[Analysis of postoperative urgenturies after prostate photovaporization by the laser Greenlight ®]. / Étude des urgenturies postopératoires après photovaporisation prostatique par laser Greenlight ®.

UNLABELLED: Urgencies are classically described after prostate photovaporization (PVP). The objective of this study was to analyze the incidence of urgency in patients who underwent PVP using the International Prostate Symptom Score (IPSS) to defined urgencies. METHOD: This is a single-center prospective cohort study assessing patients who underwent surgery between May 2005 and January 2011. The questions 2 and 4 of the IPSS and open questions were selected to evaluate urgency during the follow-up. RESULTS: Two-hundred and four patients were operated during this period and 93 complete records were analyzed. Twenty-one percent of these patients had a clinical urgency after 1 month and 1,9% at 12 months (significant improvement, P<0.001) corresponding to scores greater than 4 for questions 2 and 4 of the IPSS. Answer scores to questions 2 and 4 improved significantly over 12 months (P<0.001). The clinical urgencies decreased significantly as well as answers to questions 2 and 4 of the IPSS. CONCLUSION: Urgencies decreased significantly between 3 and 12 months of postoperative follow. Questions 2 and 4 of the IPSS score appeared to be a standardized definition of these urgencies.

[Bacillus Calmette-Guerin maintenance treatment in non-invasive bladder tumors: 1 year follow-up results of multicenter URO-BCG-4 trial]. / Traitement d'entretien par BCG-thérapie des tumeurs de vessie n'infiltrant pas le muscle (TVNIM): résultats à un an de l'étude multicentrique URO-BCG-4.

INTRODUCTION: Intravesical instillations of BCG remains the gold standard for intermediate and high risk NMIBC management. Maintenance treatment is recommended, however, the frequency of side effects responsible for the discontinuation of maintenance therapy over four out of five patients before the third year suggest a reduction or even spacing instillations. The objective of the study URO-BCG-4 was the evaluation of a new maintenance schedule by intravesical instillations of BCG combined reduced dose (third dose) and a decrease number of instillations per cycle (two or three). MATERIAL AND METHODS: Multicenter study of the French Association Oncologic Committee (12 university hospital centers), randomized, prospective, comparing reference diagram of BCG maintenance therapy one third of usual dose (group I) to a regimen combining third dose and decrease the number of instillations per cycle (two instead of three) (group II). We present the preliminary results at 1year of this Program of Clinical Research (CHU Rouen Promoter 2003-081). RESULTS: The rate of recurrence was respectively 9 and 7% (P=0.678) in groups I and II. The rate of tumor progression are 3 and 2.8% in groups I and II (P=1). Tolerance of intravesical instillations of BCG scored according to the WHO classification (Geneva 1979) was similar in the two groups. CONCLUSION: The decrease in the BCG dose (third dose) and the changes in the number and rate of instillations did not alter free tumor recurrence survival. The toxicity of intravesical instillations of BCG was identical in both groups. The use of the WHO classification has shown its limitations in the study of side effects of BCG as too complex and often not exhaustive. The rate of increase muscle was comparable in the two groups; however, a larger clinical experience is required.

[Input from a specialized nurse consultation in the management of detrusor overactivity treated with intradetrusor injections of botulinum toxin in urology department. Pilot study]. / Apports d'une consultation infirmière spécialisée dans la prise en charge de l'hyperactivité détrusorienne traitée par injections intradétrusoriennes de toxine botulique dans un service d'urologie. Expérience pilote.

OBJECTIVES: To adapt in daily practice, in a urology department, recommendations for good clinical practice for follow-up of neurological patients with neurogenic detrusor overactivity treated with injections of botulinum toxin type A by involving a referent nurse in neuro-urology. METHOD: A nurse consultation in neuro-urology has been created in June 2007 to intervene at each follow-up consultation at D0, D8, D45, then by phone until reappearance of functional signs to organize a new injection of botulinum toxin. This pilot study evaluated the faisability, the input on clinical workload, and the benefit on relationship between the patient and the caregiver. RESULTS: An improvement of the quality of care has been given to the patient since first contact to follow-up. The number of neurological patient transfers and waiting time between the recurrence of functional signs and new therapeutic care were reduced. The number of medical consultations has been reduced saving time to redistribute on other activities. Knowledge improvement and privileged relationship with the patient and the doctor were reported by the referent nurse. CONCLUSION: The participation of a referent nurse in neuro-urology has improved the quality of care of these patients from first contact to follow-up and has allowed adaptation of the recommendations in the practice of caring of an urology department.

[Renal angiomyolipoma with inferior vena cava extension]. / Angiomyolipome renal à extension veineuse cave inférieure.

Angiomyolipoma is generally a benign and noninvasive tumor. We report a case of angiomyolipoma with tumor thrombus from the renal vein into the inferior vena cava suggesting a malignant disease.