[Long-term results of the treatment of urinary incontinence with bulbar implantation of artificial urinary sphincter in men: a single-center experience]. / Résultats à long terme du traitement de l'incontinence urinaire masculine par implantation de sphincter artificiel urinaire (AMS 800) en position bulbaire: expérience monocentrique.

OBJECTIVE: To report the functional results and morbidity after implantation of bulbar artificial urinary sphincter (AUS) in incontinent men with at least 5 years of follow-up. PATIENTS AND METHODS: The files of patients treated between 1984 and 2003 by setting up a SAU at bulbar location were reviewed. The following data were recorded: age, etiology of incontinence, intra-operative complications. To evaluate the results on continence, patients were seen at 1, 3, 6 and 12 months, and yearly thereafter. RESULTS: Overall, 159 men implanted with an AUS were included. The median age was 68.4 years and the median follow-up was 69 months. The etiology of incontinence was a prostate surgery in 83% of cases. The five-year rates of continence and satisfaction were 74.2% (n=118) and 92% (n=140), respectively. The five-year rates of infections and erosions were 4.4% and 9.4%, respectively. In case of previous radiotherapy, the rate of erosion at 5 years was 22.2%. The rate of atrophy and urethral mechanical failure at 5 years was 7.5% and 23.6%, respectively. The rate of reoperation at 5 years was 41.5%. CONCLUSION: Our results confirm that the AUS is still the standard treatment for male with urinary incontinence due to intrinsic sphincter deficiency. Minimally invasive therapies are being developed that could overcome the mechanical failures and offer an alternative in case of primary or even secondary failure of the AUS.

[Treatment of benign prostatic hyperplasia by radiofrequency (TUNA): a monocentric study of 28 cases treated in ambulatory surgery]. / Traitement de l'hypertrophie bénigne de prostate par radiofréquence (TUNA) : étude monocentrique à propos de 28 cas traités en chirurgie ambulatoire.

AIM: To assess the feasibility of ambulatory surgery in the treatment of benign prostatic hyperplasia using radio frequency (TUNA) and evaluate its place in terms of efficiency among other minimally invasive surgical techniques. METHOD: Fifty-four patients suffering from benign prostatic hyperplasia and for whom medical treatment was ineffective, were treated with radio frequency between September 2004 and June 2007. Among them, 28 patients, whose average age was 65.8 (aged 52-82), were selected for Transurethral Needle Ablation (TUNA) as outpatients. Urine status was assessed before and after TUNA treatment using the International Prostate Score System, the Quality Of Life-score to urinary symptoms, the measures of the maximal flow rate and of the residual urine. The erectile function was assessed using the five-item version of the International Index of Erectile Function (IIEF-5). RESULTS: With an average regression of 12.14 months, a significant improvement in urine status was observed with an average IPSS score passing from 22.4 to 9.75 and an average quality of life score passing from 4.9 to 1.9. The maximum flow rate and average flow volume increased significantly from 8.66 to 14.6 ml/s and from 202 to 248.4 ml respectively. Average urine residue was reduced from 177.4 to 112.2 ml (p<0.05). The IIEF-5 score did not increase significantly (14.1 versus 12.8). There were no cases of patients being rehospitalised. One case of prostatitis and six cases of acute urinary retention were observed at the postoperative stage. The rate of retreat was 21.4%. CONCLUSION: TUNA treatment is a minimally invasive technique of benign prostatic hyperplasia which can be carried out in ambulatory surgery and which is effective for urinary symptoms with little risk of morbidity. It is an alternative to medical treatment and does not replace planned surgical treatment.

[Mycotic aneurysm and renal transplant. A case report]. / Anévrisme mycotique et transplantation rénale. A propos d'un cas.

The arterial aneurysm secondary to Candida is a rare but frightening complication of renal transplant. We report the case of a 58-year-old patient who developed an arterial aneurysm secondary to a Candida infection in 3 weeks of a third renal transplant. Candida albicans was isolated from the preservation solution. The treatment consisted of a transplant nephrectomy, aneurysm excision and an iliac bypass with cryopreserved iliac homograft. All of bacteriologic culture was positive for Candida. The positive bacteriologic culture for Candida in preservation solution requires antifongic treatment. In case of arterial aneurysm, a surgical treatment is necessary but majority of kidney transplant had to be removed.