[Concurrent chemotherapy and hyperfractionated radiotherapy for non-operable carcinoma of the bladder]. / Chimiothérapie et radiothérapie hyperfractionnée concomitantes pour carcinomes de vessie non opérables.

Two sequences of concomitant chemotherapy with 5-FU + cisplatin and hyperfractionated radiotherapy (67.2 Gy/56 fractions/38 days, two fractions of 1.2 Gy per day spaced to 6 hours) in the bladder volume were administered to 17 patients with infiltrative carcinoma of the bladder (1 pT1, 6 pT2, 8 pT3a, 2 pT3b or pT4, 8/17 N0-2). They were separated by an interval of 21 days with an intermediate bladder tumor evaluation. A complete histological response was observed in 69% (11 of 16 evaluable patients). With a mean follow-up of 21 months, the bladder preservation was stated in 8/11 (73%) of patients treated, of whom 6 with a complete tumor response, and 2 with a pTa recurrence; these results are similar to other series reported with conventional radiation therapy. No deficit in the bladder was observed in these eight patients.

[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.

[Pyelo-ureteral junction syndrome in a transplanted kidney]. / Syndrome de jonction pyélo-urétérale sur un rein transplanté.

The authors report a case of decompensated pyelo-ureteric junction obstruction in a renal transplant patient with anuria on the 27th day, while the IVP (on the 22nd day) was normal. They compare this case with the literature.

[Transplantation and tumors of the kidney]. / Transplantation et tumeurs du rein.

The authors report the case of a woman who was transplanted with a cadaveric kidney. It was a cyst on the kidney; a biopsy was performed: it was a carcinoma. The transplanted kidney was removed. The second case was a man, transplanted with a cadaveric kidney, with a tumor at the lower pole: a tumorectomy was performed: it was a angiomyolipoma.

[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.

[Emphysematous pyelonephritis]. / Pyélonéphrite emphysémateuse.

The authors report on a case of a emphysematous pyelonephritis due to Klebsiella pneumoniae, occurring in a diabetic patient and successfully treated by nephrectomy. They compare it to 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.

Renal transplantation and Kock pouch: a case report.

We report on a young woman with anuric, terminal renal insufficiency whose bladder could not be used for renal transplantation. A Kock pouch was implanted during stage 1 of treatment and the capacity of the pouch was increased artificially with physiological saline solution. The patient subsequently underwent renal transplantation. Results were excellent with regard to continence and ease of catheterization. No complications due to infection were observed despite immunosuppression and electrolyte disorders were minor.

[False positive urinary cytology. Diagnostic and prognostic value in the detection and surveillance of urothelial tumors. Apropos of 57 false positive cases in a series of 1000 cytologies]. / Les cytologies urinaires "faussement positives". Valeur diagnostique et pronostique dans le dépistage et la surveillance des tumeurs urothéliales. A propos de 57 cas de "faux positif" sur une série de 1,000 cytologies.

Out of 1,000 optical cytological urine tests carried out over a period of two years, 84 isolated cases were "positive" and alerted 57 patients. These cases are analyzed by the authors with a follow-up period of 48 to 72 months: among those patients already under supervision for urothelial tumours, 40.4% showed urothelial recurrence of which 70%, that did not appear to carry a worse prognosis, were detected in the first twelve months. Since these patients usually underwent annual endoscopic examination, this meant that for 20% (i.e. 4.15% of the group under supervision) the diagnosis of recurrence could be made at least 6 months earlier. This alone is a justification for cytological examination which does not involve any complications but merely entails increased cystoscopic and biopsy tests. On the other hand, there appear to be no grounds to advocate mass "screening" except in populations with warning symptomatology (especially haematuria) for which the ratio of positive findings in this series was 2.3/1,000. The future development of automatic apparatus for cytological tests should obviate the significant personal factor involved in cytological examinations, as shown by a review of the literature.

[Suspended ileo-ureteroplasty following appendiculoplasty]. / Iléo-urétéroplastie suspendue faisant suite à une appendiculoplastie.

The authors report on a case of a stenosis of a uretero-appendiculoplasty, treated by an ileal suspended loop, with a good result.

Accumulation of glycolic acid and glyoxylic acid in serum in cases of transient hyperglycinemia after transurethral surgery.

Experimental data are presented here proving the accumulation of glycine in serum after transurethral prostatectomy and increased production of glycine metabolites: serine, alanine, glyoxylic acid, and glycolic acid. The presence of the metabolites glyoxylic acid and glycolic acid was demonstrated by gas-liquid chromatography and mass spectrometry. Glycine, glyoxylic acid, and glycolic acid possess neurological activity, so we examined the pathophysiology of the transurethral prostatectomy syndrome in view of the transient accumulation of these compounds in serum.

