Surgical treatment of the static perineal modifications in spinal cord or cauda equina lesions.

Severe dysuria, due to insufficiency of the perineal floor associated during micturition with a posterior tilting of the prostate-bladder block in lower or in associated upper and lower motor neuron lesions, can be treated surgically by a prostato cytso pexy. Since 1971, eight patients with post-traumatic conus and/or cauda equina lesions have been treated by this intervention. On the follow-up the satisfactory results appear to remain stable. An alternative surgical technique using the abdominal pyramidalis muscle is described so as to fix the prostate, associated with a bladder-pexy. The recurrence of dysuria, after the intervention, has always been caused by an additional lower urinary tract pathology. The comfort of the patients has been greatly improved.

[The silent kidney. Evolving ultrasonic picture of emphysematous pyelonephritis: the vanishing kidney. Apropos of a case]. / Le rein sourd. Aspect évolutif échographique de la pyélonéphrite emphysémateuse: l'évanescence rénale. A propos d'un cas.

The authors report the progressive disappearing of the sonographical image of a previously visualized kidney in a case of emphysematous pyelonephritis. They have called the sonographic vanishing kidney "the sign of the Deaf Kidney". The non-visualisation of a kidney with advanced emphysematous pyelonephritis is due to the infiltration of the perirenal environment by a gas envelope and the filling of the excretory cavities by gas. The perirenal gas-bag forms a shield against ultrasonic waves. The sonographer must be aware of the eventuality of not being able to individualize a renal structure when wrapped in gas. He must then ask for a zonography of the renal area in order to confirm the gas-containing collection in the kidney.

[Renal obstruction during pregnancy. Internal drainage using the JJ ureteral probe]. / Blocage rénal pendant la grossesse. Drainage interne par sonde urétérale JJ.

The advantage of using JJ ureteral stent during pregnancy in case of ureteral obstruction is shown two clinical observations. We use ultrasonography to control the site of this catheter during the operation and for the follow-up of the patients.

[Invasive cancer of the prostate. Reconstruction of the lower urinary tract by prostatic resection and ureteral reimplantation into the bladder vault]. / Cancers de la prostate invasifs. Rétablissement du bas appareil par résection prostatique et réimplantation des uretères dans le dôme vésical.

Some prostatic cancers (T4) spread out along the ureters to the kidneys. Patients, usually arrive with terminal renal failure and bladder retention and have often fast-advancing cancer with massive nodes invading. T.U.R., reimplantation of the ureters into the bladder dome or into a psoïc bladder and the specific treatment of the cancer, have often permitted these patients to survive for some years without any dialysis. In these cases we often find very important lower limbs oedema. With lymphatic nodes radiotherapy and subcutaneous injections of heparin, these oedema may regress completely.

[Anuria due to bilateral ureteral blockage by the iliac pedicles (retro-iliac ureters)]. / Anurie par blocage urétéral bilatéral sur les pédicules iliaques (uretères rétro-iliaques).

The authors report a case of bilateral retro-iliac ureter with renal failure. The transvascular segments of the ureters were eliminated, and the two ureters were reanastomosed in front of the iliac vessels.

[Determination of plasmatic beta2-microglobulin in benign and cancerous diseases (author's transl)]. / Intérêt de la détermination de la beta2-microglobuline plasmatique dans diverses affections néoplasiques et bénignes.

The authors report on their experience of the beta2-microglobulin dosage in cancerous diseases and note an increase of its rate in 47% of the cases. A comparative study with certain benign diseases of the digestive tract shows that this dosage proves to be interesting.