[Evaluation of the tolerance of the ureteral catheter JJ by the use of the USSQ self-questionnaire]. / Évaluation de la tolérance de la sonde JJ par l'utilisation de l'auto-questionnaire USSQ.

OBJECTIVE: Evaluation of the quality of life patients with a ureteral catheter JJ (US). METHOD: This study was conducted from 01/2016 to 15/02/2017, including all patients operated on a rise of US. The USSQ questionnaire (Ureteral Stent Symptom Questionnaire) validated in French in 2010 was filled during the perioperative period with SU in place (S1), 4 weeks after putting the US (S2) and 4 weeks after removal of the US (S3), it is grouped into 6 sections: urinary symptoms, body pain, general condition, professional impact, sexuality, other problems. The Wilcoxon test was used to compare the statistical averages. RESULTS: We identified 150 patients including 89 women (59.3%) and 61 men (40.7%). The average age of our patients is 49.5 years. The quality of life appeared to be significantly altered in all areas explored by the questionnaire: urinary symptoms had a mean score one week after the US rise (S1) was 29.5 versus 25.3 at four weeks after ablation (S3) of US at P<0.0001), pain persisted at four weeks after US ablation at an average S3 score of 10.6 versus 14.5 at S1 at P=0.003. The patients' EG was also altered after the placement of the SU: S1 of 16.6 versus S2 18.5 (P<0.0001), the presence of a US did not have a great impact on the activity professional active patients: active (S1 of 14.9 versus S3 of 13.3 P=0.6). But it was a sexual disability of the sexuality carrier: average score of 5.3 in S1 vs. 5.2 in S3 for a value=0.122. There is no significant difference if the US is raised urgently or in a scheduled manner. CONCLUSION: US appears to have a significant impact on the quality of life of patients. LEVEL OF EVIDENCE: 3.

[Male genital self-mutilation: A case series]. / Automutilation des organes génitaux externes chez l'homme.

INTRODUCTION: Genital self-mutilation is a rare phenomenon that often occurs on a psychotic ground. Its diagnosis is clinical and its management involves a coordinated action of urologists and psychiatrists. MATERIALS AND METHOD: We report a retrospective monocentric series of 14 cases of genital self-mutilation (penis and testicles), collected from January 2000 to May 2019. In addition to psychiatric care and according to the type of lesions, we performed implantations of penis, cutaneous urethrostomies, hemostatic ligature of spermatic cord, ablation of rings. The implantations of the penis were done without microscope or magnifying glass and on the basis only of an end-to-end anastomosis of the erectile bodies and the urethra. Sexual abstinence was indicated for 6weeks. RESULTS: The average age of our patients was 31.5years. We have identified ten cases of penis section including two incomplete, two cases of strangulation of penis by a metal ring, an isolated wound of the glans and three cases of testicular ablation, two of which were associated with a section of penis. We performed as first line: 5 penis reimplantation, 5 cutaneous urethrostomy, 2 ablation of strangulation rings and 3 hemostatic ligature of the spermatic cord. Three reimplanted patients had fairly satisfactory immediate operating suites: 2 patients healed well with good penile sensitivities, while one patient presented with a loss of penile skin sensitivity. The other two patients, on the other hand, presented on D1 a necrosis of the reimplanted stump, requiring an amputation and cutaneous urethrostomy. Also, necrosis of the strangulated penis was observed in one case and also required a second operating time with an amputation of the necrotic penis and a cutaneous urethrostomy. One patient died on D7 by autolysis. From a distance, the sexual and urinary function of reimplanted patients could not be assessed because they were lost to follow-up. Only a few patients who received a skin urethrostomy were seen at follow-up consultations. And with an average follow-up of 3years, no functional urinary disorder was found in them. CONCLUSION: The management of genital self-harm requires coordination between urologist and psychiatrist. With our conditions the results are mixed and penile reimplantation should ideally be done under a microscope with an experienced surgeon. However, it can be attempted as long as possible, with the possibility of making an urethrostomy in the second time in case of failure. The pillar of care for these patients, however, lies in a good psychiatric balance because they are not immune to recurrence or autolysis. LEVEL OF EVIDENCE: 3.