Double pigtail ureteral stent in pediatric urology.

We used a double pigtail ureteral stent in 16 children (aged 15 days to 13 years). Indications included: pyeloplasty (12 cases with 2 anastomotic leakages and 1 acute post-operative renal retention), renal trauma (1 case), difficult ureterocystoneostomy (1 case), urinary ascites (1 case), and abdominal tumor compression (1 case). This drainage procedure provides a useful alternative to an external tube diversion (standard ureteral stent or nephrostomy). In pediatric urology, the double stent offers the advantages of exceptional patient tolerance, drainage security and efficiency, and short hospital stay. In our experience, stents were removed on an out-patient basis under general anesthesia but non-endoscopic removal will be possible when smaller magnetic retrievers become available in the urologic armamentarium.

[Internal urinary drainage by double J stent in pediatric urology]. / Le drainage urinaire interne par sonde double J en urologie pédiatrique.

We used double pigtail ureteral stent in 16 children (aged 15 days to 13 years old). Indications included: pyeloplasty (12 cases with 2 anastomotic leakages and 1 acute postoperative renal retention), renal trauma (1 case), difficult ureterocystoneostomy (1 case), urinary ascites (1 case), and abdominal tumor compression (1 case). This drainage procedure provides a useful alternative to an external tube diversion (standard ureteral stent or nephrostomy). In pediatric urology, the double pigtail stent offers the advantages of exceptional patient tolerance, drainage security and efficiency, and short hospital stay. In our experience, stents were removed in an outpatient basis under general anesthesia but non endoscopic removal will be possible when smaller magnetic retrievers become available in urologic armamentarium.

[Posterior epispadias with unknown complete duplicated urethra]. / Epispadias postérieur avec duplicité uréthrale complète méconnue.

The authors report a case of posterior epispadias associated with complete ventral urethra only discovered during the urethroplasty phase of the operation. This malformation is a rare form of urethral duplication and should be considered in any case of apparently isolated posterior epispadias.

Renal oncocytoma in a child.

Oncocytoma is an exceptionally rare renal tumor in children. We report on one case of a twelve-year-old girl treated by nephrectomy.

[The possibilities of endoscopy in the treatment of various childhood ureteroceles. Apropos of a case]. / Possibilités de la voie endoscopique dans le traitement de certaines urétérocèles infantiles. A propos d'une observation.

A case is reported of a large left ureterocele in a duplicated system at the expense of the upper renal pelvis. This ureterocele caused acute pyelonephritis and dilatation of both left systems. It was treated by a classic endoscopic incision of its roof but 18 months later, infecting vesico-renal, grade 2, reflux was developed. This secondary reflux was treated successfully by submeatal polytetrafluoroethylene's (Teflon) paste injection. This new combination of endoscopic techniques proved to be available in this case.

'Sting' procedure in the treatment of secondary reflux in children.

The authors present their experience (24 children) with the endoscopic subureteral injection of Teflon paste in the correction of secondary vesicoureteral reflux: reimplantation failure; ureterocele; obstructive bladder; exstrophy; postchemocystitis, and Hutch's diverticulum. Of these 24 cases (31 refluxing ureters), 18 were treated with success. Each cause justifies a comment on the particularities of its endoscopic treatment. The 'sting' can be particularly attractive to cure secondary reflux, avoiding the difficulties and complications of open surgical reimplantation.

[Urachal pathology]. / La pathologie de l'ouraque.

Reviewing 5 recent cases, different anatomical and clinical forms of partial or complete urachal persistency are described: patent urachus, urachal cyst, urachal sinus and urachal diverticulum. The risk of late malignant evolution of this embryonic vestige justifies radical surgical removal at time of diagnosis.

[Comparative characteristics of the course of upper obstructive uropathies diagnosed during the perinatal period]. / Caractères évolutifs comparés des uropathies obstructives hautes dépistées en période périnatale.

This study compares two groups of 30 infants each, less than 1 month old. The first group includes neonates with ureteropelvic junction obstruction (UPJO) and the second with primary obstructed megaureter without reflux (POM). Diagnosis was made prenatally in 80% of UPJO and 64% of POM. 19 infants with UPJO and 24 with POM no required immediate surgery but have been just supervised. Contrary to UPJO, even grade III POM can present spontaneous resolution. Radiographic improvement is seen generally from 3d to 4th++ months. Tc-DTPA renal diuretic scan (10 cases) and percutaneous pyelomanometry (4 cases) are more accurate tests for UPJO than for POM.

[Treatment of vesico-renal reflux in children with endoscopic injection of polytetrafluoroethylene (teflon). Apropos of a series of 100 cases of reflux in 72 children]. / Le traitement du reflux vésico-rénal de l'enfant par injection endoscopique de polytétrafluoroéthylène (teflon). A propos d'une série de 100 reflux chez 72 enfants.

The endoscopic subureteral injection of teflon is a new alternative to correct vesicorenal reflux in children. We report the use of this procedure in 72 children presenting with 100 refluxing ureters. In 98 refluxing units the disappearance of reflux was noted on a cystogram performed immediately (success rate: 98%). Followup after 6 months, the reflux recurred in 6 ureters of 52 controlled units (success rate 88.5%). Obstruction was not observed in any cases by repeated ultrasonography. The procedure is simple and reliable. In a failure that required an open operation, surgical reimplantation was not difficult. An endoscopic technique to cure reflux, of various grades would be a valuable alternative. The procedure certainly has advantages for difficult surgical reimplantations (neurogenic bladder, failed reimplant ureters). However, many years follow up are needed to demonstrate lasting success and absence of complications.

[Initial reduction of the lung volume and capillary escape syndrome in gram negative peritonitis]. / Réduction initiale du bolume pulmonaire et syndrome de fuites capillaires sur péritonite à germes gram-négatifs

Report on a female patient aged 29 with gramnegative bacterial peritonitis due to perforation of a postpyloric ulcer. A reduction of lung volume was observed, followed after 24 h by non cardiogenic interstitial and alveolar edema resulting in severe hypoxemia and hypercapnia with metabolic acidosis for 4 days. Return of gas exchange to physiological values was established prior to the restoration of normal lung volume. The pathophysiological mechanism of these phenomena is discussed.