[What the last 10 years have brought in the treatment of benign prostatic hyperplasia]. / L'évolution des traitements de l'adénome prostatique au cours des 10 dernières années.

Benign prostatic hyperplasia (BPH) is a very frequent condition, most of the times related to age, and with initial manifestations and long term development that may vary widely. Treatment is necessary only if the patient is symptomatic or if he has complications related to the BPH. During the last 10 years, the various BPH treatment means have evolved significantly. Regarding medical treatment, new drugs have been introduced and new combinations of drugs have shown their efficacy in BPH treatment. The surgical treatment of BPH has seen the development of minimally invasive surgical techniques, with broader indications and better results compared to classical surgical techniques. Among these techniques, the better studied and developed is the endoscopic Holmium Laser Enucleation of the Prostate (HoLEP). The continuous development of medical lasers and minimally invasive surgical techniques for the treatment of BPH will, in our opinion, lead the way towards a rich and innovative future decade with regard to the surgical treatment of BPH.

L'hyperplasie bénigne de la prostate (HBP) est une pathologie extrêmement fréquente, favorisée par le vieillissement et dont les manifestations cliniques peuvent être très variées. Un traitement n'est nécessaire que lorsque le patient se plaint de symptômes secondaires à l'HBP ou souffre de ses complications. Ces 10 dernières années, les traitements de l'adénome prostatique ont évolué de manière importante. De nouvelles molécules ainsi que de nouvelles associations (de molécules connues ayant déjà prouvé leur efficacité) se sont ajoutées au traitement médical. Le traitement chirurgical, quant à lui, a été significativement marqué par le développement des techniques mini-invasives, aux indications plus larges et aux meilleurs résultats. Parmi ces techniques, la plus développée et étudiée, est la technique d'énucléation endoscopique de la prostate à l'aide du laser Holmium (HoLEP). Le développement des lasers à usage médical ainsi que la recherche de nouvelles techniques chirurgicales mini-invasives ouvrent la voie à une prochaine décennie riche en innovations thérapeutiques pour la prise en charge chirurgicale des adénomes prostatiques.

[Can we treat sexual addiction ?]. / L'addiction au sexe, ça se soigne?

Sexual addiction or sexual dependence is characterized by hypersexuality, impaired regulation of sexual desire and sexual compulsivity, including having sex with uncontrolled excessive frequency (5 to 15 sexual acts per day for more than 6 months, from 15 years old). Between 3% and 6% of the adult population (> or =18 years) would have the characteristics of sexual addiction, disorder prevalent in the male population. The addictive processes affect three behavioral domains : motivation-reward, affect regulation and behavioral inhibition. Sex addiction is usually accompanied by other addictions, such as abuse of drugs or alcohol or sex toys that enhance sexual performance. Psychiatric comorbidities can be found : anxiety disorders, mood disorders. Several forms of treatment have been tried, using medication, cognitive-behavioral therapy and psychotherapy sessions alternated with exposure therapy in virtual reality. In this article, we will discuss the multiple definitions of hypersexuality and the possibilities of therapeutic approaches.