[Post-traumatic priapism in a 11 year-old child]. / Priapisme post-traumatique chez un enfant de 11 ans.

We report on the case of a post-traumatic priapism in an 11-year-old boy. The clinical features and pathophysiological data showed that it was a high flow form with normal venous outflow; such a condition is very uncommon in the literature. Surgery aimed to perform a spongiocavernosal shunt and allowed recovery.

[The Devine urethroplasty. Our experiences apropos of 18 cases]. / L'urétroplastie selon Devine. Notre expérience à propos de dix-huit observations.

Our experience with a 1-stage procedure using free patch graft for correction or urethral stricture is reported. Eighteen cases of urethral stricture have been treated. Fourteen of the 18 cases (77%) had a good result. The follow up is more than 5 years. This procedure is recommended with considerable enthusiasm.

[Vascularization of a pedicled flap intended for the urethra]. / Etude de la vascularisation des lambeaux pédiculés à destinée urétrale.

One stage urethroplasties using a cutaneous island pedicle flap have been described by Quartey, Orandi, Marberger, Gattegno and Blandy. Anatomical study after colored injection and dissection shows, for each of them, a good blood supply from large anastomoses between the internal and external pudendal arteries. The pedicle is very well individualized on Quartey's flap.

[The enigma of varicocele in children]. / Les énigmes de la varicocèle de l'enfant.

After a review of the literature and their own experience, the authors relate the various dilemmas of infantile varicocele. These dilemmas are diagnostic and therapeutic. On the basis of clinical, epidemiological, etiological and pathological studies, the authors conclude that grade III and grade II varicoceles associated with testicular hypotrophy must be operated, while the others must be followed.

[The value of mobilization of the prostatic region via perineal approach in the treatment of ruptures and stenoses of the posterior urethra]. / Intérêt de la mobilisation du bloc prostatique par voie périnéale dans le traitement des ruptures et sténoses de l'urètre postérieur.

UNLABELLED: 11 cases of end to end anastomosis associated with the mobilization of the prostate is reported. The authors use only the perineal access. The operation is utilised in two circumstances: injuries or traumatic strictures to the membranous urethra. 4 ruptured prostato-membranous urethras with 4 good results. 7 stenosis with 5 good results. 2 recurrences which one of them had a good result with a simple urethrotomy. Complication: no incontinence. 2 cases of impotence are noted. One of them had recovered, the other is secondary of the pelvic fracture. Follow up: mean 3 years (6 months-5 years). CONCLUSION: our experience suggest that the mobilization of the prostate is an excellent aid to end to end anastomosis. This technique permits the only perineal access.

[Value of arterioscopy in the prevention of renal artery stenosis after transplantation]. / Intérêt de l'artérioscopie dans la prévention des sténoses de l'artère rénale après transplantation.

Renal artery stenosis is frequent after transplantation. The systematic pre-operative search for arterial injuries by angioscopy allows a reduction in their incidence. The authors report a series of 60 transplantations with pre-operative angioscopy, which revealed benign injuries and two major injuries which were successfully treated surgically. This prevention allows a reduction in the incidence of stenosis from 12 to 6.6% according to a previous series of 210 transplantations without angioscopy.

[Urology facing the courts. The basis of professional responsibility]. / L'urologue face aux tribunaux. Fondements de la responsabilité professionnelle.

The liability of the urologist can be involved according to 3 procedures: The civil procedure is that of the Tribunal de Grande Instance (High Court) then the Cour d'Appel (Court of Appeal). Financial compensations are claimed from the surgeon for not respecting the medical contact. This contract is tacit, oral and carries obligations for the surgeon. The administrative procedure is that of the Tribunal Administratif (Administrative Court) then the Conseil d'Etat (Council of State). This only concerns the salaried surgeon in his salaried activities. The penal procedure is that of the Tribunal Correctionnel (Criminal Court) then the Cour d'Appel (Court of Appeal). The surgeon is then charged with a crime, usually unintensional injuries or through negligence. Although the harlm is easy to prove, the reality of the fault of the surgeon and the relation between fault and damage are far less so. It is the plaintiff (Civil Course, Administrative Cours) or the State Prosecutor (Penal Course) who must prove the fault and causality by the help of an expert's report. So, the responsibility of the surgeon can be committed. However, the development of the insurance system has allowed more widespread compensation without any fault found on the surgeon's part and increasingly frequent conciliatory procedures.

[Internal urethrotomy with endoscopic resection of the callus. 32 cases with a follow-up exceeding 5 years]. / Urétrotomie interne avec résection endoscopique du callus. Trente-deux cas avec recul supérieur à cinq ans.

Thirty-two patients were operated for urethral stricture by internal urethrotomy with endoscopic resection of the callus. Complications consisted of one urethral perforation, one urethral haemorrhage and one case of acute epididymitis. With a follow-up of 5 to 15 years, the authors obtained 85% of good results for strictures less than 1.5 cm long. The success rate was 66% for strictures between 1.5 and 2 cm. The recurrence rate was high for strictures longer than 2 cm (75%). The indications for this technique therefore depend more on the length of the stricture than on its cause or its site. Lastly, endoscopic resection of the callus improves the results or urethrotomy alone by 15%.