[Reflections on a series of 39 cases of primary vesico-renal reflux in adults]. / Réflexions sur une série de trente-neuf cas de reflux vésico-rénal primitif de l'adulte.

The authors report thirty nine cases of primary vesicorenal reflux in adults, involving sixty nine ureters. The series includes two women for every three men, with an onset normally in the twenties (the average age was 28 years and 6 months). In 86.6% of the patients, the disorder was revealed by urinary infections, and the case history extended back over an average of eight years. The urinary infection had a severe impact on the renal parenchyma, so that 54% of the patients presented with bilateral parenchymal lesions. Isotopic cystography appears to provide a more sensitive diagnostic tool than conventional radiological cystography, and the radiation effects are far less pronounced, so that the examination can be repeated more frequently in search of intermittent refluxes in patients with pyelonephritic lesions. The surgical management is by uretero-vesical reimplantation. The authors presently prefer Cohen's technique, which gives 88% good results. On the other hand, after surgical élimination of the urinary infection, the pyelonephritic lesions or renal insufficiency are irreversible, but they remain stable.

[Treatment of urethral stenosis. 1]. / Traitement des sténoses de l'urètre. Première partie.

The treatment of urethral strictures has considerably developed over recent years: surgical urethroplasty has been perfected at the same time as internal urethrotomy has gained a new lease of life as a result of endoscopy. Urethral dilatation by means of probes used for arterial stenoses constitutes another interesting development in this field. We reviewed our case files with a double objective in mind: to determine the reasons for our changing therapeutic practices and the results of these three methods. Our study was also interesting because it was the first time that the incidence of this therapeutic development on the economic consequences of this disease, which generally affects professionally active adults, has been assessed. Several factors can be taken into consideration: however, as the length of time off work and the cost of concomitant drug treatments were unable to be determined with sufficient accuracy by our survey, we finally assessed the duration and the number of hospital admissions for each patient. Although only fragmentary, these data appear to reflect fairly accurately the economic impact of the treatments used.