[The many urological consequences of smoking]. / Les nombreux impacts urologiques du tabagisme.

The detrimental consequences of tobacco use in urology are often underestimated, despite its strong association with urological pathologies, including malignancies, sexual dysfunction, and urinary tract symptoms. Tobacco's components damage DNA, increasing the risk of bladder and urinary tract cancers, as well as renal cancer. In males, it's also correlated with prostate and penile cancers. Functionally, it leads to sexual dysfunctions, reducing erectile capacity and fertility in males. In females, it's linked to elevated urinary incontinence. In both genders, urinary tract symptoms worsen. Smoking cessation is consistently beneficial and should be encouraged by healthcare practitioners.

Les méfaits du tabagisme en urologie sont peu connus, pourtant il provoque diverses pathologies, incluant des cancers urologiques et des troubles sexuels et mictionnels. Les composants du tabac endommagent l'ADN, favorisant la survenue de cancers de la vessie et des voies urinaires, dont il est le principal facteur de risque, ainsi que du rein. Chez l'homme, le tabac accroît également le risque de cancer de la prostate et du pénis. Sur le plan fonctionnel, il induit des troubles sexuels, réduisant l'érection et la fertilité chez l'homme. Chez la femme, l'exposition au tabac est associée à une prévalence augmentée d'incontinence urinaire. Chez les deux sexes, les symptômes mictionnels sont aggravés. Une désintoxication tabagique est toujours bénéfique à court et long termes et doit être encouragée par les praticiens à chaque consultation médicale.

[Male contraception: what are the currently available options?] / Contraception masculine : quelles options actuellement disponibles ?

Male contraception plays a small role in global contraception. However, safe and effective means exist and are available with a low failure rate, such as vasectomy or to a lesser extent, condoms. Other so-called natural methods are used despite being less effective, such as periodic abstinence or withdrawal. Finally, new methods are currently being evaluated or developed, such as thermal contraception, hormonal and non-hormonal contraception. Although preliminary results are encouraging, the effectiveness of these methods remains variable and sometimes difficult to reproduce, and still requires controls and validation regarding their safety over long-term use.

La contraception masculine ne représente qu'une faible proportion de la contraception mondiale. Pourtant, des moyens sûrs et efficaces existent et sont disponibles avec un taux d'échec faible, comme la vasectomie ou, dans une moindre mesure, le préservatif. D'autres méthodes dites naturelles telles que l'abstinence périodique ou le retrait sont utilisées malgré leur efficacité moindre. Enfin, certaines méthodes sont en cours d'évaluation ou de développement comme les contraceptions thermique, hormonale et non hormonale. Bien que certains résultats préliminaires soient encourageants, l'efficacité de ces méthodes reste variable et parfois difficilement reproductible. Elle nécessite encore des contrôles et validations concernant leur sûreté pour une utilisation à long terme.

Introduction of a specialized consultation prior to insertion of totally implantable access venous devices: Impact on cancellation rate and patient satisfaction.

OBJECTIVES: Preoperative consultation is usually not performed before insertion of a totally implantable venous access device (TIVAD). In our experience, an incomplete preoperative assessment, a predictable medical condition contraindicating surgery, or no-show patients the day of surgery led to several surgery cancellations. Therefore, we introduced a specific preoperative surgical consultation for TIVAD that took place shortly before surgery. The aim of the present study is to evaluate the patients' satisfaction and to establish the rate of cancellation after the adoption of this strategy. METHODS: Two-hundred and four patients who benefited from the preoperative consultation before TIVAD insertion from August 2014 to August 2016 were included. Satisfaction of patients and cancellation rate were documented. RESULTS: With that strategy, no TIVAD insertion was either delayed or cancelled. The overall level of satisfaction was high (91.8%); 184 patients (90.2%) judged the consultation useful in preparation for the surgery. The surgical procedure met their expectations in 92.2% of cases. Patients known for a psychiatric comorbidity were more likely to express dissatisfaction. CONCLUSIONS: The introduction of a specific preoperative surgical consultation for TIVAD insertion led to a high level of patients' satisfaction. After the preoperative consultation, no cancellation was recorded. Special approaches have to be considered for patients with a psychiatric comorbidity.

Functional outcomes obtained with intracorporeal neobladder after robotic radical cystectomy for cancer: a narrative review.

Robot-assisted radical cystectomy with intracorporeal urinary diversion is one of the most challenging procedures in urological surgery. Over the past 15 years, this procedure has gained in popularity and the number of procedures performed has increased significantly. While ileal conduit remains the most common diversion, orthotopic neobladders are also formed in a few expert centres that have developed their technique for totally intracorporeal neobladder. The objective of this review is to summarise the techniques currently used to perform totally intracorporeal neobladder with a special focus on their functional outcomes, such as continence or sexual function. The techniques described are the Karolinska-modified Studer neobladder, the USC-modified Studer neobladder, the pyramid pouch, the Y-pouch, and the vesica Ileale Padovana, some trying to totally reproduce the steps of open surgery and others trying to simplify them. Functional outcomes vary depending on the technique performed. Standardisation in assessing outcomes is lacking, as well as objective outcome measurements with questionnaires or urodynamic assessments. Current evidence shows acceptable functional outcomes after totally intracorporeal neobladder construction, but larger prospective randomised series with longer follow-up, better defined outcomes, and more objective measurements are needed in the future.