[Neurotoxic role of glycocolle and derivatives in transurethral resection of the prostate]. / Rôle neurotoxique du glycocolle et de ses dérivés au cours de la résection transuréthrale de la prostate.

72-year-old patient underwent an elective transurethral resection of the prostate (TURP) performed with a spinal anaesthesia. The irrigation solution contained glycine at a concentration of 15 g.l-1. The patient's level of consciousness deteriorated over the next 4 hours. He went in an areflexic coma with pupillary areflexia and left mydriasis. The diagnosis of TUR syndrome was substantiated by a sodium blood concentration of 98 mmol.l-1, an osmotic gap of 48 mosmol.kg-1 and blood ammonia at 415 mumol.l-1. To investigate the pathophysiological role of glycine and its metabolites, their concentrations were measured by chromatography and spectrometry in plasma and CSF 8, 24 and 48 hours postoperatively. Glycine and its metabolites (serine, alanine, glyoxylic acid and glycolic acid) accumulated during the postoperative period in both blood and CSF. The central nervous system is in direct contact with these neurotropic compounds. Glycine is an inhibitory neurotransmitter, whereas glyoxylic acid and glycolic acid are considered as to be neurotoxic.

[Urinary fistula after renal transplantation]. / Les fistules urinaires après transplantation rénale.

Among 336 consecutive renal transplantations performed in our centre from March 1979 to December 1988, we have observed 26 cases of urinary leak in 25 patients. We have separated the ischemic and non-ischemic urinary leaks. The former (11 episodes) would have been prevented in most cases with better graft removal. The latter (15 episodes) were predominantly secondary to an anastomotic leak. We have treated surgically these urological complications. Only one patient died. The one-year graft survival rate was 67% in the 25 kidneys but the graft loss was directly due to the urinary leak in three cases.

[Ureteral stenosis in kidney transplantation]. / Les sténoses urétérales en transplantation rénale.

The authors report 13 cases of ureteral or periureteral sclerosis in a series of 330 cases of renal transplantation (3.9%): they occurred early, were asymptomatic (except for anuria); the renal cavities were always dilated, the renal function always deteriorated; the treatment was essentially surgical without mortality and with a low complication rate but 23% of the transplants were lost because of urological complications at 18 months. The authors compare their series with the literature.

[Recurrent bladder calculi after colpocystopexy]. / Lithiase vésicale récidivante après colpocystopexie.

The authors report a case of bladder stones after urethro-vesical suspension, due to non absorbable suture material in the bladder. After surgical treatment, new stones were found, removed transurethrally with a good result after two years.

[Ureteral stenosis of a kidney transplant: a rare cause. Percutaneous nephroscopy of the transplant: an uncommon indication]. / Sténose urétérale d'un transplant rénal: une cause rare. Néphroscopie percutanée du transplant: une indication inhabituelle.

The authors report a case of a ureteral stenosis of a transplanted kidney. The cause was a compression by the spermatic cord. The treatment was surgical, with a ureteroureterostomy with pyelostomy tube intubating the anastomosis. A bit of the drain remained in the renal pelvis; it was removed by percutaneous nephroscopy.