[Secondary recurrent haemorrhage with peristomal varices complicating a urinary derivation according to Bricker and treated efficiently by endoscopic way]. / Hémorragie récidivante secondaire à des varices péristomiales compliquant une dérivation urinaire selon Bricker et traitée efficacement par voie endoscopique.

Stomal varices developed in patients with cirrhosis and enterostomy can be source of important haemorrhages. It is a rare event but often recurrent and difficult enough to treat efficiently. In certain cases, consequences can be severe. We report the case of a 63-years-old patient with medical history of hepatic cirrhosis who underwent a radical cystoprostatectomy with urinary derivation type Bricker. Five years afterwards, he developed stomal varices very haemorrhagic treated efficiently by endoscopic way, without any recurrence 12 months later. This observation shows that stomal haemorrhages can be treated by endoscopic way.

[HIFU for prostate cancer in patients with a history of severe colorectal disease]. / Cancer de prostate associé à une pathologie rectale sévère. Résultats préliminaires carcinologiques et fonctionnels du traitement par HIFU (Ablatherm).

OBJECTIVES: To report the functional and oncological outcomes of HIFU for prostate cancer in patients with a history of severe colorectal disease. METHODS: Between 2002 and 2009, 14 patients with a history of severe colorectal disease (cancer, lymphoma, inflammatory bowel diseases [IBD]) were treated with HIFU as a primary care option for localized prostate cancer. RESULTS: Mean age was 65.8 ± 6.1 years. Mean time between colorectal disease treatment and HIFU was 10.6 ± 6.8 years. The mean Prostate Specific Antigen (PSA) before HIFU was 12.1 ng/mL (4.5-55). Gleason score was inferior or equal to 6 in four patients (28.6%), equal to 7 in nine patients (64.3%) and superior or equal to 8 in one patient (7.1%). The mean prostate volume before HIFU was 22.1 ± 11.7 mL. The number of HIFU sessions per patient was 1.35. The mean nadir PSA was 0.61 ± 0.82 ng/mL. Systematic control biopsies were negative in seven patients (50%). Mean follow-up was 22 months with a 35.7% complication rate (three erectile dysfunctions, two urinary stress incontinences). No recto-urethral fistula occurred. CONCLUSION: HIFU was an interesting therapy for patients with a history of colorectal disease for whom regular treatment was challenging or non feasible.