[Ambulatory prostate photoselective vaporisation with GreenLight laser (180W): prospective evaluation from 115 patients]. / Vaporisation laser prostatique par GreenLight (180 W) en ambulatoire: évaluation prospective sur 115 patients.

OBJECTIVE: The goal of this prospective study was the evaluation of ambulatory (less than 12h) prostate photoselective vaporisation (PVP) with GreenLight laser XPS. MATERIEL AND METHODS: One hundred and fifteen consecutive patients eligible for ambulatory procedure according to selective criteria (age less than 80, no anticoagulation treatment, no diabetes, patient not alone at home) who underwent ambulatory PVP from 1st May 2012 to 30th June 2013 have been evaluated. The principal criterion was the success rate of ambulatory. Secondary criteria were 3 months functional results and complication rate and satisfaction rate on ambulatory procedure. RESULTS: Around 93.1% patients were successfully treated in ambulatory procedure. The main reason of failure was organizational. There were 2 conversions in monopolar resection and one operative complication. At 3 months, there were 11.5% grade 2 complications with 3.48% rehospitalizations and no reintervention. CONCLUSION: This study demonstrates the feasibility of ambulatory PVP. This procedure should be proposed to selected patients.

[Fournier's gangrene involving all of the scrotum: treatment by multiple repeated surgical excisions, diversion colostomy, triple antibiotic therapy and postoperative intensive care]. / Gangrène de Fournier étendue à la totalité du scrotum: traitement par excisions chirurgicales itératives multiples, colostomie de dérivation, triple antibiothérapie et réanimation post-opératoire.

OBJECTIVES: To describe and analyse the proposed therapeutic modalities to treat a series of patients suffering from Fournier's gangrene involving the entire scrotum. MATERIAL AND METHODS: Four patients with macroscopically identical lesions of Fournier's gangrene involving the entire scrotum were managed by wide surgical debridement, diversion colostomy, triple combination antibiotic therapy, transfer to surgical intensive care, multiple repeated operations under general anaesthesia for excision of atonic tissues and mesh skin grafts. The colostomy was closed after 4 months. RESULTS: All patients survived after skin cover. Three of them were reviewed 2 months after restoration of gastrointestinal continuity and presented a good general status with a satisfactory esthetic result. The fourth patient was lost to follow-up. The mean reoperation rate was 6.5 per patient. The mean intensive care stay was 9.5 weeks. CONCLUSION: The choice of intensive treatment depends on the extent of the lesions. When the entire scrotum is involved, repeated surgical excisions and systematic colostomy, combined with the other treatment modalities appear to be necessary to manage this disease, which still has a serious prognosis.