[Problems in the clinical evaluation of an endoscopic lithotripter. The case of the Lithoclast EMS]. / Les problèmes de l'évaluation clinique d'un lithotripteur endoscopique. Le cas du Lithoclast EMS.

The rapid appearance of various clever and efficient techniques for fragmenting urinary stones in the past 10 years, and their often combined use, makes an objective evaluation of an intracorporeal lithotripter impossible since the criss-cross of the factors to be considered is very important in the literature. Two University Hospitals, one in France (Paris), the other in Germany (Bochum-Herne) have agreed upon a common protocolic, making a coherent and numeral evaluation possible, derived from two different and independent spheres. After a methodological introduction, the results of the research concerning the EMS Lithoclast are reported.

The Swiss Lithoclast: a new device for endoscopic stone disintegration.

Even in the presence of extracorporeal shock wave lithotripsy there is still the need for endourological treatment of stones in the urinary tract. Stone fragmentation usually is achieved with either ultrasonic, electrohydraulic or laser lithotripsy. We report our early experience with a new, simply constructed machine at a reasonable cost for endoscopic stone disintegration--the Swiss Lithoclast. The principle of this lithotriptor is based on pneumatic shock waves induced by the central compressed air system of a hospital or by a compressor. This device was used to treat 151 patients with stones in the kidney, ureter, bladder or a Kock pouch continent urinary diversion. Endoscopic fragmentation was successful in all patients. Independent of the composition, all stones were disintegrated within a short period, indicating that the device may well represent an attractive alternative to standard endoscopic lithotriptors.

[First clinical evaluation of the CHUV ballistic lithoclast]. / Première évaluation clinique du lithoclaste CHUV à énergie balistique.

The authors present the first clinical evaluation of the ballistic lithoclast CHUV based upon results of 55 treated patients. Their conclusion is that the lithoclast CHUV is a simple, reliable, easy to use, efficient and patient-friendly machine.

[First clinical results using a pulsed dye laser Rhodamine 590 lithotripter in treatment of ureteral calculi]. / Premiers résultats cliniques de l'utilisation d'un lithotriteur laser à colorant pulsé Rhodamine 590 dans le traitement des calculs de l'uretère.

A collaborative study about a pulsed dye laser Rhodamin 590 was undergone, 2 years ago, between the laser application center of EPFL and both urological departments of the university of Geneva and the university of Lausanne. First clinical results are presented. Ten patients have been treated for various ureteral stones, mainly calcium oxalate stones. Laser fragmentation was successful in seven cases. No serious complication was noted. Fragmentation efficiency seems better with a 320 microns fiber than with a 200 microns fiber.

[Preoperative or palliative embolization of renal tumors]. / Embolisation préoperatoire ou palliative des tumeurs rénales.

This study evaluates our experience of renal preoperative or palliative embolization in 72 patients with a localized renal carcinoma or a metastatic disease. Angio-infarction of a renal malignant neoplasm is a helpful procedure to reduce the tumoral vascularization before an operation and to palliate symptoms and paraneoplastic syndromes of a metastatic disease with a very low morbidity.

[Brief intracavitary radiation (137 cesium) of the prostatic site in localized cancer of the prostate: preliminary results after 9 years]. / L'irradiation endocavitaire brève (césium 137) de la loge prostatique dans le cancer localisé de la prostate: résultats préliminaires après 9 ans.

Incidental detection of an adenocarcinoma's microscopic focus inside a piece of adenoma or TURP-chips is not rare. Generally, these hidden or "latent" carcinomas without any clinical event, are staged T0 (UICC) or stage A (Whitmore). In reviews, we can find justification of two contrasting attitudes: radical prostatectomy or therapeutic abstention. For the last nine years, we have proposed a third method: endocavitary curietherapy by 137 Cs of prostatic lodge, whose first results, in terms of morbidity and mortality, are discussed.

The morphological basis for the Polster theory of penile vascular regulation.

The discovery of the papaverine erection test by Virag in 1982 stimulated the interest of research workers in the physiology of the penis. Since then, the scheme of functioning proposed by Conti [Acta anat. 14:217-262, 1952] in 1952 has been frequently cited in the literature, although its finalism is evident. It is based upon the presence of regulatory mechanisms along penile arteries, veins and arteriovenous anastomoses. In spite of the fact that these anastomoses were unanimously admitted, recently the presence of arterial and venous cushions has been controverted or even denied. Before attempting any functional explanation using nerves and chemical mediators, we made sure first of the concrete material reality of these anatomical structures. Thirty-five years after the main study, the present observations confirm the morphologic descriptions made in 1952. The contrary would have been astonishing. In fact, arterial and venous cushions were demonstrated by the School of Anatomy of Padova, the most ancient and venerable of all (Fallope, 1550), then by other institutes of morphology that dealt with these cushions in practically all the organs of the human body. It remains to establish their role in erection - whether it is null, complementary or primordial: that is the question.

Long-term oral treatment of urinary tract infections with single daily doses of a new antibacterial drug combination (Kelfiprim).

Of 30 patients with severe, complicated U.T.I. 27 have been given single daily doses of Kelfiprim (KP), a new sulfatrimethoprim combination, for 8 weeks. In 24 bacteriuria was lastingly controlled, one had a relapse, one had a reinfection, and in one, with bladder carcinoma, bacteriuria persisted. Three other patients received KP for shorter periods, as they presented gastric intolerance or skin hypersensitivity, but in two of them a lasting sterilization of the urine has been obtained. The usefulness of a single daily dose schedule is stressed.

[Urethral complications of severe fractures of the pelvis. (author's transl)]. / Les complications urinaires des fractures graves du bassin.

Between 1975 and 1979, 282 fractures of the pelvis were treated in Centre Hospitalier Universitaire Vaudois' sixty-eight of these patients sustained severe fractures, with two or more rupture of the pelvic ring. Twenty-eight patients presented with hematuria (microscopic or macroscopic) and five others with urethral bleeding. Urethral bleeding is even more serious; in the present study, it was always associated with urethral rupture. These cases are discussed; mechanism, diagnosis and treatment of these injuries are described.

[Subclinical varicocele: detection using Doppler and thermography]. / Varicocéle subclinique: détection par Doppler et thermographie.

We think that we must find out a varicocele in every case of oligospermia, asthenospermia and teratospermia, particularly with spindle-shaped spermatozoa. If the clinical examination remains negative, it is necessary to provoke a backflow at the Doppler by carrying out a Valsalva's maneuver. If the obtained result is positive, we must then make a high ligature on the left vena spermatica. It seems that the bursae thermography has a prognostic value on the spermogramme's evolution following a subclinical varicocele cure.