Base bibliographique

Chirurgie urologique et ambulatoire
2012
- Réf : Prog Urol, 2012, 14, 22, 898-902




 


The ambulatory surgery is the realization of a surgical act with entrance and taken out the same day. The evolution of the surgery in traditional hospitalization towards the ambulatory is a cultural revolution. The function care and accommodation of our establishments of health are disconnected. The ambulatory surgery is source of progress for the surgery, the anesthesia, our organizations. She corresponds to a demand of the public. She is ethical. There is an institutional will shared by all the actors of health today. The AFU measured its delay and has the objective to facilitate to the urologic community this mode of taken care. Learned recommendations are going to be produced in association with the HAS. The role of the IDE of urology is specified there.

Injections de toxine botulique : une nouvelle voie thérapeutique en urologie
2012
- Réf : Prog Urol, 2012, 14, 22, 892-897




 

La radioprotection en endo-urologie
2012
- Réf : Prog Urol, 2012, 14, 22, 867-870




 


The aim of radioprotection is to protect people against harmful effects of radiation; those radiations come from electromagnetic wave or radioactivity that can be natural or related to human activity. Radiation risk is dose related and biological dose is expressed in millisievert (mSv). Mean dose received from natural radioactivity is about 3 mSv, which is a low and non-dangerous dose. Total annual biological dose received should not exceed 20 mSv a year. In endo-urology image intensifier is the main source of irradiation in operating theatre. Rules for utilisation are detailed.

Lithiase urinaire : bilan métabolique et prévention
2012
- Réf : Prog Urol, 2012, 14, 22, 876-880




 

Place de la chirurgie conservatrice dans le traitement des tumeurs de la voie excrétrice urinaire supérieure
2012
- Réf : Prog Urol, 2012, 14, 22, 861-866




 


Urothelial carcinomas of the upper urinary tract (UUT-UCs) are rare and represent about 5% of all urothelial carcinomas. The standard treatment is still open radical nephroureterectomy. Low-grade and non-invasive UUT-UCs have a favourable outcome as non-muscle invasive bladder carcinomas (80% specific - survival rate at 5 years). First-line conservative treatment is being increasingly performed in patients with a normal controlateral kidney for surgical management of UUT-UCs. Conservative surgical management allows for kidney preservation contingent upon it is technically feasible to achieve. Conservative procedures (i.e., flexible ureteroscopy or open conservative surgery) for the treatment of superficial or low grade UUT-UCs have good outcomes and are therefore an alternative to open radical surgery. The important cost of the endoscopic techniques remains currently a limiting factor for the spread of the technique in France.

Prise en charge des effets secondaires de l'hormonothérapie dans le traitement du cancer de prostate
2012
- Réf : Prog Urol, 2012, 14, 22, 881-885




 


Hormone replacement therapy in prostate cancer is androgen deprivation. This deprivation causes side effects that are well known. The most frequent complications are hot flashes, erectile dysfunction and libido disorders. These complications have a strong impact on the quality of life of the patient. The other side effects, namely metabolic syndrome and osteopenia, are less frequent, but have a worse prognosis due to their significant impact on patients’ survival. The metabolic syndrome results in dyslipidaemia and insulin resistance. Patients under hormone therapy must have an initial evaluation and a subsequent close monitoring. Screening for these side effects and their specific management must be essential during the monitoring of long-term hormone therapy.

Prise en charge des pyélonéphrites aiguës
2012
- Réf : Prog Urol, 2012, 14, 22, 871-875




 


Pyelonephritis is a bacterial infection of the upper urinary tract and renal parenchyma. Infection occurs primarily by urinary contamination upward and backward from the intestinal flora, and genital skin, explaining that the seeds are most commonly encountered Gram-Negative bacilli (GNB), Escherichia coli in mind. The peak incidence is among women aged 15 to 65, but pyelonephritis may include subjects of all ages and both sexes. The diagnosis is usually straightforward and based on a combination of fever, unilateral flank pain and a positive urine culture. Biology and imaging aim to seek any form of pyelonephritis complicated, especially due to the obstructive form a barrier (usually a calculation) of the urinary tract and is a surgical emergency. Support depends on the existence of signs of severity or complications. Treatment consists of antibiotics, to begin immediately, initially probabilistic and secondarily adapted to the antibiogram. Patients hospitalized in the urology will be those with complicated pyelonephritis (urinary obstruction, abscess, sepsis, renal insufficiency, solitary kidney, comorbidity).

Traitement de l'incontinence urinaire d'effort féminine : les bandelettes sous-urétrales
2012
- Réf : Prog Urol, 2012, 14, 22, 886-891




 


Female stress incontinence is often the consequences of obstetrical traumatisms. They are responsible of a weakness of perineal musculoaponevrotic structures. Until 1996, the reference treatment of this pathology was the “Burch” colposuspension, by laparotomy, then laparoscopic way. After 1996, a new procedure was developped by Ulmten, reproducible, easy, safe and mini-invasive: the tension free-vaginal-tape (TVT) followed by the trans-obturator-tape (TOT). This therapeutic tool has become the reference for the treatment of the female stress incontinence. There are now 15years from the beginning of this procedure and still 80% of the patients are improved.