RESUMO
OBJECTIVE: To assess safety and efficacy at short-term of a light-weight polypropylene mesh (28 g/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±9 years, 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 12 months (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.
Assuntos
Cistocele/cirurgia , Telas Cirúrgicas , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Polipropilenos , Estudos Prospectivos , Desenho de Prótese , Índice de Gravidade de Doença , Fatores de Tempo , VaginaRESUMO
We present a case report of uretero-acetabular fistula in a female complicating orthopaedic surgery of congenital coxal difformity. An ileal pedicle graft was used to replace the terminal ureter. The difficulty of such complication is to choose the best the rapeutic strategy between surgical and non surgical techniques. We review here the various urological armamentarium to affront such a rare and multifactorial complication.
Assuntos
Acetábulo , Doenças Ósseas/etiologia , Prótese de Quadril/efeitos adversos , Fístula Urinária/etiologia , Adulto , Feminino , HumanosRESUMO
The authors report a retrospective series of 114 radical prostatectomies performed over a ten-year period. This study was designed to investigate the factors likely to cause complications in order to prevent them. Stenosis of the vesicourethral anastomosis was observed in 22 patients and represented the commonest complication (19.2%). It generally occurred before the 12th month, while late stenoses. An anastomotic leak after removal of the bladder catheter appears to be the most significant factor. The decreasing incidence of these stenoses over the ten-year study period illustrates the role of operator experience. The most effective treatment for these stenoses is mono-incision which, completed by dilatation sessions, prevents recurrence without compromising continence.
Assuntos
Anastomose Cirúrgica/efeitos adversos , Prostatectomia , Uretra/cirurgia , Bexiga Urinária/cirurgia , Idoso , Constrição Patológica/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Fifty-seven bladder neck incisions were studied with a minimum follow-up of 5 years. The results published after one year were very satisfactory, but became more disappointing after 5 years, with a 38.7 reoperation rate. The weight of the prostate appears to be the determining factor. The indications, 5 years ago, were much wider than they are today, with prostate weights of up to 45 g on digital rectal examination. This type of operation should now be reserved for young subjects wishing to retain antegrade ejaculation with a prostate not exceeding 20 to 30 g and in high surgical risk patients unsuitable for transurethral resection.
Assuntos
Próstata/cirurgia , Hiperplasia Prostática/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Ejaculação , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Próstata/patologia , Hiperplasia Prostática/patologia , Recidiva , Reoperação , Uretra/cirurgia , Bexiga Urinária/cirurgia , Transtornos Urinários/cirurgiaRESUMO
We report a case of prostatic non Hodgkin lymphoma arising in a 61-year-old man. The treatment consisted of a chemotherapy with cyclophosphamide, adriamycine, vincristine and prednisone (CHOP regimen). A complete remission histologically proved was obtained. The literature and the treatment approach of prostatic lymphomas are reviewed.
Assuntos
Linfoma de Células B/patologia , Linfoma não Hodgkin , Neoplasias da Próstata/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Humanos , Linfoma de Células B/complicações , Linfoma de Células B/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico , Indução de Remissão , Vincristina/administração & dosagemRESUMO
The authors report a case of renal hydatid disease, a rare disease in France. After reviewing the recent data of the literature, they stress the value of computed tomography and especially MRI in the presumptive diagnosis.
Assuntos
Equinococose Hepática/diagnóstico , Idoso , Feminino , HumanosRESUMO
The authors report a case of idiopathic priapism in a 4 year old boy. This is an exceptional disease at this age, which was treated urgently by creating a cavernosospongiosum fistula with a rapidly favourable clinical course. The prognosis appears to be related to the rapidity of treatment. Although aetiological treatment can be proposed in the case of priapism due to haematological malignancies, only surgical treatment appears to be truly effective in the other forms.