Approche symptomatique des douleurs épididymo-testiculaires chroniques 963 KEYWORDS Chronic testi... more Approche symptomatique des douleurs épididymo-testiculaires chroniques 963 KEYWORDS Chronic testicular pain; Chronic scrotal pain; Chronic pelvic pain; Chronic testicular pain; Diagnosis Summary Objective. -To list clinical and ethiopathogenical elements relevant to the analysis of an epididymal and testicular pain. Material and methods. -Review of published articles on the subject in the Medline ® (PubMed ® ) database, selected according to their scientific relevance.
The aim of this multicenter study was to determine the prognostic value of the depth of invasion ... more The aim of this multicenter study was to determine the prognostic value of the depth of invasion of lamina propria and more specifically the influence of the invasion of the muscularis mucosae on survival parameters in T1 bladder carcinoma. Six urological centers included patients between 1994 and 2004 who had an initial T1 bladder tumor. All T1 tumors were substaged according to the muscularis mucosae (MM) invasion into T1a (no invasion beyond the MM) and T1b (invasion beyond MM but preserving the muscle). Among the 387 patients included, 269 (69.5%) were found T1a and 118 (30.5%) T1b. Mean follow-up was 45.4 months. T1a and T1b groups were comparable except for tumor grade that was higher in T1b (p<0.001). Survival without recurrence was not significantly different between T1a and T1b groups (p<0.3) but T1a stage was found as an independent factor for survival without progression (RR=0.49; IC 95%=[0.71-0.90]), specific survival (RR=0.33; IC 95%=[0.16-0.67]) and global survival (RR=0.52; IC 95%=[0.32-0.85]). This study, the largest on the subject to our knowledge, have shown that muscularis mucosae invasion was a prognostic factor for survival without progression, specific survival, and global survival. We support that routine pathological assessment of the level of MM invasion in patients with stage T1 bladder cancer should be included in the histopathological report.
Progrès en urologie (2010) 20, 584-589 ARTICLE ORIGINAL Apports d'une consultation infirmière spé... more Progrès en urologie (2010) 20, 584-589 ARTICLE ORIGINAL Apports d'une consultation infirmière spécialisée dans la prise en charge de l'hyperactivité détrusorienne traitée par injections intradétrusoriennes de toxine botulique dans un service d'urologie. Expérience pilote ଝ Input from a specialized nurse consultation in the management of detrusor overactivity treated with intradetrusor injections of botulinum toxin in urology department. Pilot study Incontinence urinaire ; Vessie neurologique ; Toxine botulique
Evaluation of the effectiveness and tolerance of thermoformable metallic spiral stents Memokath(®... more Evaluation of the effectiveness and tolerance of thermoformable metallic spiral stents Memokath(®) 051 (Bard, Pnn Medical) in the treatment of localized ureteral stenosis in non-operable patients who have JJ ureteral stents. Prospective, descriptive and multicenter study of patients with ureteral strictures treated with metallic ureteral stents Memokath(®) 051. Assessment criteria (recurrent stenotic, permeability, tolerance) were measured by clinical, biological and radiological examination at 1 month, and then every 3 months. Fifteen stents (average length: 9.15 cm, range 6-15 cm) were implanted in 14 patients (mean age: 55 years, range: 38-72 years) with secondary suspended ureteral stenosis during 2 years in two centers. The median follow-up was 11 months (range 6 to 24 months). Technical difficulty was observed with two patients. Stents are still up in four patients. The stenosis recurred in four patients with spontaneous progression of stenosis but without endoprosthetics tissue invasion. Two and three migration were observed with spontaneous expulsions. Two lower urinary infections and one high occurred, resolved on antibiotic therapy, no inlay or hematuria, no pain (mean VAS score=3/10) or urinary disorders of the lower unit have been identified. Stents Memokath(®) 051 are well tolered and seem to position themselves as an interesting alternative to JJ ureteral stent in some frails patients. The refinement of contraindication should help to improve the stent's efficacity and to reduce the risk of migration and expulsion.
