[Renal cell carcinoma in the department of Hérault: Results over a 30 year period]. / Le cancer du rein dans le département de L'Hérault : résultats de 30 ans d'enregistrement.

OBJECTIVE: The objective of the study was to determine the specificities of renal cell carcinoma (RCC) in the department of Herault using the Herault Tumor Registry over 30 years. METHODS: Data of this study were obtained from the Herault cancer database. We analysed the evolution of RCC from 1987 to 2016, including the incidence, mortality, cancer pathology and staging at the moment of diagnosis. We compared our results with national and international data. RESULTS: We identified 3769 newly diagnosed RCC: 2628 in men (69,7%) and 1141 in women (30,3%). In 2016, RCC was the 8th most frequent cancer, both genders combined, the 7th most frequent cancer in men and the 11th in women. New cases of RCC increased by 4.2 in men and 3.3 in women over the study period. The number of localised forms increased by 9% over 20 years. In 2016, the probability of having a RCC before the age of 75 was of 2.11% for a man and of 0.62% for a woman. CONCLUSION: Over 30 years, the incidence rate of RCC increased in the department of Herault; however, mortality decreased over the same period. This analytical data should be improved by the development of the Registry of Herault Specialised in Onco-Urology (RHESOU). LEVEL OF EVIDENCE: 3.

[Management of adult's renal and ureteral stones. Update of the Lithiasis Committee of the French Association of Urology (CLAFU). General considerations]. / Prise en charge urologique des calculs rénaux et urétéraux de l'adulte. Mise au point du Comité Lithiase de l'Association Française d'Urologie (CLAFU). Aspects généraux.

The Lithiasis Committee of the French Association of Urology (CLAFU) aimed to update the current knowledge about urolithiasis. This update will be divided into four parts: 1) general considerations; 2) the management of ureteral stones; 3) the management of kidney stones; 4) metabolic assessment and medical treatment of urolithiasis. Recent technicals advances helped the urologists to improve stones management: new extracorporeal shockwave lithotripsy (ESWL) devices, new flexible ureterorenoscopes, development of laser fragmentation. ESWL, semi-rigid and flexible ureteroscopy and the percutaneous nephrolithotomy (PCNL) remain currently the main therapeutic options. The first part of this update deals with the description and classification of stones, preoperative assessment, post-operative management and clinical follow-up. Main criteria of therapeutic choices are stone location, stone composition and stone size. Stone composition is assessed with infrared spectrophotometry analysis and its hardness is correlated with U.H. density on CT scan assessment. Preoperative assessment consists in urinary cytobacteriological examine, urinary PH, blood creatininemia, hemostasis. Low-dose CT scan is recommended before urological treatment. The result of the treatment must be done 1 or 3 months later with plain abdominal film and ultrasonography. Medical management of urolithiasis will be based on stone composition, metabolic and nutritional evaluation. Treatment success is definited by absence of residual fragments. Annual follow-up is recommended and based either on plain abdominal film and ultrasonography or low-dose CT scan.

[Place of the flexible ureterorenoscopy first choice for the treatment of kidney stones. Survey results practice committee of the AFU lithiasis completed in 2011]. / Place de l'urétérorénoscopie souple en première intention pour le traitement des calculs du rein. Résultats de l'enquête de pratique du comité lithiase de l'AFU réalisée en 2011.

UNLABELLED: The flexible ureterorenoscopy coupled with photovaporisation LASER (USSR-L) for the treatment of kidney kidney is a modern tool whose place is under evaluation. METHODS: Its place has been assessed in France in 2010 by the Committee of urolithiasis of the French Association of Urology (CLAFU). A practice survey among 27 experts concerned the following decision criteria: comorbid patient's supposed nature of the calculation, anatomy of the urinary tract of the patient. This investigation has been proposed to calculate the size not exceeding 20mm, for a calculation of size greater than 20mm and for multiple calculations kidney. RESULTS: Fourteen experts responded. The criteria for the USSR-The first line were: morbid obesity (BMI>30), anticoagulation or anti platelet aggregation, calculations Hard (UH>1000, cystine stones), calculations within diverticular caliceal calculations below, the failure of a first treatment or the wish of the patient. CONCLUSION: The URS-SL was a first-line treatment validated regardless of size and number of kidney stones, when ESWL and PCNL were contraindicated or when their predictable results were poor (hard stones/morbid obesity/lower pole stones) or when stone access is difficult (intradiverticular). It was also the treatment of choice after the failure of a first treatment (ESWL/PCNL).

