Base bibliographique

Cancer de prostate et optimisation de la prise en charge multidisciplinaire le point sur la RCP, et la prise en charge du cancer de prostate résistant à la castration
2013
- Réf : Prog Urol, 2013, 4, 23, 7-12
Mots clés:
R. / D'après les communications de J.-L. / S. / L. / I.
Mots-clés:
hematuria / prostate / Bleeding / Biopsy / complication
Points forts du Congrès 2012 de l'Association Française d'Urologie lithiase, infectiologie, cystectomie, tumeur du rein et cancer de prostate
2013
- Réf : Prog Urol, 2013, 4, 23, 1-6
Mots clés:
R.
Mots-clés:
hematuria / prostate / Bleeding / Biopsy / complication
Ballons ACT ® : quelle place dans le traitement de l'incontinence urinaire de la femme ?
2013
- Réf : Prog Urol, 2013, 4, 23, 276-282


Introduction



Objectives

Assessment of the Adjustable Continence Therapy device (ACT®) in the treatment of female stress or mixed urinary incontinence in terms of efficacy and complications.


Material

Between April 2005 and September 2011, the device ACT® was put by two different operators to treat a stress and/or mixed urinary incontinence at women. The results were studied under two shutters: complications and efficacy.


Results

Seventy-seven women were operated. Mean age of the patients was of 68years (34–87). Mean follow-up was of 22months (1–72). Over the 77 patients, eight peroperative complications (10%) were noted. Twenty-five explantations were required in 22 patients (28%). In terms of efficacy, after an average follow-up of 22months, the results were: 19 patients (25%) were continents, 25 (33%) very improved and five (6%) improved regards to the initial stage preceding the implantation. Fifteen patients (19%) were in failure. Seven patients (9%) were unchanged and in the course of adjustment (recent implantation) and six others (8%) explanted waiting for another implantation.


Conclusion

The ACT® procedure was feasible on a population of multi-operated women with 64% of improvement in our hands. Complications were rare, easily detected and repaired. The risk of explantation was reported to be 28%.

Mots clés:
incontinence urinaire féminine / insuffisance sphinctérienne / Ballons ACT /
Mots-clés:
Female urinary incontinence / Sphincter insufficiency / ACT / device
Genital prolapse repair with Avaulta Plus ® mesh: Functional results and quality of life
2013
- Réf : Prog Urol, 2013, 4, 23, 270-275


Introduction


Mots clés:
Genital prolapse / Cystocele repair / Vaginal route / Quality of life / Vaginal mesh exposure
Mots-clés:
A. / C. / D. / S. / M.
Réintervention par bandelette sous-urétrale pour récidive d'incontinence urinaire d'effort féminine après une première bandelette sous-urétrale
2013
- Réf : Prog Urol, 2013, 4, 23, 262-269


Introduction



Introduction

There are few data concerning the results of the treatment of recurrent stress urinary incontinence (SUI) after redo mid-urethral sling (MUS) procedure.


Methods

Retrospective study concerning 34 patients presenting with recurrent SUI following the placement of a first MUS procedure and who have undergone a second MUS procedure. Results were evaluated objectively (cough stress test) and subjectively using International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF).


Results

The surgical technique for the placement of the first MUS was a retropubic approach in seven (20.5%) cases and a transobturator approach in 27 (79.5%) cases. Concerning the redo MUS procedure, a retropubic procedure was performed in 25 (73.5%) patients and a transobturator procedure in nine (26.5%) patients. Among the 34 patients, 32 (94%) were re-examined at 2 months follow-up, and contacted through telephone after 1-year follow-up. Post-operatively, the cough stress test revealed no urine leakage in 27/32 (84%) patients. Median follow-up was 15.5 months. ICIQ-SF score was 0 (complete continence) in 19/32 (59%) patients; between 4 and 12 in 11/32 (34%) and between 13 and 20 in 2/32 (6%) patients. A bladder injury was diagnosed during the surgical procedure in two patients. A reintervention was required in 2/34 (5%) patients because of postoperative urinary retention or bladder outlet obstruction. A partial sling resection was required in 2/34 (5%) patients because of vaginal exposure of the synthetic sling.


