Base bibliographique

Infirmière clinicienne en urologie, la voie est lancée
Nurse specialized in urology, the way is on
2009
- Editoriaux
- Réf : Prog Urol, 2009, 12, 19, 863


Instillations endovésicales et cancer de la vessie
2009
- Réf : Prog Urol, 2009, 12, 19, 868-871




 


Superficial bladder cancer is treated by transuretral resection and in some cases by intravesical chemotherapy. Modalities, ways of administration and indications of these treatments will be presented and discussed.

L'incontinence urinaire d'effort chez l'homme : place des alternatives au sphincter artificiel urinaire
2009
- Réf : Prog Urol, 2009, 12, 19, 897-901




 


Male stress urinary incontinence is most often the consequence of surgery for localised cancer of the prostate. The mechanism is a deficit of the sphincter and a problem of support. Clinical analysis is based on a questionnaire together with mictional results, a standard questionnaire and the pad-test. The value of the pressure of the urethral sphincter and a verification of the absence of urethral stenosis are checked. This allows for the gravity of the incontinence to be evaluated: severe, moderate or minor. First line treatment for severe forms is an artificial sphincter. For more moderate forms or disabling minor forms, mini-invasive surgery can be proposed if physiotherapy does not work. Suburethral tape is inserted via the perineal and transurethral routes, the periurethral balloons are inserted by perineal route and inflated progressively. Total continence is reestablished for half the patients treated with the tape and a third of those with the balloons. There are many complications with the balloons but the long-term effectiveness of both methods needs to be assessed.

L'urologie : une spécialité médicochirurgicale
Urology: Medical and surgical speciality?
2009
- Editoriaux
- Réf : Prog Urol, 2009, 12, 19, 864


La dysfonction érectile après prostatectomie totale : quelle prise en charge ?
2009
- Réf : Prog Urol, 2009, 12, 19, 893-896




 


The objective of a radical prostectomy is to cure cancer of the prostate while preserving the best quality of life of patients. Changes in the quality of erections after the operation pose the greatest problems as far as sexuality is concerned. This is the consequence of lesions of the cavernous nerves during the lateral dissection of the prostate, which are sometimes definitive. The treatment of erectile dysfunction after radical prostectomy begins with an evaluation of the sexuality of the patient who is informed of the consequences of surgery before operating. Specialized physiotherapy should be proposed to patients in the 2 to 3 months following the intervention. Should this treatment prove to be unsuccessful, patients are treated using classical therapy for erectile dysfunction. In the case of patient transfer and delegation of competences, consultation between the doctor and clinical nurses is advised throughout treatment.

Les autosondages : pour quels patients ?
2009
- Réf : Prog Urol, 2009, 12, 19, 885-889




 


Clean intermittent self-catheterization is often proposed to patients with bladder emptying disorders. It is based on clinical conditions but motor, visual, cognitive and sensory patient’s skills have also to be taken into account.

Les techniques de destruction in situ des tumeurs rénales : où en est-on en 2009 ?
2009
- Réf : Prog Urol, 2009, 12, 19, 865-867




 


Radical nephrectomy is the gold standard in renal cancer treatment. Imaging techniques allow to discover small renal masses for which conservative surgery is now validated. In parallel, in situ ablative techniques of these small renal masses have developed. This article will make a review of these ablative techniques in situ.

Quel bilan face à une suspicion de cystite interstitielle ?
2009
- Réf : Prog Urol, 2009, 12, 19, 881-884




 


Despite considerable research on the etiology and treatment of interstitial cystitis, diagnosis still depends on the suspicion of this condition by the physician.

Remplacement vésical et cancer de la vessie
2009
- Réf : Prog Urol, 2009, 12, 19, 872-880




 


Urothelial tumours which infiltrate the vesical muscle or more superficial tumours which resist localised treatment (resection±BCG or mytomicin C) should be considered for excision. Excision is successful in female cystectomy and in male radical cystoprostatectomy. For local tumours of the bladder (<T3), this treatment allows for a specific survival of 5 years at 90 % to be obtained. After the excision of the bladder, several types of urinary diversions may be proposed. The replacement neo-bladder by ilioplasty (orthotopic replacement) should be chosen when possible (conservation of the urether). Numerous techniques were proposed. The ilieum would appear to be the segment of the intestine best adapted for this use and of a short segment is preferable (less than 50cm). For the creation of the neo-bladder it is necessary that the established surgical rules are followed carefully. Pre-operative preparation and post-operative treatment have become easier but must be well respected. Patients have a check-up every 6 months for the first 3 years, then annually, in order to detect possible local or secondary relapses. The correct functioning of the neo-bladder should be verified regularly in order to ensure that the bladder is emptied properly. Continence returns through auto-exercise.

Traitement de la maladie de Lapeyronie
2009
- Réf : Prog Urol, 2009, 12, 19, 902-906




 


Lapeyronie’s disease occurs mostly in middle age men and consists in pain and bending or arching of the penis during erection. This could negatively impact quality of life. A good knowledge of the physiopathology is necessary to adapt the different treatment modalities.

Traitement médical de l'hyperplasie bénigne de prostate
2009
- Réf : Prog Urol, 2009, 12, 19, 890-892




 


Four therapeutic classes can be used for the treatment of BPH: alphablockers, 5 alpha reductase inhibitors (5ARI), muscrinic receptor antagonists, and plant extracts. Two combination therapies have been proven to be efficient: 5ARI – alphablockers, and muscarinic receptor antagonists – alphablockers. Alphablockers have the advantage to be efficient quickly. 5ARI decrease prostate volume. Efficacy of plant extracts is still discussed, but their tolerance is excellent. Muscrinic receptor antagonists can be a viable treatment option for men with predominantly bladder storage symptoms but without bladder outlet obstruction.