Intermittent catheterization: Clinical practice guidelines from Association Française d'Urologie (AFU), Groupe de Neuro-urologie de Langue Française (GENULF), Société Française de Médecine Physique et de Réadaptation (SOFMER) and Société Interdisciplinaire Francophone d'UroDynamique et de Pelvi-Périnéologie (SIFUD-PP).

INTRODUCTION: Our objective was to provide guidelines covering all aspects of intermittent catheterisation (intermittent self-catheterisation and third-party intermittent catheterisation). MATERIALS AND METHODS: A systematic review of the literature based on Pubmed, Embase, Google scholar was initiated in December 2014 and updated in April 2019. Given the lack of robust data and the numerous unresolved controversial issues, guidelines were established based on the formal consensus of experts from steering, scoring and review panels. RESULTS: This allowed the formulation of 78 guidelines, extending from guidelines on indications for intermittent catheterisation, modalities for training and implementation, choice of equipment, management of bacteriuria and urinary tract infections, to the implementation of intermittent catheterisation in paediatric, geriatric populations, benign prostatic hyperplasia patients and continent urinary diversion patients with a cutaneous reservoir as well as other complications. These guidelines are pertinent to both intermittent self-catheterisation and third-party intermittent catheterisation. CONCLUSION: These are the first comprehensive guidelines specifically aimed at intermittent catheterisation and extend to all aspects of intermittent catheterisation. They assist in the clinical decision-making process, specifically in relation to indications and modalities of intermittent catheterisation options. These guidelines are intended for urologists, gynaecologists, geriatricians, paediatricians, neurologists, physical and rehabilitation physicians, general practitioners and other health professionals including nurses, carers….

[Surgery, radiotherapy or hormonal therapy in the treatment of prostate cancer]. / Chirurgie, radiothérapie ou hormonothérapie dans le traitement du cancer de la prostate.

Prostatic cancer (PC) became the first diagnosed cancer in western men and is the second leading cause of cancer death in men. Wide utilisation of serum PSA and free PSA measurements, identifies patients requiring transrectalultrasonography (TRUS) and TRUS guided biopsies. Most prostatic cancers diagnosed today are locally limited and may be treated by radical surgery or radiotherapy. In case of disseminated disease, hormonal manipulations remain the treatment of choice. In that field, many new drugs have been designed to allow medical castration with less complications, especially regarding sexual potency.

[Antegrade scrotal embolization of varicocele: results]. / L'embolisation scrotale antegrade de la varicocele--résultats.

The aim of this study is to judge the effectiveness of the new treatment of varicoceles, introduced in 1987 by Tauber: the antegradal scrotal sclerotherapy of varicoceles. From february 1996 to april 1998, we have realised 150 antegrade embolisations of varicoceles. The study is lead on 75 patients with mean time follow-up of 12 months. Patient's mean age is 20 years. 85% of patients had a grade 3 left varicocele and 15% a grade 2 left varicocele. The criterium of success rests on the lack of veinous flow-back during clinical examination, which is than confirmed by doppler-ultrasound. Clinical success is obtained in 87% of the cases and the doppler control is normal in 80% of the cases. We have 9% of minor complications, and no major complication. The number of failures in our study is higher than in Tauber' study, but is the same as those described in the other procedures of treatment of varicocele. On the other hand the surgical procedure is simple and the morbidity is low.

Uretero-arterial fistula: two observations.

Two cases of life-threatening haematuria, secondary to an uretero-arterial fistula, are reported. Both cases present predisposing causative factors. One patient had a combination of previous aorto-bifemoral bypass grafting, an iliac artery aneurysm (retrogradely perfused), and an indwelling ureteral stent for ureteral compression. The other patient had previous aortoiliac surgery and obstructive uropathy with chronic urinary tract infection. Preoperative diagnosis of uretero-arterial fistula was made in only one patient. He was successfully operated (exclusion of the iliac aneurysm). In the other patient, nephrectomy was attempted to control reno-ureteral bleeding of unknown origin. Fatal recidive of brisk haematuria occurred some days later. Factors contributing to the development of uretero-arterial fistula, their diagnosis and optimal treatment are discussed.

[Recurrent urethral stenosis treated with a Urolome Plus stent implantation: intermediate multicenter follow-up]. / Sténose urétrale récidivante traitée par implantation d'un stent Urolume Plus: suivi multicentrique à moyen terme.

We present the medium-term results of 33 patients treated with Urolume Plus urethral stent between August 1990 and June 1996 in 9 Belgian and Luxembourg centers. They all had previous treatments for bulbo-membranous urethral stricture, but without sustained benefit (dilatation, internal urethrotomy, or/and urethroplasty). The mean age of the stricture was 5.4 years (+/- 4). The stent was inserted easily during a short hospitalisation. Median time of follow-up is two years (6 months to 4 years). Maximum flow rate at last follow-up was 20.7 ml/sec (+/- 7), and 83.3% of the patients were satisfied with the stent. In 70% of the cases, the stent achieved its purpose of maintaining a good urethral lumen. In 5 patients (15.15%), stricture recurred inside the stent and in 2 patients (6.06%) a new stricture appeared on another site. Among these 7 patients, 5 were satisfactorily treated by endoluminal resection (4 cases) or dilatation (1 case). There were 2 real failures (= 6%): one patient who has refused any complementary endoscopic treatment and the other one who is still undergoing repeated urethral dilatations. Having respected the right indications for this device, we are satisfied of the results. It is a good alternative after failure of other treatments for bulbar-membranous stricture.

Protease inhibitors of Manduca sexta expressed in transgenic cotton.

To explore the effectiveness of insect derived protease inhibitors in protecting plants against insect feeding, anti-trypsin, anti-chymotrypsin and anti-elastase protease inhibitor (PI) genes from Manduca sexta L. were expressed in transgenic cotton (Gossypium hirsutum L.). From 198 independent transformants, 35 elite lines were further analyzed. Under the control of the 35S promoter of CaMV, PI accumulated to approximately 0.1% of total protein, depending on the tissue analyzed. Using cell-flow cytometry, DNA content/ nuclei of transgenic and non-transformed cotton were identical. On cotton plants expressing PIs, fecundity of Bemisia tabaci (Genn.), the sweetpotato whitefly, was reduced compared to controls. Expression of these protease inhibitors may reduce the developmental rate of B. tabaci and other insects, and provide a strategy for cotton protection.

Phenazine antibiotic biosynthesis in Pseudomonas aureofaciens 30-84 is regulated by PhzR in response to cell density.

We have identified a gene that acts in trans to activate the expression of the phenazine biosynthetic genes in the biological control organism Pseudomonas aureofaciens 30-84. This gene, phzR (phenazine regulator), is located upstream of and divergently transcribed from the phenazine biosynthetic genes. Thus, the phenazine biosynthetic locus consists of at least two divergently transcribed operons. A functional phzR gene is required for phenazine production. The nucleotide sequence of phzR revealed an open reading frame of 723 nucleotides encoding a protein of ca. 27 kDa. The predicted amino acid sequence of PhzR has homology with other bacterial positive transcriptional activators, including LasR of Pseudomonas aeruginosa, LuxR of Vibrio fischerii, and TraR of Agrobacterium tumefaciens. The addition of cell-free supernatants from late-exponential-phase cultures of strain 30-84 resulted in expression of a genomic phzB:lacZ reporter strain at a lower cell density than normal, indicating the possible presence of an autoinducer. These results indicate that PhzR is a member of a two-component sensor-regulator family with known or predicted carboxy-terminal DNA-binding domains which regulates gene expression in response to environmental and cell density signals.