientate the etiologic diagnosis and prognosis when positive responses are obtained in cases of impotence. Third, they are of therapeutic interest as auto-injections in impotence with, however, the risk of secondary cavernous fibrosis. Lastly, they represent a new treatment for priapism. However, these ICI procedures are still in the experimental stage, and should be used with some caution because of their potential morbidity and unknown long-term effects.

[Transurethral resection of the prostate. Our experience in a series of 244 cases. Mid-term results]. / La résection trans-urétrale de la prostate. Notre expérience sur une série de deux cent quarante-quatre cas. Résultats à moyen terme.

Two hundred and forty four patients were treated by transurethral resection of the prostate (68% for adenomas and 32% for epitheliomas) between June 1980 and August 1982. The indications for surgery are based on obstruction of the urinary outflow tract, and the weight of prostatic tissue, which can best be assessed by ultrasound. TURP is the technique of choice for small and medium-size prostates. Hemorrhage is the most frequent complication at operation. Resorption TURP syndrome is extremely rare if an isotonic liquid is used. Urinary tract infections are best treated preoperatively. 2.6% of the patients suffered from urethral stricture despite the use of a 24 French resectoscope and early removal of the catheter. The greater the surgeon's experience, the lower the incidence of definitive urinary incontinence.

[Our experience with the treatment of urethral stenosis in a series of 90 cases at the Strasbourg Hospital Center]. / Notre expérience du traitement de la sténose de l'urètre sur une série de quatre-vingt-dix cas au Centre Hospitalier de Strasbourg.

Ninety patients presenting with urethral stenosis were treated surgically at the Strasbourg Hospital, involving 100 internal urethrotomies and sixteen urethroplasties. The authors consider that short bulbous stenosis, with no previous treatment, should be treated endoscopically; that, if the stenosis recurs after two internal urethrotomies, or if the stenosis is infected or located in the pendulous or membranous urethra, a urethroplasty is indicated, as in cases of long bulbous stenosis; and that, even though the rate of complications is high following Johansson's urethroplasty, this procedure is indicated in cases of infection. The use of free full-thickness grafts led to a 100% success rate.

[Late urological complications of abdominopelvic radiotherapy. A personal series of 39 cases (author's transl)]. / Les complications urologiques tardives de l'irradiation abdomino-pelvienne. A propos d'une série personnelle de 39 cas.

The authors study 39 cases of late genitourinary sequelae following abdominopelvic radiotherapy. Several points appear to be of interest: - the mean latent period was 3.5 years for bladder sequelae and 4 years for ureteric complications. Fistulae could develop on average 14 years after radiotherapy; - the possibility of ureteric complications in the form of stenosis after radiotherapy, exclusive of associated surgery; - all lesions were purely due to radiation, excluding recurrences of neoplasm; - bladder complications had striking symptoms with dysuria and haematuria. Ureteric stenosis was sometimes found by chance, being latent; - associated digestive tract radiation lesions were seen in 1 case in 4; - the frequent need for surgery, since this was required in 30 patients out of 39. The operations performed were often extensive; - the grave nature of surgical operations including a digestive phase in these patients who had received large doses of radiation. Peritonitis due to the breakdown of sutures was a notable source of mortality; - one of the great difficulties in investigating such patients is to be able to confirm the purely radiation aetiology of these complications, bearing in mind that amongst urological complications following the treatment of pelvic carcinomas, the majority are related not only to radiation but also to recurrence of neoplasm.