[Radical retropubic prostatectomy (RRP) without postoperative bladder catheter: study about 14 cases]. / Prostatectomie radicale rétropubienne (PRRP) sans drainage vésical postopératoire : étude de faisabilité à propos de 14 cas.

OBJECTIVES: To report the feasibility of radical retropubic prostatectomy (RRP) without postoperative bladder catheter. MATERIAL & METHODS: We report our experience in 14 patients (mean age 62 [48-75]) who underwent radical retropubic prostatectomy for localised prostatic adenocarcinoma from May 2006 to January 2010. The surgical technique was performed as classically described, without bladder neck preservation (tennis-racket closure), with or without nerve sparing (JP). The criteria that led us not to drain were the satisfactory urethral length, a tension-free anastomosis performed on a bladder catheter with separate sutures, and a lack of anastomotic leack after bladder filling with 200cc. RESULTS: The mean hospital stay was 4 days (3-8). Ten patients (71.4%) needed intermittent bladder catherism four times (1-11) before starting micturitions, without any technical difficulties. No anastomic leack was reported. Nine patients (64.3%) were continent leaving the hospital. With a mean follow-up of 30 months (5-48), all of 14 patients (100%) were perfectly continent. No anastomotic stricture was reported. CONCLUSION: RRP without postoperative bladder catheter was feasible, with no other early or late complication associated. Early and late continence were perfect (100% at 2 years).

[Adrenal hemorrhage acutised by adrenocorticotropin hormone]. / Hématomes surrénaliens potentialisés par le Synacthène (HSS).

OBJECTIVE: Many spontaneous adrenal hematomas have been observed in patients being treated by Synacthène. The purpose of this study is to define how to take those patients in charge on a short-, mid- and long-term. PATIENTS AND METHODS: From January 2000 to December 2008, five patients (four males and one female), mean age 47, were taken in charge in our service for spontaneous adrenal hematomas. All those patients had been treated with Synacthène for a mid-sciatic pain for 72 hours. We associated a clinical, endocrine and radiologic staging to treat those patients. RESULTS: Four patients underwent a watchful waiting, only one patient needed surgery. No adrenal tumor was ever found during the mean two years follow-up (one to four). Two patients suffered of the condition of the antiphospholipid syndrome. CONCLUSION: Spontaneous adrenal hematomas are a most uncommon pathology. The clinical attitude has thus to be defined clearly. The patient must be under close clinical evaluation. Biological and morphological parameters have to be often repeated. An adrenal tumor has to be excluded by the evaluation, as that tumor could be secreting or could not be secreting. Antiphospholipid syndrome must also be excluded.