[Vesico-renal reflux and pregnancy]. / Reflux vésico-rénal et grossesse.

By modifying the anatomical location of the bladder and ureter, and by favoring urinary stasis and pyuria, pregnancy may reveal or aggravate an existing vesico-renal reflux. In reporting six cases of vesico-renal reflux in pregnant women, revealed by attacks of feverish lombalgia, or mictional disorders associated with pyuria, and confirmed postpartum by intravenous urography, retrograde cystography and cystoscopy, the authors recall the factors associated with pregnancy which favor the appearance of a reflux, mechanical, hormonal and metabolic action. Surgical correction of refluxes associated with pyuria and detected during pregnancy would seem indicated.

[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.

[Pregnancy and purulent retention of urine in the upper urinary tract. Apropos of 4 cases]. / Grossesse et rétention purulente d'urines dans la voie excrétrice supérieure. A propos de quatre cas.

The authors report their diagnostic and therapeutic approach to four recent cases. While ultrasound is an excellent diagnostic aid, only simplified intravenous urography can establish the nature and localization of the obstacle. As regards management, surgery, when it is possible, allows removal of the obstacle and the repair of the excretory tract. In pregnant women, as in other cases when surgery is not feasable, the drainage of the infected and retained urine is achieved endoscopically. The J ureteral catheter offers a sure and comfortable method. When retrograde catheterization is unsuccessful, percutaneous nephrostomy can be used as a temporary measure to tide over the pregnancy.

[A simple detubularized ileal neobladder]. / Une technique simple de néo-vessie iléale détubulée.

Generalized use of bladder replacement techniques has turned Cystoprostatectomy into a less mutilating operation and made its indication easier, particularly in patients with bladder carcinoma. The authors propose an easy way of detubularizing an ileal loop by mechanical section-suture with the GIA*, resulting in a good capacity neobladder by a simple and quick operation. Results of this technique in 38 Patients, with a mean follow-up of 13.5 months (2 to 36.9 months), point out its reliability, good tolerance of the high urinary tract and obtaining of a satisfying continence in most of the patients. The only real risk, that is stone formation on staples, seem negligible according literature, and only one case was observed in this series urodynamic results are presented and do not seem in close relation with clinical state, nor having any predictive value. At last considerations on cystoplasties continence are discussed, and nocturnal continence of neobladders is debated.

Ultrasonographic anatomy and physiology of the fetal kidney.

The aim of this work was to demonstrate the impact of ultrasonography in utero to gain a better understanding of the anatomy, growth, anatomical variations and function of the fetal kidney and urinary tract. Three main topics are discussed in this paper based on the authors' personal experience and data from the literature: 1) the technique of ultrasonography in utero, including the main difficulties encountered and limitations of this technique; 2) ultrasonographic study of the morphology, growth and anatomical variations of the fetal kidney. The length of the fetal kidney was found to be the most significant parameter for assessment of its growth. At term, the kidney measures slightly more than 4 cm in length, while the renal pelvis is usually no more than 10 mm thick; 3) current knowledge of the physiology of the fetal urinary apparatus especially the kidney. Excretory function of the kidney begins in the third month of gestation and its main role involves the regulation of the amniotic fluid.

Ultrasonographic anatomy and diagnosis of fetal uropathies affecting the upper urinary tract. II. Nonobstructive uropathies.

The authors describe the ultrasonographic anatomy and semiology of allowing detection of the main types of fetal non-obstructive uropathies. The results of the author's personal experience in this domain are compared to data from the literature. Differential features of the uropathies are given and the limitations and practical significance of prenatal and postnatal ultrasonography are discussed.

Ultrasonographic anatomy and diagnosis of fetal uropathies affecting the upper urinary tract. I. Obstructive uropathies.

The authors describe the ultrasonographic anatomy and semiology of allowing detection of the main types of fetal uropathies. The results of the author's personal experience in this domain are compared to data from the literature. Differential features of the uropathies are given and the limitations and practical significance of prenatal and postnatal ultrasonography are discussed.