Conclusion

In this study, redo MUS procedure was associated with good functional results despite a high rate of complications.

Mots clés:
Incontinence urinaire à l’effort / IUE / incontinence urinaire / Bandelette sous-urétrale / TVT
Mots-clés:
Stress urinary incontinence / SUI / Urinary incontinence / Midurethral sling / TVT
Tolérance et résultats à 12 mois d'une prothèse légère pour la cure de cystocèle de stade 3-4 par voie vaginale
2013
- Réf : Prog Urol, 2013, 4, 23, 237-243


Introduction



Objective

To assess safety and efficacy at short-term of a light-weight polypropylene mesh (28g/m2) for stage 3-4 cystocele repair by the vaginal route.


Material and methods

A multicentric prospective cohort study, performed between 2010 and 2011 in seven centers. Pre-operative assessment included prolapse quantification using the POP-Q. Pre- and postoperative validated symptoms and quality of life questionnaires were used. Main objective was mesh safety. Secondary objectives were anatomical and functional success.


Results

One hundred and eleven patients, with a mean age of 67±9years, were included in the study, and 94 were included in the analysis (84.7%). In 14 cases (12.8%), it was a secondary surgery. Two intra-operative complications occurred (2.2%). Safety analysis on 86 patients followed up at 12months (91.5%) has shown satisfaction rate of 98.8% (85/86), mesh contraction rate of 9.3% (8/86), one case of vaginal mesh exposure (1.2%), no cases of pelvic pain and rate of postoperative dyspareunia of 5.5% (3/55). Anatomic success rate on cystocele (Ba point<−1) at short-term was 82/86 (95.3%) and improvement of symptoms and quality of life was highly significant. Five patients (5.3%) were reoperated.


Conclusion

Cystocele repair by the vaginal route using a light-weight transobturator polypropylene mesh was safe and efficient at short-term. Long-term data are needed.

Mots clés:
Prolapsus génito-urinaire / Chirurgie vaginale / Prothèse de polypropylène / Prothèse légère / Surgimesh
Mots-clés:
Genital prolapse / Vaginal surgery / Polypropylene mesh / Light-weight mesh / Surgimesh
Traduction et validation linguistique en Arabe classique du questionnaire de l'Urinary Symptom Profile (USP)
2013
- Réf : Prog Urol, 2013, 4, 23, 244-248


Introduction



Objective

The objective was to translate and linguistically validate in classical Arabic; the French version of the Urinary Symptom Profile (USP), the scale adapted to vesico-sphincter disorders.


Patients and methods

Prospective study of 30 patients suffering the vesico-sphincter disorders. The translation was obtained by the method: translation back-translation. Patients completed the final questionnaire on day 0 and day 15. The feasibility, acceptability, internal consistency using Cronbach’s alpha and test-retest repeatability by the interclass correlation coefficient (ICC) with the confidence interval (CI) were studied.


Result

The sample consisted of 30 subjects including 20 men (66.6%) and 10 women (33.3%). The mean age was 48±18,14 years ranging from 25 to 70 years. The questionnaire was feasible and acceptable. The Cronbach’s alpha of the three dimensions, urinary stress incontinence, overactive bladder and voiding difficulties was respectively 0.9880, 0.9774 and 0.9683, respectively; the ICC was 0.9762 (95% CI: 0.9307–0.9919), 0.9558 (CI 95%: 0.8738–0.9849) and 0.9385 (95% CI: 0.8274–0.9789).


Conclusion

The Arabic version of the classic USP had excellent internal consistency and excellent repeatability enable a full assessment of all urinary disorders and their severity.