ABSTRACT Objective To summarize current knowledge on prevalence, characteristics and ethiopathoge... more ABSTRACT Objective To summarize current knowledge on prevalence, characteristics and ethiopathogenical hypothesis concerning sexuality and fertility dysfunctions in patients with chronic pelvic pain. Material and methods Review of articles published on this subject in the Medline (PubMed) database, selected according to their scientific relevance. Results In the male subject, most frequent sexual dysfunctions are erectile dysfunction and ejaculation disturbance (premature ejaculation, painful ejaculation). Chronic epididymal and testicular pain has a negative impact on the quality of sexual intercourse and satisfaction of both partners. Association between lower urinary tract symptoms – frequent in the event of chronic pelvic pain syndrome – and sexual dysfunction has been proved. Change in spermatic parameters exists in the event of chronic pelvic pain syndrome, but their impact on male fertility has not yet been established. In the female subject, sexual dysfunction is less studied. However, effect of chronic pelvic and perineal pain on female patient sexuality cannot be ignored, as they can affect all components of the sexual cycle. There is no data published on the link between infertility and chronic pelvic and perineal pain in the female subject. Conclusions Allowing to the frequency of sexual dysfunction and its impact on quality of life, sexual function assessment must be a part of every consultation for chronic pelvic and perineal pain
To colligate the clinical and ethiopathogenical elements to take into account in the assessment o... more To colligate the clinical and ethiopathogenical elements to take into account in the assessment of sexual activity-related chronic pelvic and perineal pain, in the male as well as in the female subject. Review of articles and consensus conferences published on this subject in the Medline (Pubmed) database, selected according to their scientific relevance. In the female subject, only dyspareunia has benefitted from a consensual definition. Deep dyspareunia must start investigations in search of pelvic organs disorders, endometriosis, painful bladder syndrome adhesions. Superficial dyspareunia can be a part of provoked vestibulodynia. Vaginismus can be linked to a local disorder, but can also be caused by an excess of nociception. In the male subject, painful ejaculation must start investigation in search of a local urological disorder. It can also be of iatrogenous origin, or be included in a chronic pelvic pain syndrome. Although less documented, other pelvic and perineal pain syndrome, coitus-related or not, exist in the male subject. Assessment of these sexual dysfunctions is primarily based on history taking and clinical examination. In the absence of systematically researched organic disorder, these pains can be part of functional disorders, in which case a global assessment must be undergone, by taking into account all aspects of the pain, including emotional aspects.
Approche symptomatique des douleurs épididymo-testiculaires chroniques 963 KEYWORDS Chronic testi... more Approche symptomatique des douleurs épididymo-testiculaires chroniques 963 KEYWORDS Chronic testicular pain; Chronic scrotal pain; Chronic pelvic pain; Chronic testicular pain; Diagnosis Summary Objective. -To list clinical and ethiopathogenical elements relevant to the analysis of an epididymal and testicular pain. Material and methods. -Review of published articles on the subject in the Medline ® (PubMed ® ) database, selected according to their scientific relevance.
The incidence of vesicoureteral reflux (VUR) varies between 10% and 80% of transplanted kidneys. ... more The incidence of vesicoureteral reflux (VUR) varies between 10% and 80% of transplanted kidneys. In cases of failure of endoscopic treatment or recurrent urinary tract infections, surgical correction is proposed by ureteral reimplantation or pyeloureteral anastomosis using the native ureter. The aim of this study was to assess the results of a technique that increases the submucosal length of the ureter without a ureterovesical reimplantation. We treated 12 patients with VUR in the transplanted kidney by open surgery. Retrograde cystography showed resolution of reflux in all the patients. Our technique has the advantage of avoiding ureteral dissection thereby avoiding its devascularization and no invasion of the bladder mucosa.
Numerous parameters have to be tested to identify optimal conditions for prepubertal testicular t... more Numerous parameters have to be tested to identify optimal conditions for prepubertal testicular tissue banking. Our study evaluated 19 different cryopreservation conditions for immature testicular tissue using a rapid screening method. Immature mice testes were cryopreserved using either 1,2-propanediol (PROH) or dimethyl sulfoxide (DMSO) at a concentration of 0.75 or 1.5 M using a controlled slow-cooling rate protocol with (S+) or without seeding (S2). Equilibration was performed either at room temperature or at 4uC for 15 or 30 minutes. Seminiferous cord cryodamage was determined by scoring morphologic alterations. Cell proliferation ability was evaluated using a proliferating cell nuclear antigen (PCNA) antibody. Testes cryopreserved with optimal conditions were grafted into immunodeficient mice. The highest proportions of PCNA-positive nuclei and lowest morphologic alterations were observed with 1.5 M DMSO. Tissues were more altered with 0.75 M DMSO or PROH. Complete germ cell maturation was observed after allografting of testicular pieces previously frozen with 1.5 M DMSO, S2, 30 minutes. The 1.5 M DMSO, S+ or S2 protocol preserved prepubertal mice testicular tissue architecture and germ cell and Sertoli cell proliferation potential. Allografting of thawed testis fragments into immunodeficient mice confirmed that the 1.5 M DMSO, S2, 30 minutes protocol maintained testicular somatic and germ cell functions. Postthaw histologic evaluation and PCNA immunostaining are useful to rapidly test numerous freeze-thaw parameters. They may also be efficient tools to control human prepubertal frozen testis quality, within the context of a clinical application.