[A case of hydronephrosis disclosed after traumatic rupture of the kidney pelvis]. / A propos d'un cas d'hydronéphrose découverte lors de rupture traumatique de bassinet.

We report a typical case of traumatic ruptured hydronephrosis (moderate trauma, unknown hydronephrosis). Conservative treatment with pyeloplasty appears to be the best solution in these cases when as is frequently the case the major lesions affect the renal pelvis.

[Transurethral resection of the prostate. Our experience in a series of 244 cases. Mid-term results]. / La résection trans-urétrale de la prostate. Notre expérience sur une série de deux cent quarante-quatre cas. Résultats à moyen terme.

Two hundred and forty four patients were treated by transurethral resection of the prostate (68% for adenomas and 32% for epitheliomas) between June 1980 and August 1982. The indications for surgery are based on obstruction of the urinary outflow tract, and the weight of prostatic tissue, which can best be assessed by ultrasound. TURP is the technique of choice for small and medium-size prostates. Hemorrhage is the most frequent complication at operation. Resorption TURP syndrome is extremely rare if an isotonic liquid is used. Urinary tract infections are best treated preoperatively. 2.6% of the patients suffered from urethral stricture despite the use of a 24 French resectoscope and early removal of the catheter. The greater the surgeon's experience, the lower the incidence of definitive urinary incontinence.

[Our experience with the treatment of urethral stenosis in a series of 90 cases at the Strasbourg Hospital Center]. / Notre expérience du traitement de la sténose de l'urètre sur une série de quatre-vingt-dix cas au Centre Hospitalier de Strasbourg.

Ninety patients presenting with urethral stenosis were treated surgically at the Strasbourg Hospital, involving 100 internal urethrotomies and sixteen urethroplasties. The authors consider that short bulbous stenosis, with no previous treatment, should be treated endoscopically; that, if the stenosis recurs after two internal urethrotomies, or if the stenosis is infected or located in the pendulous or membranous urethra, a urethroplasty is indicated, as in cases of long bulbous stenosis; and that, even though the rate of complications is high following Johansson's urethroplasty, this procedure is indicated in cases of infection. The use of free full-thickness grafts led to a 100% success rate.

[Cyclophosphamide haemorragic cystitis in a child. Radiological and endoscopic aspects (author's transl)]. / Cystite hémorragique au cyclophosphamide chez un enfant. Aspects radiologiques et endoscopiques.

Haemorragic cystitis is a well known complication of cyclophosphamide therapy. In the reported case, a 7 years old boy treated for lymphosarcoma, as an excretory urogram demonstrated important focal irregularity of the bladder wall. Cystoscopy revealed areas of important bullous oedema with generalized hyperemia. A biopsy disclosed normal urothelium raised by oedematous and congestive chorion and excluded a malignant tumor. Various kinds of endoscopic and surgical procedures are reported to control persisting hematuria after withdrawal of the cyclophosphamide treatment.

[Severe digestive hemorrhage from ulcers on the posterior surface of the first part of the duodenum: clinical aspects and therapeutical results in 107 cases (author's transl)]. / Les hémorragies graves des ulcères de la face postérieure du premier duodénum. Problèmes pratiques et données actuelles du traitement. A propos de 107 cas.

The mode of onset, and clinical, radiological, and endoscopic findings in 107 cases of digestive hemorrhage are described, as well as variations in the period elapsing between onset and surgical intervention. Indications for surgery and the results obtained are analyzed. Operation consisted of subdiaphragmatic truncal vagotomy in 74 cases (followed by pyloroplasty in 68 and gastroenterostomy in 6 cases), gastroduodenal resection in 23 cases (with subsequent gastrojejunal anastomosis in 17 and gastroduodenal anastomosis in 6 cases), resection for exclusion operation as described by Finsterer in 8 patients, and highly selective vagotomy with pyloroplasty in 2 cases. Hemorrhage reoccurred in 12 patients (11.2 p. cent), after vagotomy and pyloroplasty in 11 patients (with 3 deaths), and one case after resection. Of the 8 early relapses, 4 were treated medically, leading to 2 recoveries and 2 deaths, the other 4 patients being treated by gastroduodenal resection, with subsequent recovery in 5 cases and one death. The 4 patients with late recurrences were successfully treated medically (2 cases) or surgically (2 cases). Though Weinberg's operation can still be considered as the basic operation in patients with hemorrhage from ulcers on the posterior in patients with hemorrhage from ulcers on the posterior wall of the duodenum, immediate gastric resection is still a valid procedure for large ulcers with thickened walls. Early relapse of hemorrhage after Weinberg's operation should be treated by resection.