[Is pressure transmission quality during cystometry dependent on the type of effort?] / La qualité de transmission des pressions pendant la cystomanométrie est-elle dépendante du type d'effort ?

INTRODUCTION: The International Continence Society (ICS) recommends a control of the good pressure transmission by a coughing effort during cystometry. While poor transmission is sometimes observed in routine practice, other maneuvers can also be proposed. The main objective of this study was to determine if there is a better maneuver to evaluate the pressure transmission ratio between the abdominal cavity and the bladder. METHODS: We performed a prospective, consecutive, single-center study in a tertiary neuro-urology department in 31 subjects. During a cystometry, each patient was asked to perform at 0ml and 100ml of bladder filling, a cough effort, an abdominal push and a Valsalva maneuver controlled by a manometer. The value of the bladder pressure to abdominal pressure ratio was collected manually. The average variations were compared between each maneuver for the same volume of replenishment and between the 2 volumes of replenishment studied. RESULTS: At 0ml of filling, the difference in pressure variation between the Pves and the Pabd is significantly higher during the cough maneuver compared to the Valsalva (P=0.015), which is not found at 100ml of filling. CONCLUSION: During bladder filling, the pressure transmission ratios during the 3 maneuvers are equivalent. Coughing or abdominal thrusting, which are easier to perform than the Valsalva maneuver, should be recommended to check the quality of the recording during cystomanometry.

[Analysis of anorectal manometry data in central and peripheral neurological deseases: Review of the literature]. / Analyse des données de manométrie ano-rectale dans les pathologies neurologiques centrales et périphériques : revue de la littérature.

INTRODUCTION: Peripheral or central neurological deseases are providers of anorectal disorders of variable clinical expression (constipation, dyschezia, faecal incontinence (FI)…). Anorectal manometry (ARM) participates in their exploration to determine the underlying mechanisms, guide and optimize treatments. The objective of this work was to determine if there is a pattern of ARM data in neurological populations. MATERIALS ET METHODS: Literature review from PubMed, Cochrane and Google scholar databases, using the following keywords: parkinsonian disorders; parkinson's disease; multiple slcerosis; neurolog*; spinal cord injury; spina bifida occulta; stroke; pudendal; endometriosis; peripheral nervous system diseases. 196 articles were isolated and finally 45 retained after reading the title and the abstract. RESULTS: Data comparison was difficult due to the heterogeneity of techniques and thresholds used. In central lesions, resting and squeeze anal pressures were often altered. The presence of FI or constipation, the sex and the lesion level were factors influencing these data (low if complete injury, women or EDSS>5.5). In case of peripheral lesion, it is the anal tone and the contraction that varied the symptomatology. The sensory thresholds were variable regardless of the impairment. CONCLUSION: This review did not identify a data pattern of ARM in central and peripheral neurological deseases. Gradual standardization of techniques and protocols will allow better comparison of data.

[3 cases of uterine inversion. Description of a new technic for the management of this complication]. / A propos de trois cas d'inversion utérine. Description d'une technique originale pour la cure de cette complication.

We report three cases of complete inversion of the uterus following delivery. One became chronic and this gave rise to the need for surgical cure, which consisted in carrying out a midline hysterotomy longitudinal and sagital, without reaching down to the cervix. The two halves of the body of the uterus which resulted were reduced easily one after the other. The hysterotomy was then sewn up correctly.

[Abdominal cystic lymphangioma. Apropos of a case in an adult]. / Lymphangiome kystique abdominal. A propos d'un cas chez l'adulte.

The authors report a case of cystic abdominal lymphangioma that appeared 4 months after delivery in a woman of 31 years of age. As in most of these cases, the exact diagnosis was not made before operation. Its occurrence following recent pregnancy makes one think that it could have arisen from a lymphatic block.