Approche symptomatique des douleurs épididymo-testiculaires chroniques 963 KEYWORDS Chronic testi... more Approche symptomatique des douleurs épididymo-testiculaires chroniques 963 KEYWORDS Chronic testicular pain; Chronic scrotal pain; Chronic pelvic pain; Chronic testicular pain; Diagnosis Summary Objective. -To list clinical and ethiopathogenical elements relevant to the analysis of an epididymal and testicular pain. Material and methods. -Review of published articles on the subject in the Medline ® (PubMed ® ) database, selected according to their scientific relevance.
The aim of this multicenter study was to determine the prognostic value of the depth of invasion ... more The aim of this multicenter study was to determine the prognostic value of the depth of invasion of lamina propria and more specifically the influence of the invasion of the muscularis mucosae on survival parameters in T1 bladder carcinoma. Six urological centers included patients between 1994 and 2004 who had an initial T1 bladder tumor. All T1 tumors were substaged according to the muscularis mucosae (MM) invasion into T1a (no invasion beyond the MM) and T1b (invasion beyond MM but preserving the muscle). Among the 387 patients included, 269 (69.5%) were found T1a and 118 (30.5%) T1b. Mean follow-up was 45.4 months. T1a and T1b groups were comparable except for tumor grade that was higher in T1b (p<0.001). Survival without recurrence was not significantly different between T1a and T1b groups (p<0.3) but T1a stage was found as an independent factor for survival without progression (RR=0.49; IC 95%=[0.71-0.90]), specific survival (RR=0.33; IC 95%=[0.16-0.67]) and global survival (RR=0.52; IC 95%=[0.32-0.85]). This study, the largest on the subject to our knowledge, have shown that muscularis mucosae invasion was a prognostic factor for survival without progression, specific survival, and global survival. We support that routine pathological assessment of the level of MM invasion in patients with stage T1 bladder cancer should be included in the histopathological report.
Progrès en urologie (2010) 20, 584-589 ARTICLE ORIGINAL Apports d'une consultation infirmière spé... more Progrès en urologie (2010) 20, 584-589 ARTICLE ORIGINAL Apports d'une consultation infirmière spécialisée dans la prise en charge de l'hyperactivité détrusorienne traitée par injections intradétrusoriennes de toxine botulique dans un service d'urologie. Expérience pilote ଝ Input from a specialized nurse consultation in the management of detrusor overactivity treated with intradetrusor injections of botulinum toxin in urology department. Pilot study Incontinence urinaire ; Vessie neurologique ; Toxine botulique
Evaluation of the effectiveness and tolerance of thermoformable metallic spiral stents Memokath(®... more Evaluation of the effectiveness and tolerance of thermoformable metallic spiral stents Memokath(®) 051 (Bard, Pnn Medical) in the treatment of localized ureteral stenosis in non-operable patients who have JJ ureteral stents. Prospective, descriptive and multicenter study of patients with ureteral strictures treated with metallic ureteral stents Memokath(®) 051. Assessment criteria (recurrent stenotic, permeability, tolerance) were measured by clinical, biological and radiological examination at 1 month, and then every 3 months. Fifteen stents (average length: 9.15 cm, range 6-15 cm) were implanted in 14 patients (mean age: 55 years, range: 38-72 years) with secondary suspended ureteral stenosis during 2 years in two centers. The median follow-up was 11 months (range 6 to 24 months). Technical difficulty was observed with two patients. Stents are still up in four patients. The stenosis recurred in four patients with spontaneous progression of stenosis but without endoprosthetics tissue invasion. Two and three migration were observed with spontaneous expulsions. Two lower urinary infections and one high occurred, resolved on antibiotic therapy, no inlay or hematuria, no pain (mean VAS score=3/10) or urinary disorders of the lower unit have been identified. Stents Memokath(®) 051 are well tolered and seem to position themselves as an interesting alternative to JJ ureteral stent in some frails patients. The refinement of contraindication should help to improve the stent's efficacity and to reduce the risk of migration and expulsion.