Mots clés:
dysurie / hyperactivité vésicale / Incontinence urinaire à l’effort
Mots-clés:
Voiding difficulties / Overactive bladder / Stress urinary incontinence
Traitements pharmacologiques de l'hyperactivité vésicale idiopathique : revue de la littérature
2013
- Réf : Prog Urol, 2013, 4, 23, 227-236


Introduction et objectif



Objective

To depict the recent advances in the field of pharmacological treatment of idiopathic overactive bladder (iOAB).


Methods

A literature search was conducted, using the PubMed/Medline database. Articles were included if published as full papers, after 2008 and before September 2012, and focused on recent pharmacologic treatment options for iOAB management. Publications having the highest level of evidence have been analyzed to summarize the available evidence, prioritizing the treatments available in France.


Results

Some meta-analyses have been published between 2008 and 2012, gathering information about 82 level 1 evidence studies about efficacy and safety of anticholinergics. According to the most recent meta-analysis, anticholinergics have proved their efficacy for iOAB management, reducing the number of micturitions per day by up to 1.59, the number of incontinence episodes per day by up to 0.7, the number of urgency episodes by up to 1.7, the number of urgency incontinence episodes by up to 2.25, and the number of nocturnal voids by up to 0.24. Safety profile was good, especially for solifenacin and fesoterodine, supported by strong scientific evidence. However, data were limited to short-term follow-up, with no anticholinergic drug superior to another. Few data were available about observance, risk factors for failure and results in specific populations. Anticholinergics can be used safely for management of lower urinary tract symptoms in men, but their role is still to be determined. Data about innovative drugs were still preliminary.


Conclusions

Anticholinergics are a valuable option for management of iOAB, and have a growing role in management of lower urinary tract symptoms in men without bladder outlet obstruction.

Mots clés:
Hyperactivité vésicale idiopathique / anticholinergiques / Fésotérodine / Toltérodine / Trospium
Mots-clés:
Overactive bladder / Idiopathic / Antimuscarinics / Fésotérodine / Toltérodine
Troubles vésicosphinctériens et syndrome métabolique : étude prospective
2013
- Réf : Prog Urol, 2013, 4, 23, 256-261


Introduction



Objective

Metabolic syndrome (MS) risk factors are potentially implicated in the development of lower urinary tract symptoms (LUTS). The goals of this study were to analyze the prevalence of the LUTS in patients presenting with MS and to evaluate the correlation between the MS components and LUTS.


Methods

A prospective study was conducted on a group of 34 patients with MS according to the criteria of the NCEP ATP III. Urinary symptom profile (USP) questionnaire was used to evaluate LUTS. The physical examination included: weight, waist circumference, body mass index (BMI) and blood pressure looking for orthostatic hypotension. The following laboratory data were obtained: fasting blood sugar, postprandial glycemia, glycosylated hemoglobin (HbA1c), HDL-cholesterol, LDL-cholesterol, triglycerides and total cholesterol.


Results

The mean age was 56.2 years (±9.2). Twenty of the patients (58.8%) were females. All patients underwent diabetic and hypertension therapy. The mean BMI was 30.2±4.8 and waist circumference was 107.8±9.3cm. USP total score was 8.3±6. Besides, 29 (85.2%) patients had overactive bladder symptom, and 13 (38.2%) patients presented with urinary stress incontinence. The overactive bladder USP score was significantly correlated with age, waist circumference, BMI and postprandial glycemia. The other parameters of MS were not correlated with urinary symptoms.


Conclusion

The most frequent urinary symptom in the MS was overactive bladder symptoms and urinary incontinence. The components of MS that influenced the USP score were abdominal obesity and hyperglycemia. The hypothesis of a link between MS and overactive bladder in diabetic patients with MS is plausible.

Mots clés:
Syndrome métabolique / diabète / Troubles vésicosphinctériens / Tunisienne
Mots-clés:
Metabolic syndrome / Diabetes / Lower urinary tract symptoms / Tunisian
Urinary incontinence in women: Study of surgical practice in France
2013
- Réf : Prog Urol, 2013, 4, 23, 249-255


Introduction


Mots clés:
epidemiology / Urinary incontinence / Woman / Surgery / France
Mots-clés:
D. / F. / X.