[Experience of day case robotic prostatectomy. About thirty-two patients]. / Expérience de la prostatectomie totale robot-assistée ambulatoire. À propos de 32 cas.

OBJECTIVE: To report a monocentric experience of outpatient management of robot-assisted radical prostatectomy using a rapid recovery protocol. PATIENTS AND METHODS: In this retrospective observational study, thirty-two patients underwent a prostatectomy by the same surgeon between February 2017 and September 2018 as part of an outpatient hospitalization. The surgery was a transperitoneal robot-assisted prostatectomy with a urinary catheter duration of 7 days. A satisfaction questionnaire on outpatient care and functional results was sent to all patient during follow-up. RESULTS: Of the thirty-two patients initially planned for ambulatory care, two patients remained hospitalized overnight: the first at the request of his wife, the second because of severe nausea. Of the thirty ambulatory patients, nine (30%) required emergency attention in the days following their discharge, including one with Clavien complication IV. Seven patients would have preferred to be hospitalized one night, but twenty-six patients would recommend ambulatory care to one of their relatives, should they undergo prostatectomy. Oncological findings and functional are comparable to conventional hospitalization. CONCLUSION: Radical prostatectomy can be performed routinely in an outpatient setting with no increase in morbidity or decrease in functional and oncological results, with a high patient-family satisfaction rate. LEVEL OF EVIDENCE: 4.

[PTa bladder tumours: prognostic factors of recurrence and progression]. / Tumeurs de vessie pTa: facteurs de récidive et de progression.

OBJECTIVE: The aim of this work has been to study the prognostic factors of recurrence and progression of stage pTa bladder tumours. PATIENTS AND METHODS: The case files of 193 patients, consecutively undergoing transurethral resection for primary pTa bladder tumour between 1980 and 2003, were retrospectively reviewed. Recurrence, progression and specific survival rates were studied. Prognostic factors associated with this type of tumour were then investigated. RESULTS: After a mean follow-up of 58 months, the recurrence rate was 56.5% and the rate of progression to stage T1 was 9.3%. The 10-year specific survival was 95.8%, but the 10-year recurrence-free survival rate was only 22.5%. Two risk factors for recurrence were identified on univariate analysis: haematuria at the time of diagnosis (p=0.009) and tumour size (p=0.01). Two factors were associated with a risk of progression: tumour size (p=0.03) and relapse during the first year after initial resection (p=0.003). None of these factors were independent prognostic factors on multivariate analysis. CONCLUSION: pTa bladder tumours present a high risk of recurrence. However, with attentive follow-up, the risk of progression is low and their 10-year specific survival rate is greater than 95 %. Tumour size at the initial diagnosis and early relapse increase the risk of progression to more aggressive disease.

[Testicular implants, patient's and partner's satisfaction: a questionnaire-based study of men after orchidectomy]. / Prothèses testiculaires après orchidectomie: enquête de satisfaction auprès des patients et de leurs partenaires.

OBJECTIVE: To assess the satisfaction of men and of their partner towards their testicular implants after undergoing orchidectomy. MATERIALS AND METHODS: Hundred and twenty-four consecutive patients, who had undergone orchidectomy, and their partner were sent an anonymous questionnaire. The follow-up after the implantation was at least one year. The testicular implants used were all Perthèse. RESULTS: Seventy-two patients answered to the questionnaire, among whom 63 had a testicular implant. Fifty-eight partners answered. From the patients with implant, 5% thought their body image was worse than before the operation and 80% thought their sexual activity was unchanged. Ninety-six percent thought the implantation was worthwhile and would do it again if they had to do the choice again. The reasons for dissatisfaction were: for the shape (n=8), for the size (n=3), for the position (n=2) and one patient thought the implant was too cold. Forty percent of the partners did not care about the implants and 58% thought the implant was essential. The dissatisfaction rate for the partners was 26% and reasons for were: for the shape (n=5), for the size (n=2), and one partner thought the implant was too cold. From the patients without implant, only one is thinking about having one. CONCLUSION: Testicular implants are well accepted, but some reasons of dissatisfaction appeared in our study. It was the first evaluation of the partner's satisfaction.