ABSTRACT Objective To summarize current knowledge on prevalence, characteristics and ethiopathoge... more ABSTRACT Objective To summarize current knowledge on prevalence, characteristics and ethiopathogenical hypothesis concerning sexuality and fertility dysfunctions in patients with chronic pelvic pain. Material and methods Review of articles published on this subject in the Medline (PubMed) database, selected according to their scientific relevance. Results In the male subject, most frequent sexual dysfunctions are erectile dysfunction and ejaculation disturbance (premature ejaculation, painful ejaculation). Chronic epididymal and testicular pain has a negative impact on the quality of sexual intercourse and satisfaction of both partners. Association between lower urinary tract symptoms – frequent in the event of chronic pelvic pain syndrome – and sexual dysfunction has been proved. Change in spermatic parameters exists in the event of chronic pelvic pain syndrome, but their impact on male fertility has not yet been established. In the female subject, sexual dysfunction is less studied. However, effect of chronic pelvic and perineal pain on female patient sexuality cannot be ignored, as they can affect all components of the sexual cycle. There is no data published on the link between infertility and chronic pelvic and perineal pain in the female subject. Conclusions Allowing to the frequency of sexual dysfunction and its impact on quality of life, sexual function assessment must be a part of every consultation for chronic pelvic and perineal pain
To colligate the clinical and ethiopathogenical elements to take into account in the assessment o... more To colligate the clinical and ethiopathogenical elements to take into account in the assessment of sexual activity-related chronic pelvic and perineal pain, in the male as well as in the female subject. Review of articles and consensus conferences published on this subject in the Medline (Pubmed) database, selected according to their scientific relevance. In the female subject, only dyspareunia has benefitted from a consensual definition. Deep dyspareunia must start investigations in search of pelvic organs disorders, endometriosis, painful bladder syndrome adhesions. Superficial dyspareunia can be a part of provoked vestibulodynia. Vaginismus can be linked to a local disorder, but can also be caused by an excess of nociception. In the male subject, painful ejaculation must start investigation in search of a local urological disorder. It can also be of iatrogenous origin, or be included in a chronic pelvic pain syndrome. Although less documented, other pelvic and perineal pain syndrome, coitus-related or not, exist in the male subject. Assessment of these sexual dysfunctions is primarily based on history taking and clinical examination. In the absence of systematically researched organic disorder, these pains can be part of functional disorders, in which case a global assessment must be undergone, by taking into account all aspects of the pain, including emotional aspects.
Approche symptomatique des douleurs épididymo-testiculaires chroniques 963 KEYWORDS Chronic testi... more Approche symptomatique des douleurs épididymo-testiculaires chroniques 963 KEYWORDS Chronic testicular pain; Chronic scrotal pain; Chronic pelvic pain; Chronic testicular pain; Diagnosis Summary Objective. -To list clinical and ethiopathogenical elements relevant to the analysis of an epididymal and testicular pain. Material and methods. -Review of published articles on the subject in the Medline ® (PubMed ® ) database, selected according to their scientific relevance.
The incidence of vesicoureteral reflux (VUR) varies between 10% and 80% of transplanted kidneys. ... more The incidence of vesicoureteral reflux (VUR) varies between 10% and 80% of transplanted kidneys. In cases of failure of endoscopic treatment or recurrent urinary tract infections, surgical correction is proposed by ureteral reimplantation or pyeloureteral anastomosis using the native ureter. The aim of this study was to assess the results of a technique that increases the submucosal length of the ureter without a ureterovesical reimplantation. We treated 12 patients with VUR in the transplanted kidney by open surgery. Retrograde cystography showed resolution of reflux in all the patients. Our technique has the advantage of avoiding ureteral dissection thereby avoiding its devascularization and no invasion of the bladder mucosa.
Numerous parameters have to be tested to identify optimal conditions for prepubertal testicular t... more Numerous parameters have to be tested to identify optimal conditions for prepubertal testicular tissue banking. Our study evaluated 19 different cryopreservation conditions for immature testicular tissue using a rapid screening method. Immature mice testes were cryopreserved using either 1,2-propanediol (PROH) or dimethyl sulfoxide (DMSO) at a concentration of 0.75 or 1.5 M using a controlled slow-cooling rate protocol with (S+) or without seeding (S2). Equilibration was performed either at room temperature or at 4uC for 15 or 30 minutes. Seminiferous cord cryodamage was determined by scoring morphologic alterations. Cell proliferation ability was evaluated using a proliferating cell nuclear antigen (PCNA) antibody. Testes cryopreserved with optimal conditions were grafted into immunodeficient mice. The highest proportions of PCNA-positive nuclei and lowest morphologic alterations were observed with 1.5 M DMSO. Tissues were more altered with 0.75 M DMSO or PROH. Complete germ cell maturation was observed after allografting of testicular pieces previously frozen with 1.5 M DMSO, S2, 30 minutes. The 1.5 M DMSO, S+ or S2 protocol preserved prepubertal mice testicular tissue architecture and germ cell and Sertoli cell proliferation potential. Allografting of thawed testis fragments into immunodeficient mice confirmed that the 1.5 M DMSO, S2, 30 minutes protocol maintained testicular somatic and germ cell functions. Postthaw histologic evaluation and PCNA immunostaining are useful to rapidly test numerous freeze-thaw parameters. They may also be efficient tools to control human prepubertal frozen testis quality, within the context of a clinical application.
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