[Hydatid cyst of the kidney rupturing in the kidney pelvis and associated with lithiasis. Apropos of a case]. / Kyste hydatique du rein fissuré dans le bassinet et associé à une lithiase. A propos d'un cas.

The authors report one case of renal hydatid disease, with lithiasis and rupture into the renal pelvis. Pre-operative diagnostic investigation included ultrasound and CT scan imaging. Serologic test was negative. Treatment was surgical: removal of the hydatid and resection of the protruding part of the cyst. The fistula is closed with a drainage into the pelvis.

[Ureteral stenosis following colpocystopexy of urinary stress incontinence. Apropos of 5 cases]. / Les sténoses urétérales après colpocystopexie pour incontinence urinaire d'effort. A propos de 5 cas.

The authors report 5 cases of a rare urethrovesical suspension's complication = the ureteral obstruction. Its cause is always a surgical fault, its diagnosis is based on urography. Its treatment is surgical. The kidney can be preserved by an early repair; the continence's preservation is possible when the suspension can be preserved.

[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.

[Preventive value of intravesical thiotepa on the recurrence of Ta-T1 vesical tumors treated by conservative surgery. Apropos of 247 cases a mean follow-up of 88 months]. / Valeur prophylactique du thiotepa intra-vésical sur les récidives des tumeurs vésicales Ta-T1 traitées par chirurgie conservatrice. A propos de 247 cas suivis avec un recul moyen de 88 mois.

The retrospective homogeneous study of 247 patients with follow-up from 12 months to 384 months (mean 88 months) and managed with or without intra-vesical instillations of thiotepa as prophylactic chemotherapy after surgical conservative treatment is compared with some literature's data principally multicentric randomized series. Statistics contradictions remain with no significative results for possible progression towards infiltration, better "free interval" between recurrences, and better recurrence rate for 100 patients/months. In this series the number of tumors recurrences in each bladder was evaluated: this mean rate of tumors recurrences/year is 1,7 without prophylactic thiotepa and only but always 1,08 with thiotepa. Prophylactic instillations chemoprophylaxy seems to be justified but must be emphasized: mitomycin C, BCG therapy would be better in the future?

[Cancer of kidney with venous invasiveness: prognosis. Apropos of 238 renal excisions with 64 cases of venous invasiveness]. / Cancer du rein avec extension veineuse: pronostic. A propos de 238 exérèses rénales avec 64 envahissements veineux.

About a series of 238 surgically managed renal cell carcinoma with 64 venous invasion's cases (without no lost of follow-up) the prognosis is bad: post-operative mortality: 12,5%. Overall uncorrected five-years actuarial survival: 25%. But 42% of these patients with venous invasion had associated lymph node invasion and-or visceral metastasis. About 37 cases with only venous extension five-years actuarial survival reaches 45,9%. The inferior vena cava (I.V.C.) extension is the worst. Five american data reports some cases (5 to 18 cases) with near half and half surviving patients. In this series about 14 isolated I.V.C. invasion, only 4 patients are surviving with no evidence of disease but 2 have more than six years and fourteen years follow-up.

[Cancer of the kidney in Von Hippel-Lindau disease. Apropos of a case. Diagnostic and therapeutic considerations. Review of the literature]. / Le cancer du rein dans le cadre de la maladie de Von Hippel-Lindau. A propos d'un cas. Considérations diagnostiques et thérapeutiques. Revue de la littérature.

About a case of Von Hippel-Lindau syndrome with association of retinal angioma, bilateral pheochromocytomas, bilateral renal cysts, the authors had many difficulties to confirm associated unilateral renal cell carcinoma. Three solid left renal tumors were not seen neither with abdominal ultrasound, nor with CT scan, but only with hypervascularity on renal angiography. Even intra-operative histologic examination fail to confirm the malignity. After the complete histologic examination of the tumorectomy piece, the unilateral renal cell carcinoma was secondary managed by radical nephrectomy, although the risk of bilateral carcinoma is known in this disease.

Comparative study of actuarial survival rates in P3 P4 (N+ Mo) transitional cell carcinoma of bladder managed by total cystectomy alone or associated with preoperative radiotherapy and pelvic lymphadenectomy.

In P3 P4 (N+ Mo) bladder cancer patients we conclude the following: 1) The addition of preoperative radiotherapy and meticulous pelvic cellulo-lymphadenectomy to total cystectomy has improved the actuarial survival at five years from 10.5% to 41%. 2) With this protocol, the pelvic recurrence has been reduced from 47.4% to 4.5% and presently the failures are due to undectectable distant metastases.