[Right obstructive pyelonephritis due to supra-piriform herniation of the pelvic ureter: a clinical case]. / Pyélonéphrite obstructive droite par étranglement herniaire supra-piriforme de l'uretère pelvien: cas clinique.

Ureteric herniations are extremely rare. We are reporting the case of a 57-year-old female presenting with an upper urinary tract sepsis due to a pelvic ureteral herniation into the supra-piriform sciatic foramen. The diagnosis was made by the CT scan and the treatment was performed in two steps: first the upper urinary tract was drained, and then the hernia was surgically treated. Although ureteral hernias are exceptional causes for nephritic colic, urologists must be aware of the specificity of the diagnosis and of the treatment in order to avoid complications.

Robotic-assisted laparoendoscopic single-site surgery (R-LESS) in urology: an evidence-based analysis.

The objective of this manuscript is to provide an evidence-based analysis of the current status and future perspectives of robotic laparoendoscopic single-site surgery (R-LESS). A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). All clinical and investigative reports for robotic LESS and NOTES procedures in the urological literature have been considered. A significant number of clinical urological procedures have been successfully completed utilizing R-LESS procedures. The available experience is limited to referral centers, where the case volume is sufficient to help overcome the challenges and learning curve of LESS surgery. The robotic interface remains the best fit for LESS procedures but its mode of use continues to evolve in attempts to improve surgical technique. We stand today at the dawn of R-LESS surgery, but this approach may well become the standard of care in the near future. Further technological development is needed to allow widespread adoption of the technique.

Prolonged outbreak of B meningococcal disease in the Seine-Maritime department, France, January 2003 to June 2005.

Between January 2003 and June 2005, an outbreak of meningococcal disease occurred in the department of Seine-Maritime in northern France. Eighty six cases were notified, giving an average annual incidence of 2.7 cases per 100,000 inhabitants, compared with 1.6 in France. An especially affected area was defined as the city of Dieppe and its surrounding area (26 cases, giving an annual incidence of 12 cases per 100,000). This outbreak was due to N. meningitidis phenotype B:14:P1.7,16 belonging to the clonal complex ST-32/ET-5. Over the 31 B14:P1.7,16 cases confirmed by phenotyping methods at the national reference centre for meningococci (CNR, Centre National de Reference des meningocoques) the case-fatality rate (19%) and the proportion of purpura fulminans (42%) were especially high. Teenagers aged between 15 and 19 years and children aged 1 to 9 years were the most affected. In 2003, health authorities put in place enhanced epidemiological surveillance and informed practitioners and population about the disease. In 2004, the national vaccination advisory board studied the opportunity of using a non licensed outer membrane vesicle vaccine developed in Norway which may be effective against the B14:P1.7,16 strain. The Ministry of health decided in 2006 to offer vaccination with this vaccine to people aged 1 to 19 years in Seine-Maritime.

Prolonged outbreak of B meningococcal disease in the Seine-Maritime department, France, January 2003 to June 2005.

Between January 2003 and June 2005, an outbreak of meningococcal disease occured in the department of Seine-Maritime in northern France. Eighty six cases were notified, giving an average annual incidence of 2.7 cases per 100 000 inhabitants, compared with 1.6 in France. An especially affected area was defined as the city of Dieppe and its surrounding area (26 cases, giving an annual incidence of 12 cases per 100 000). This outbreak was due to N. meningitidis phenotype B:14:P1.7,16 belonging to the clonal complex ST-32/ET-5. Over the 31 B14:P1.7,16 cases confirmed by phenotyping methods at the national reference centre for meningococci (CNR, Centre National de Référence des méningocoques) the case-fatality rate (19%) and the proportion of purpura fulminans (42%) were especially high. Teenagers aged between 15 and 19 years and children aged 1 to 9 years were the most affected. In 2003, health authorities put in place enhanced epidemiological surveillance and informed practitioners and population about the disease. In 2004, the national vaccination advisory board studied the opportunity of using a non licensed outer membrane vesicle vaccine developed in Norway which may be effective against the B14:P1.7,16 strain. The Ministry of health decided in 2006 to offer vaccination with this vaccine to people aged 1 to 19 years in Seine- Maritime.