ABSTRACT
Obstetric vesicovaginal fistula is nowadays rare in developed countries. We are reporting two cases of patients with obstetric vesicovaginal fistula that occurred after operative vaginal deliveries performed in a French hospital. Early postpartum symptoms were vaginal urine leakage and infectious syndrome. The fistula has been cured by vaginal surgery one case and combined (laparotomy and vagina surgery) in the other case. Patients were totally healed a few months following the surgery.
Subject(s)
Vesicovaginal Fistula/surgery , Adult , Delivery, Obstetric/adverse effects , Female , France , Humans , Laparotomy/methods , Obesity, Morbid/physiopathology , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/surgery , Treatment Outcome , Urinary Incontinence/diagnosis , Urinary Incontinence/surgery , Vagina/surgery , Vesicovaginal Fistula/diagnosis , Vesicovaginal Fistula/microbiologyABSTRACT
INTRODUCTION: The pelvic lymph nodes dissection (PLND) is indicated in case of prostate cancer with high risk of ganglionic metastasis. Criteria admitted for indication of PLND are PSA>or=10ng/ml and/or Gleason score >or=7. Two techniques are available for PLND: minilap and laparoscopy. The purpose of this study was to compare retrospectively minilap and the 2 ways of laparoscopy: intra- and extraperitoneum, in terms of efficiency and complications. MATERIAL AND METHOD: We reviewed 147 cases of men who's had a PLND in our department between 1992 and 2006. The distribution for every technique was: 34 cases of minilap (23%), 39 cases of intraperitoneum laparoscopy (27%) and 74 cases of extraperitoneum laparoscopy (50%). The mean age was of 67.9 years (52-79). The mean PSA was 19.01ng/ml (0.3-93) and the average Body Mass Index (BMI) was 26.75kgm(-2) (17.6-41). RESULTS: Twenty-eight patients (19%) presented a postoperating complication. There was no statistically significant difference according to technique. We did not either find statistical difference concerning the number of analyzed nodes between three groups and the duration of hospitalization. Only the mean operating time and the number of drain of Redon were statistically different. CONCLUSION: This study did not show any difference in terms of result and complications between the laparoscopy and minilap for the PLND in case of prostate cancer. We think each technique could be proposed.
Subject(s)
Laparoscopy , Lymph Node Excision/instrumentation , Lymph Node Excision/methods , Prostatic Neoplasms/surgery , Aged , Humans , Male , Middle Aged , Pelvis , Retrospective StudiesABSTRACT
OBJECTIVES: Our study aimed at evaluating, retrospectively, the outcome of the surgical management of urinary tract endometriosis. PATIENTS AND METHODS: Twelve women with a mean age of 36,4 were recruited between 1994 and 2007. They all had a histologically-proven and surgically-treated endometriosis of the urinary tract. RESULTS: Seven of them had a unilateral ureteric localization, two had a bilateral ureteric localization and three had a vesical localization. One patient with bladder nodules underwent a partial cystectomy and the two other patients with bladder localization underwent a transurethral resection. Out of the nine patients who had a ureteric localization of endometriosis, seven had a ureterectomy and re-implantation with bladder psoas hitching and had no recurrence. CONCLUSIONS: Our experience showed that ureterectomy and re-implantation with bladder psoas hitching is probably the best way of preventing recurrences in the case of urethral endometriosis. In the case of bladder endometriosis, transurethral resection did not appear as the most effective treatment although it remains an acceptable alternative, especially as far as premenopausal women or young women wishing to conceive are concerned.
Subject(s)
Endometriosis/surgery , Ureteral Diseases/surgery , Urinary Bladder Diseases/surgery , Adult , Female , Humans , Recurrence , Retrospective StudiesABSTRACT
OBJECTIVE: We compared the incidence of the Urinary Tract Infection between a single preoperative dose and a three-day antibiotic prophylaxis regimen for transrectal ultrasound guided biopsy in randomized multicenter trial. MATERIAL AND METHODS: Between February 2006 and December 2007, 322 men who underwent transrectal ultrasound-guided prostate biopsy were included in a multicentre prospective randomised study. Patients received antibiotic prophylaxis by ciprofloxacin orally, either 1g single dose two hours before the biopsy (Group 1: n=139) or a prolonged prophylaxis for three days (Group 2: n=149). Assessment five days before and five days following the biopsy included a clinical examination, biological tests and a self-questionnaire. RESULTS: Two patients developed prostatitis, one in each group: 0.75% of the first group, 0.69% of the second. Twelve developed asymptomatic bacteriuria, six in each group: 4.51% of the first group and 4.19% of the second. There was no significant difference between the two groups (Fisher test; p>0.9). CONCLUSIONS: There was no significant difference between the two antibiotic prophylaxis regimen (one single dose or three days) for patients undergoing TRUS guided biopsies. Therefore, the single preoperative dose should be the preferred option.
