[Prostate cancer screening: an update]. / Dépistage du cancer de la prostate: actualité.

Prostate cancer screening using PSA is controversial because of a low specificity and detection of non clinically relevant cancer. Two important studies have been published recently. One of two studies suggests a 20% lowering in specific prostate cancer mortality due to PSA screening. This benefit is relevant but implies at a high risk of overtreatment and treatment-related complications. Currently PSA screening is only proposed as an individual screening for informed patients.

[Active surveillance for early-stage prostate cancer]. / La surveillance active dans la prise en charge du cancer de la prostate précoce.

Diagnostic and treatment management of prostate cancer at its initial stage continues to raise important debates within the involved medical community. To establish a protocol for active surveillance, a validated option in specific conditions of localised prostate cancer management for eight years, is a unique opportunity to gather different specialists in this field. This paper presents this concept.

Ischemic cecal perforation secondary to ESWL of junctional stone in ureterosigmoidostomy (Mainz Pouch II).

We report an unusual case of ischemic cecal perforation after extracorporeal shock wave lithotripsy for an impacted stone at the distal end of the right ureter of a ureterosigmoidostomy in a 78-year-old female patient.

[Closed "penile" fractures: about two cases]. / Fractures << fermées >> de la verge: à propos de deux cas.

Closed penile fractures without hematoma and without rupture of the albuginea, though frequent, are not well documented. In most cases, faced with no or few symptoms, the patient makes little case of this painful episode. These fractures are secondarily responsible for a fibrotic response of the corpus cavernosum, which bring patients later on to the clinic. Radiological investigations show the fibrotic reaction. A diagnosis is made retrospectively, based on the patient's history.

[Partial nephrectomy in renal cancer: a new standard?]. / La néphrectomie partielle dans le cancer du rein: un nouveau standard?

Rising renal cell carcinoma incidence is in relationship with early diagnosis during radiological exams. Radical nephrectomy was the gold standard treatment for 30 years. Partial nephrectomy is nowadays a validated therapeutic option for renal cell carcinoma up to 7 cm with comparable oncological results associated with better life quality and survival. Partial nephrectomy is tricky and laparoscopic approach remains reserved for expert centers.

A case report on idiopathic recurrent priapism.

Idiopathic recurrent priapism is a difficult problem to treat and a potentially devastating condition that may result in irreversible penile fibrosis. We present the case of a patient who, during a period of 10 years, had recurrent episodes of idiopathic priapism and we show that therapeutic options do exist for the management.

[Urology]. / Urologie.

This reviewed publication summarized the newly therapeutic procedures in different urological pathologies. In the treatment of benign prostate hyperplasia (BPH), laser KTP with high power is now becoming a standard. For small benign testicle lesions, the surgical biopsy under echographic control avoid radical orchidectomy. In non-invasive bladder cancer, Hexvix fluorescence is gaining a wide acceptance. In invasive bladder cancer, new protocols of neoadjuvant chemotherapy demonstrate an increased interest. In renal cancer, immunomodulation and angiogenesis molecules seem to offer some hopes for advanced tumors. In bladder dysfunctions such as hyperactive bladder, new molecules have widens the range of the available treatments.

Urological complications in renal transplantation from cadaveric donor grafts: a retrospective analysis of 20 years.

