[Treatment of detrusor-striated sphincter dyssynergia with permanent nitinol urethral stent: results after a minimum follow-up of 2 years]. / Résultats à moyen terme du traitement de la dyssynergie vésicosphinctérienne par sphinctérotomie prothétique permanente.

OBJECTIVES: The aim of this study was to assess the outcomes of nitinol permanent urethral stents used in detrusor-striated sphincter dyssynergia (DSD) treatment on male patients with a spinal cord injury. MATERIALS: We investigated retrospectively all patients treated from 2004 to 2012. A total of 22 patients were included, with an age ranging from 22 to 76 years old. The DSD syndrome was due to spinal cord injury (18) or various spinal cord diseases (four) and treated with a nitinol urethral stent (11 Ultraflex(®) and 11 Mémotherm(®)). Every patient had an urodynamical study. The follow-up reached at least 2 years. RESULTS: The mean follow-up was 56 months (± 14). Complementary procedures after stenting included: five stent prolongation or displacement (mean interval 7.6 months), six bladder neck incisions (12.2 months), three urethrotomy (42 months), ten obstruction treated by laser (47.3 months). Eight patients had a change of their urinary pattern: four underwent ileal conduit diversion, one had a continent urinary diversion, one chose self intermittent catheterization, two were under indwelling catheterization waiting for another treatment. Stent retrieval was either harmful or impossible for four of them. Three patients were free of complementary procedures. CONCLUSIONS: Nitinol urethral stent was an effective treatment initially. However, by the third year, urethral stenosis and hypertrophic growth of the urethral mucosa usually require iterative endoscopic procedures (0.31 per patient per year). Patients treated with permanent uretral stent deserve a yearly endoscopic follow-up. Safety and effectiveness of permanent uretral stent compared to surgical sphincterotomy to treat DSD are discussed.

[An incrusted ureteral stent: use of a Lithoclast. Apropos of a case]. / Sonde urétérale incrustée: utilisation du Lithoclast. A propos d'un cas.

Ureteric stents can be complicated by incrustations, sometimes making it impossible to withdraw or replace the stent over a guide. In this exceptional indication, we report a case in which the use of the Swiss-Lithoclast pneumatic lithotriptor allowed withdrawal of an incrusted double J stent. There was no morbidity related to the use of the Lithoclast. Among the various techniques available for removal of these incrusted double J stents, endoprosthetic lithotripsy appears to be the most effective and the least invasive, in selected cases.

[Prostatic utricle, a rare but potentially curable cause of male sterility]. / L'utricule prostatique, une cause rare mais potentiellement curable de stérilité masculine.

This case report describes a patient presenting a cyst of the prostatic utricule that was detected during assessment for sterility and removed surgically. A review of the pertinent literature is proposed. Azoospermia or severe oligospermia associated with a low ejaculation volume are the main manifestations. Transrectal ultrasonography is the diagnostic examination of choice. In most cases incision of the mouth of the utricule promptly abolishes sterility and enables fertilization.

European experience with the urethral Wallstent for urethral strictures.

We describe the use of the urethral Wallstent in 71 patients with urethral strictures. The stainless steel stent is self expanding when released from its endoscopic introducer. The results over a 3-year period have been good with only mild discomfort and slight urethral leakage for up to 3 months. Migration, infection and encrustation have not been a problem and serial endoscopic review shows healing to be variable but complete in up to 12 months. It is considered that this simple endoscopic technique offers a simple, safe and effective alternative to multiple dilatations, urethrotomies and urethroplasty procedures in patients with bulbar urethral strictures.