[Ablative treatments in localized renal cancer: literature review for 2014]. / Les traitements ablatifs dans le cancer du rein localisé : revue de la littérature en 2014.

OBJECTIVE AND METHOD: To focus on indications and results of ablative treatments (cyoablation, radiofrequency) for small renal masses, a bibliographic research was conducted in MedLine database using terms of "ablative treatment", "cryotherapy", "radiofrequency", "kidney cancer", "renal cell carcinoma". Sixty-four articles were selected. RESULTS: Carcinologic outcomes seem to be better with cryoablation than with radiofrequency. Available results have to be balanced according to surgical approach, teams' experience and duration of follow-up. Tumour's size and central localization are the main factors of failure. The size of 3cm is the most generally validated. Hospital stay and complications seem to be better with ablative therapies than with surgical approach, especially with percutaneous approach. The renal function preservation appears to be better with ablative therapies. It could be an interesting alternative to partial nephrectomy for small masses, in particular for fragile patients or in particular indications (multifocal tumors, in case of solitary kidney or transplanted kidney). The indications in elderly people must be proposed with care after the comorbidities have been evaluated. CONCLUSION: Indications of ablative treatment for small renal masses improve, but the gold standard treatment remains partial nephrectomy and indications must be individually discussed. Other ablative treatments are under-development, needing further studies.

Results of sacral nerve neuromodulation for double incontinence in adults.

Faecal incontinence and urinary incontinence are common and often associated. Sacral neurostimulation is a validated technique for treating each of these two types of incontinence, taken separately. The purpose of this study was to review the literature on the results of this treatment for double incontinence. A literature search was conducted using MEDLINE, PubMed, EMBASE and the Cochrane Library using the keywords "faecal incontinence", "anal incontinence", "urinary incontinence", "urgency", "urinary disorder", "neurostimulation", "sacral nerve stimulation" and "electric nerve stimulation". We limited the search to English-language articles on faecal and urinary incontinence in adults published from 1995 to the present. We identified six articles, comprising 113 patients who were followed for 3-62 months. Improved faecal incontinence was observed in 44-100 % of cases, while improved urinary incontinence was observed in 20-100 % of cases. Patient satisfaction with the correction of double incontinence, both anal and urinary, was highly variable, ranging from 20 to 100 %. As anal incontinence and urinary incontinence are often associated and are sometimes responsive to sacral neuromodulation, it seems attractive to provide such treatment for double incontinence, to improve both digestive and urinary symptoms.