[Endoscopes in urology: disinfection, sterilization, labeling and tracking. Circulars and decrees. Modes of application and commentary. The Committee of Infectious Diseases of the French Association of Urology. Congressional forum UFA--Paris, November 1996. DGS Circular 20 October 1997]. / Les endoscopes en urologie: désinfection, stérilisation, marquage et traçage. Circulaires et décret. Modalités d'application et commentaires. Comité d'infectiologie de l'Association Française d'Urologie (CIAFU). Forum Congrès AFU-Paris, novembre 1996. Circulaire DGS 20 octobre 1997.

Administrative texts published in 1995, 1996 and 1997, have reinforced materiovigilance and impose disinfection precautions for endoscopes. The steps of disinfection of non-sterilizable endoscopes are: preliminary treatment, rinsing, actual disinfection, final rinsing, storage (see: Progrès en Urologie, 1997, 7, 505-507). Each procedure from collection of the endoscope until storage must be defined by written standard operating procedures validated by CLIN. The risk of transmission of Creutzfeld-Jakob disease requires autoclaving, which is only possible, at the present time, with the most recent rigid endoscopes. Until disinfection has become generalized, the traceability of endoscopes (labelling, utilization files) must be established on the model recommended for haemovigilance (circular of 02/04/96).

[Testicular germinal tumors. Current therapeutic principles]. / Tumeurs germinales testiculaires. Principes thérapeutiques actuels.

The cure rate for germinal tumors of the testes are now very high, greater than 80%, all stages and histological types taken as a whole. This calls for a revision of therapeutic indications, in light of these results and modern staging methods. In localized stages, or tumors associated with a good prognosis, therapeutic de-escalation is in progress, in order to limit the side effects. In invasive forms or forms associated with a poor prognosis, the use of more aggressive methods, such as high dose chemotherapy, should further improve prognosis.

[Treatment of varicoceles]. / Traitement des varicocèles.

The mechanisms of infertility in varicoceles are still ill-defined; their repercussions are variable and unrelated to the degree of venous dilatations (a good number of such patients have no fertility problems). Oligo-astheno-teratospermia is a non-pathognomonic entity, also encountered in chronic infections, previous history of cryptorchidism, gonadotrophic insufficiencies and toxic of iatrogenic causes. Should varicoceles be operated on, in order to treat the oligo-astheno-teratospermia? After strongly advocating surgery in the 60's, this approach is, in retrospect, being questioned. Varicoceles affect a very heterogeneous population with various degrees of infertility. To answer this question, randomized studies based on strict criteria, should be undertaken.

[Secondary paraneoplastic polycythemia of testicular cancer]. / Polyglobulie secondaire paranéoplasique d'un cancer testiculaire.

The authors report the case of a 41-year old patient with polycythaemia and a mixed testicular tumour (seminoma with choriocarcinomatous contingent). The demonstration of a raised erythropoietin level in the tumor tissue with a high gradient in relation to the serum argues in favour of secondary paraneoplastic polycythaemia. With a follow-up of 5 years, the patient is still in complete remission from his two diseases. This case may represent the first case of testicular tumour responsible for secondary polycythaemia.

[Female urethrocele. Difficult diagnosis and therapy. Apropos of 10 cases]. / Les urétrocèles féminines. Difficultés diagnostiques et thérapeutiques. A propos de dix cas.

The authors present 10 cases of urethrocele, 5 of which were diagnosed after a delay of 1 to 12 years after onset of the initial signs. A single case of endoscopic treatment: opening of the neck in an elderly patient in poor general condition; 9 excisions of the urethrocele pouch with a single transient urethro-vaginal fistula which closed spontaneously. There were no cases of postoperative incontinence. Installation of the patient in the ventral decubitus position with the thighs semi-flexed in abduction provides much greater operative comfort to the classical gynaecological position. The use of an L-shaped vaginal incision, not in the line of the urethra, limits the risks of secondary fistula.

[Renal cancers and caval thrombus, prognostic study. Apropos of 25 cases]. / Cancers du rein et thrombus cave, étude pronostique. A propos de vingt-cinq cas.

Of the 235 renal cancers treated between 1975 and 1984, twenty five cases were complicated by thrombus of the vena cava. Analysis by Kaplan-Meier's method shows a satisfactory survival rate for isolated thrombus of the vena cava (80 per cent at two years, and 45 per cent at five years). But associated lesions to the perirenal fat or lymph nodes considerably diminishes the survival rate, so that the overall survival rate in this series was only 37 per cent at two years and 20 per cent at five years. 57 per cent of the patients who seemed free of distant metastases during the preoperative investigations, nonetheless died within two years postoperatively, from a lung, liver or bone metastasis. CT scan at present allows diagnosis of renal cancer and assessment of the extension to the fatty capsule and the vena cava. It is to be hoped that nuclear spin electronic resonance will provide a better assessment of the prognostic factors, and, in particular, the lymph node extension.

[Leukemic infiltration and adenocarcinoma of the prostate gland (author's transl)]. / Infiltration leucémique et adénocarcinome de la prostate.

The appearance of a leukemic infiltration of the prostate gland as the first manifestation of a chronic lymphocytic leukemia, followed by an adenocarcinoma of the prostate gland, is exceptional, since only one case has been previously documented. For this reason the authors wish to signal the possibility of a prostatic infiltration in the course of chronic lymphocytic leukemia and insist on the association of this type of leukemia and cancer.

[Congenital recto-urethral fistula. Report of one case without associated anorectal malformation (author's transl)]. / Fistule recto-urétrale congénitale. Rapport d'un cas sans malformation ano-rectale associée.

Report of a case of congenital recto-urethral fistula in a man presenting with sterility. Cure of the fistula after a trans-anal sphincter and trans-anorectal approach of York-Mason without temporary colostomy.

[Traumatic rupture of the corpus cavernosum. Three cases (author's transl)]. / Rupture tramatique du corps caverneux. Trois cas.

"Fracture of the penis" by damage to the erectile structures is rare. This accident usually occurs when the erect penis is subjected to trauma, usually during intercourse. The diagnosis is easy in the presence of a haematoma spreading from the fraenulum to the scrotum, with sometimes an obvious breach in the albuginosa of one corpus cavernosum. In the three cases reported here, immediate surgery was possible in two. Early operation, with repair of the ruptured albuginosa, offers the best guarantee of cure without any disturbance in erection.