INTRODUCTION: This study is a retrospective analysis of ureteral complications and their management from a monocenter series of 277 consecutive renal transplantations. MATERIALS AND METHODS: From September 1979 to June 1999, 277 renal transplantations (cadaveric origin) were performed in 241 patients. The ureter from the kidney graft was inserted into the bladder according to the technique of extravesical implantation described by Lich-Gregoir and Campos-Freire. The study analyzed the time of occurrence and the type of complications observed. The different procedures to restore the transplanted urinary tract are presented. RESULTS: Complications occurred in 43/277 renal transplantations (15.5%). Anastomotic urine leakage or ureteral stricture were the most frequent. The time to appearance of these complications was either short (<1 month) or late (>1 month) in a similar number of cases. Most cases were managed surgically: 33/43 cases (76.7%). The most frequent surgical repair was ureterovesical reimplantation (n=13), followed by: ureteroureteral end-to-end anastomosis (native ureter-ureter transplant, n=5); pyeloureteral anastomosis (native ureter-renal pelvis transplant, n=5); simple revision of ureterovesical implantation (n=4); resection and end-to-end anastomosis of the transplant ureter (n=2); calico-vesicostomy (graft-bladder, n=1); implantation according to Boari (n=1); pyelovesicostomy with bipartition of bladder (n=1), and pyeloileocystoplasty with detubularized ileal graft (n=1). No deaths related to any of the urological complications were reported. However, 2 consecutive vesico-renal refluxes led to the loss of the kidney graft in the long-term. CONCLUSION: The rate of complications observed in this retrospective analysis is similar to the experience of other studies, ranging from 2 to 20%. If the classical extravesical ureteral bladder implantation is to remain an attractive technique due to its simplicity, the surgical team at the training center should be aware of all the means to prevent any ureteral complications, such as the choice of another implantation technique and/or insertion of a transient ureteral stent.

Metachronous bilateral leydig cell tumor in a male adult aged 20.

We report a young male aged 20 who has suffered two episodes of Leydig cell tumor of the testis, the second occurring 5 years after the first in the contralateral testis. The case is outlined briefly, with references taken from the literature. This young man's history is exceptional as this type of tumor is infrequent, and metachronous bilateral presentation extremely rare.

[Erectile dysfunction: reasonable diagnostics and treatment in general practice]. / Rationale Abklärung und Therapie der erektilen Dysfunktion in der hausärztlichen Praxis.

The availability of efficacious oral drugs has radically changed the diagnostic and therapeutic approach to erectile dysfunction. Complicated examinations as well as invasive treatment options have been widely abandoned. Instead the management of impotent men has become much more pragmatic and focused on the symptom. Consequently only a minority of impotent men needs to be referred to an urologist, which makes the therapy of erectile dysfunction increasingly attractive for general practitioners. However, successful treatment first of all still needs time and a genuine interest in the field of erectile dysfunction. In this article a reasonable diagnostic evaluation of impotent patients in general practice is described. Furthermore indication and use of little or non-invasive therapies are discussed.

Krukenberg's tumor, three years after a colic carcinoma.

We report a case of left ovarian Krukenberg's tumor in a 65 year-old patient, three years after resection of a colonic carcinoma (pT3, G2, pN1, Stage 3, Dukes C). The case is briefly discussed with reference to the literature. Krukenberg's tumor usually occurs in younger patients, with a peak frequency before 40 years. Both ovaries are involved in 90% of cases. Pathogenetically the ovarian involvement arises either from hematogenous, lymphatic spreading or from contiguous extension from the primary colonic tumor. There may be some anatomic predispositions such as utero-ovarian vessel anastomosis in the ligamentum latum or by peritoneal adhesions.

The eukaryotic promoter database (EPD).

The Eukaryotic Promoter Database (EPD) is an annotated non-redundant collection of eukaryotic POL II promoters for which the transcription start site has been determined experimentally. Access to promoter sequences is provided by pointers to positions in nucleotide sequence entries. The annotation part of an entry includes a description of the initiation site mapping data, exhaustive cross-references to the EMBL nucleotide sequence database, SWISS-PROT, TRANSFAC and other databases, as well as bibliographic references. EPD is structured in a way that facilitates dynamic extraction of biologically meaningful promoter subsets for comparative sequence analysis. WWW-based interfaces have been developed that enable the user to view EPD entries in different formats, to select and extract promoter sequences according to a variety of criteria, and to navigate to related databases exploiting different cross-references. The EPD web site also features yearly updated base frequency matrices for major eukaryotic promoter elements. EPD can be accessed at http://www.epd.isb-sib.ch