[Does the urologist in formation have a burnout syndrome? Evaluation by Maslach Burnout Inventory (MBI)]. / Les urologues en formation ont-ils un syndrome d'épuisement professionnel ? Évaluation par le Maslach Burn-out Inventory (MBI).

OBJECTIVES: To assess the burn-out syndrome in the population of urologists in training. MATERIAL AND METHODS: A trans-sectional study was carried out among the French urologists in training association (AFUF) members. A questionnaire including the Maslach Burnout Inventory and questions on the age, gender, professional and familial status, working time and hobbies was emailed. RESULTS: The response rate was 65.5 %. Mean burn-out, emotional exhaustion and depersonalization scores were 15.57 ± 8.55 (low burn-out), 8.56 ± 5.52 (moderate burn-out) and 37.19 ± 6.21 (moderate burn-out), respectively. Forty-five (24 %) had a severe burn-out syndrome, 11 an emotional exhaustion and 41 a depersonalization. Urologists in couple had a significant lower emotional exhaustion level than single. Depersonalization and low personal accomplishment scores were related to the age and working time. Having at least one hobby prevented emotional exhaustion and improved personal accomplishment levels. Gender had no impact on burn-out syndrome. CONCLUSION: Quarter of French urologists in training had a burn-out syndrome. Factors preventing it were working time reduction, being in couple and having at least one hobby. burn-out syndrome severity decreased with age and senior status.

[Ureteral stenosis after renal transplantation: Risk factors and impact on survival]. / Sténoses urétérales après transplantation rénale : facteurs de risque et impact sur la survie.

OBJECTIVES: To identify the risk factors for ureteral stenosis after renal transplantation and to evaluate their impact on both graft and patient survival. PATIENTS AND METHODS: This retrospective study included 789 kidney transplants among 782 patients performed at our institution between 1995 and 2007. The parameters studied included the characteristics of the donor, recipient and transplant, the surgical variables, the elements of the monitoring process and a graft and patient survival. RESULTS: The ureteral stenosis rate after renal transplantation was found to be 6.5%, and the ureterovesical junction was the most common location (68%). A univariate analysis showed that this complication was significantly associated with a higher donor age (P=0.01), abnormal graft revascularisation (P=0.032) and DGF (Delay Graft Function) (P=0.05). In multivariate analysis, only donor age (P=0.001) and abnormal graft revascularisation (P=0.035) were independent risk factors for ureteral stenosis after renal transplantation. When ureteral stenosis was treated, an analysis of the survival curves according to the Kaplan-Meier method did not reveal significant differences either in graft survival (P=0.518) or overall survival of the patients (P=0.614) as compared to the control group. CONCLUSIONS: In the present study, donor age and abnormal graft revascularisation were independent risk factors for ureteral stenosis after renal transplantation. This result is a strong argument for an ischemic component in the genesis of ureteral stenosis after renal transplantation, which should help to identify patients at risk.

Is urine culture routinely necessary before prostate biopsy?

The objective of this study was to assess the value of a urine bacterial culture performed before prostate biopsy. We performed a prospective study on 353 patients who underwent prostate biopsy. All patients had a urine bacterial culture performed before biopsy. We compared the outcomes of patients with bacteriuria (left untreated) with those of patients without bacteriuria. Of the 353 men, 12 had a pre-biopsy-positive bacterial culture and underwent prostate biopsy without any infectious complication. Fifteen patients with a negative pre-biopsy culture developed a post-biopsy-positive bacterial culture, but remained asymptomatic without any treatment. Only four men from the group without pre-biopsy bacteriuria developed an infectious complication, requiring 3 weeks of antibiotic therapy. The complication rates were similar for both groups. Our results suggest that routine urine bacterial culture before prostate biopsy is not useful when antibiotic prophylaxis and enema are performed. We do, however, suggest performing a urine bacterial culture before prostate biopsy for patients with a previous history of urinary tract infections.