Base bibliographique

Aspects pratiques de l'hydrodistension courte dans le bilan d'un syndrome douloureux vésical
Practical aspects of short bladder hydrodistention in the therapeutic management of painful bladder syndrome
2013
- Le point sur...
- Réf : Progrès FMC, 2013, 1, 23, F7




 


Painful bladder syndrome (PBS) is defined by the European Society for the Study of interstitial cystitis (ESSIC) as chronic pelvic pain lasting for more than 6 months, with a pressure or discomfort perceived in relation to the bladder, accompanied by at least one other symptoms such as: daytime and/or night-time increased urinary frequence in the absence of urinary infection or other diseases. The ESSIC recommends a classification of PBS in subgroup according to the results of bladder cystoscopy with short hydrodistention and histologic findings of bladder biopsies. The short hydrodistention test achieved by filling the bladder with saline or water with a bladder pressure of 80 to 100cmH2 0. Bladder distention should be maintained for 2 to 5minutes. The bladder mucosa is explored in research of lesions: glomerulations/petechiae, Hünner’s lesions before and after bladder hydrodistention. Bladder biopsies are performed after hydrodistension because of the bladder perforation risk. The main differential diagnosis to remove is the bladder carcinoma in situ. Bladder hydrodistention can be therapeutic in 30 to 50% of patients.

Cancer du rein, lithiase urinaire
2013
- Spécial AFU 2012
- Réf : Progrès FMC, 2013, 1, 23, F31


Hypertrophie bénigne de prostate, cancer de prostate
2013
- Spécial AFU 2012
- Réf : Progrès FMC, 2013, 1, 23, F23


Insuffisance rénale aiguë obstructive : le point de vue du réanimateur
Obstructive acute renal failure: The intensivist’s viewpoint
2013
- Avis d'expert
- Réf : Progrès FMC, 2013, 1, 23, F19




 


Obstructive acute renal failure in adults is a frequent situation. Irrespective of the cause, the urinary tract obstruction can acutely oppose glomerular filtration and induce tubulo-interstitial injury, while prolonged obstruction may eventually produce irreversible renal lesions. Importantly, depending on the completeness of the obstruction, renal failure may rapidly lead to life-threatening complications, including hyperkalemia and pulmonary edema. Therefore, prompt and adequate coordination between medical and urological management is necessary. In this article we concisely review evidence regarding the pathophysiology of obstructive nephropathy and the medical management of complications associated with obstructive acute renal failure.

L'apprentissage des autosondages propres intermittents chez l'adulte : un bon exemple d'éducation thérapeutique
Learning self-intermittent catheterization: A good example of therapeutic education
2013
- Truc et astuce
- Réf : Progrès FMC, 2013, 1, 23, F2




 


Practiced for more than 40 years, clean intermittent self-catheterization (CISC) is the gold standard method for drainage of urine in case of urinary retention or incomplete bladder emptying, regardless of etiology. It is reliable, well-accepted by the patient and allows protection of the upper urinary tract by reducing complications related to retention, continence and patients’autonomy. Learning CISC is simple but must be carefully taught. It is not recommended to perform a routine urinalysis in patients with CISC or treat bacterial colonization. A therapeutic education program for self-catheterization within specialized units may be implemented to improve the quality of care for patients.

Peut-on traiter par curiethérapie en monothérapie par grains permanents les patients présentant un cancer de la prostate Gleason 7 ?
Can we afford prostate permanent seed brachytherapy as monotherapy in Gleason score 7 prostate cancer patients?
2013
- Le point sur...
- Réf : Progrès FMC, 2013, 1, 23, F12




 


After permanent prostate seed implant (PPI) as a monotherapy, biochemical failure may occur in 20% to 30% of low or intermediate-risk prostate cancer patients. These rates are very similar to the rates of biochemical failures observed with surgery or external radiotherapy with respect to each prognostic group. It should be noted that the rates of pure intraprostatic failures remain lower. The review of the literature shows that PPI is allowed for Gleason 7 cancers in patients with favorable intermediate-risk with respect to an accurate selection of patients. Indeed, the latest recommendations from the American Brachytherapy Society (ABS) are in keeping with such assumption and ABS allows PPI for intermediate-risk patients. However, it is not recommended to use PPI as a monotherapy in patients with several intermediate-risk prognostic factors (Gleason score 7 (3+4) or clinical T2b or a PSA value between 10 and 20ng/mL).

Soyons Aware !!!
Let’s get Aware!!!
2013
- Éditorial
- Réf : Progrès FMC, 2013, 1, 23, F1


Tumeurs urothéliales
2013
- Spécial AFU 2012
- Réf : Progrès FMC, 2013, 1, 23, F27