[Pseudotumor eosinophilic cystitis with very acute course. Report of a case]. / Cystite à éosinophiles pseudo tumorale d'évolution suraiguë. A propos d'un cas.

The authors report a case of eosinophilic cystitis with a very acute course after partial cystectomy, requiring semi-urgent total cystoprostatectomy with ileal bladder replacement. The patient is completely asymptomatic ten years after the operation. This case can be classified with the pseudoneoplastic forms of interstitial cystitis occurring in patients with a history of urological surgery. The two-stage course of the disease suggests the combination of two pathophysiological mechanisms: repeated aggression to the urothelial wall responsible for an intense inflammatory reaction and allergy to suture material, accounting for the subsequent rapid development.

[Preperitoneal trans-ileal cutaneous ureterostomy. Apropos of 46 cases]. / L'urétérostomie cutanée trans-iléale pré-péritonéale. A propos de 46 observations.

A technic of preperitoneal trans-ileal cutaneous ureterostomy, first described by Archimbaud in 1979, was used to treat 46 patients. Results are compared with those of a series of 12 cases reported by Bricker. Postoperative mortality was relatively high (8/46) particularly as the diagnosis in most cases (39/46) was a cancer and not a neurologic bladder. The advantages of this technic are considered to be mainly the high situation of the loop allowing irradiation of the pelvis, the stability of the length of loop, and above all, the total isolation of the uretero-ileal anastomoses external to the greater peritoneal cavity allowing percutaneous treatment of urinary fistulae without precipitation and without the need for repeat surgery.

Thoracic duct drainage and antilymphocyte globulin for renal transplantation in man.

Thoracic duct drainage resulting in a lymphocyte depletion of more than 20 x 10(9) cells was performed during the three months prior to transplantation in 37 patients. Results obtained in this group of patients were compared to those in transplant recipients similarly treated, over the same period, but not subjected to thoracic duct drainage. Both groups received comparable doses of antilymphocyte globulins, azathioprine and corticosteroids. No clear-cut difference in transplantation outcome was found when recipients of kidneys from related living donors (whether HLA identical or HLA haploidentical) were considered. By contrast, an improved transplant survival and a decreased incidence of rejection crises were observed in recipients of kidneys from cadaver donors when a thoracic duct drainage was performed prior to transplantation. The immunosuppressive effect of thoracic duct drainage, probably enhanced by antilymphocyte globulin treatment, is therefore a valuable adjunct to more conventional methods of pretreating human cadaveric transplant recipients.

Histological and hormonal testicular changes in spinal cord patients.

Hormonal dosages and testicular biopsy are discussed in paraplegic patients of several neurological levels. There are no absolute biological criteria but histology showed slowing of spermatogenesis.

[Impaired statics of bladder and urethra in some lower motor neurobladders and its treatment by colocystopexia (author's transl)]. / La bascule postérierure de la vessie et de l'urètre de certaines neuro-vessies périphériques et son traitement par la colocystopexie

In spite of sphincter paralysis, the peripheric moto-neurone lesions induces bladder retention. Secondary retention forces fail to open the bladder neck owing to detrusor flaccidity. Long-dated, abdominal straining increases this static dysfunction by inducing posterior bladder prolapsus upon a flaccid perineum. This disorder est characterized by three components: --posterior prolapsus of the bladder, --horizontal position of the proximal urethra, --deepening of Douglas peritoneum. These patients may get a micturation using a perineal compression; similarly, surgical management consists in a making-up and fastening of the bladder by means of the rectum which is used as a hammack (colocystopexia). The procedure had been used in five cases with good results.

Pathology of the striated urethral sphincter in spinal cord injury patients: indications and results of external sphincterotomy (100 cases).

Up to date, we have carried out 100 external sphincterotomies, of which 65 only concerned traumatic spinal cord injuries.

Differential diagnosis and limitations of external sphincterotomy.

A study of 1000 neurologic bladders has shown us that a well-balanced working of the bladder must be keenly searched for, and that sphincterotomy must be early indicated, and even performed several times if necessary. So 100 sphincterotomies performed on male patients, out of 730 cases, have shown us that their one-and-only risk, incontinence, depended chiefly of the condition of the detrusor, therefore on the short or long evolution of the sclerosis of the external sphincter, which is only one out of all the possible impediments.