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Broudeur L, Loubersac T, Le Normand L, Karam G, Branchereau J, Rigaud J, Perrouin-Verbe MA. New technique of robot-assisted laparoscopic artificial urinary sphincter implantation in female by a posterior approach with intraoperative cystoscopic monitoring. World J Urol 2021; 39:4221-4226. [PMID: 34050814 DOI: 10.1007/s00345-021-03739-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/18/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To report the early experience of a modified technique of robot-assisted artificial urinary sphincter (AUS) implantation in female, with a posterior approach to the bladder neck and intraoperative real-time cystoscopic monitoring. METHODS Retrospective monocentric study included all consecutive female who underwent a primary robot-assisted AUS implantation between 2017 and 2019. Real-time intraoperative cystoscopic monitoring was carried out to check the correct level of the dissection and to avoid any injury during bladder neck dissection. Perioperative and intraoperative data, functional outcomes and complications were assessed. Continence was defined as 0 to 1 pad per day. RESULTS Twenty-four patients were included, the median age was 66 years, 23/24 (96%) had previous SUI or prolapse surgery. Two conversions to open surgery and 2 modifications of the surgical technique with anterior dissection of the bladder neck were required due to major vesicovaginal adhesions. Overall, 20 patients underwent the robotic posterior approach. Eleven intraoperative complications in 10 patients (50%) occurred, including 7 bladder injuries 4 vaginal injuries, without the need to stop the procedure. The median hospital stay was 3 days (2-7). One AUS was removed at 1 year due to vaginal erosion. At last follow-up (median 26 months (22-36)), 95% of the devices were in place and activated and the continence rate was 84%. CONCLUSIONS Early functional results of robot-assisted AUS implantation with a posterior approach to the bladder neck and intraoperative cystoscopic monitoring are promising despite the high rate of intraoperative complications due to previous surgeries. Further evaluation of this technique is required.
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Lepoittevin L, Leon G, Perrouin-Verbe B, Lefort M, Reiss B, Karam G, Rigaud J, Le Normand L, Perrouin-Verbe MA. [External sphincterotomy in neurological patients with detrusor sphincter dyssynergia: Short and mid-term results]. Prog Urol 2021; 32:40-46. [PMID: 33541792 DOI: 10.1016/j.purol.2020.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND To evaluate in the short and mid-term the success of external sphincterotomy (ES) in neurological patients with detrusor sphincter dyssynergia (DSD). METHODS Retrospective, monocentric study, conducted in 51 patients who had a first ES between January 2003 and June 2018, with at least two years of follow-up. The success of ES was defined by maintenance of reflex voiding mode at the end of follow-up. Secondary outcomes were early postoperative complications, rate of revision, functional impact, urodynamic follow-up and upper urinary tract impact. RESULTS The median age was 50.6 years and the median follow-up was 4.6 years. The success rate was 80% (n=41). Ten patients had to change their voiding mode. For 5 patients, it was related to secondary detrusor low contractility. A second ES was required for 39% of patients. At the end of follow-up, there was a significant improvement in Autonomic Dysreflexia (AD) (26 vs 7 patients, P<0.001), urinary tract infections (UTI) (31 vs 15 patients, P<0.001) and a significant decrease in post-voiding residuals (200 vs 50mL, P<0.001). CONCLUSION ES allowed to maintain reflex voiding in 80% of our patients. It significantly improves AD and UTI despite a high rate of re-operation (39%). A long-term follow-up is mandatory in order not to ignore a recurrence of bladder outlet obstruction and/or decrease in detrusor contractility, which may justify a re-operation or an alternative bladder management. LEVEL OF EVIDENCE III.
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Fosse A, Karam G, Kerleau C, Perrouin-Verbe, Rigaud J, Baron M, Mesnard B, Hedhli O, Ville S, De Vergie S, Chelghaf I, Loubersac T, Boutin JM, Faivre d'Arcier B, Bruyère F, Cantarovich D, Branchereau J. [Acute renal failure of the donor in encephalic death: A real contraindication to kidney transplantation?]. Prog Urol 2021; 31:519-530. [PMID: 33478867 DOI: 10.1016/j.purol.2020.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The shortage of kidney transplants encourages the expansion of the limits of eligibility criteria for donation. Many donors who are brain dead display acute renal failure at the time of death; is this a real contraindication to harvesting? The aim of this study was to assess kidney graft survival from donors after brain death with confirmed acute renal failure, with or without anuria previous donation. MATERIALS AND METHODS All of the transplants performed in two university hospitals between 2010 and 2017 were analyzed retrospectively. All patients who underwent single kidney transplant from a brain-dead donor with acute renal failure (ARF) were included in this study. ARI was defined here by a decrease over 50 % of glomerular filtration rate (GFR) to a threshold below 45mL/min/1.73 m2 at the time of kidney procurement. Kidney graft survival, incidence of delayed graft function (DGF) and the GFR at 12 months were analyzed. Analysis of kidney transplant survival based on pre-implantation biopsies was additionally done. RESULTS One hundred and sixty four patients were transplanted with a kidney from donor with ARF during the selected period. At the admission in ICU the average GFR was 67,7±19mL/min/1,73m2. At the time of donation, the average age of donors was 56.4±17.7 years, the GFR was 33.7±8.0mL/min/1.73 m2 16 % of donors were anuric. Cold ischemia time (CIT) was 16.8±5.0hours. The average age of recipients was 55.6±14.1 years. 81 % of the cases were primary transplants. Graft function took place within 7.8±9.4 days after transplantation. There were two non-primary functions (PNF). One hundred and fifty two patients (93 %) had a functional graft at 12 months. The mean GFR at 12 months was 46.8±20.1mL/min/1.73 m2 and 122 patients (73 %) had a GFR greater than 30mL/min/1.73 m2. Seventy-one percent of preimplantation biopsies revealed acute tubular necrosis (ATU); no cortical necrosis was observed. Survival of theses grafts was 85 %, comparable to the total population of study (P=0,21) CONCLUSION: The acute renal failure of the brain-dead donor should not alone be systematically a contraindication to harvesting and kidney transplantation.
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Poujade L, Branchereau J, Rigaud J, Perrouin-Verbe MA. Ileal ureter replacement: Early morbidity and long-term results. Prog Urol 2020; 31:357-367. [PMID: 33189554 DOI: 10.1016/j.purol.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/25/2020] [Accepted: 10/07/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Ileal ureter is a technique that consists of replacing the ureter by a segment of ileum to treat a long ureteric lesion or a lesion involving the lumbar ureter. The primary objective of our study was to assess the early perioperative morbidity of ileal ureter according to the Clavien-Dindo classification. The secondary objectives were to assess the morbidity and the medium- and long-term outcome of renal function. MATERIALS AND METHODS Single-centre retrospective study, collecting data from patients operated between February 2005 and October 2019. All patients who underwent ileal ureter replacement surgery in our unit were included in this analysis. The ureteric defect was longer than five centimetres and involved the pelvic and/or iliac and/or lumbar ureter. All ileal ureter replacements were performed by open surgery using isoperistaltic ileal grafts. RESULTS Twenty-one patients (11 women and 10 men) underwent total or subtotal, unilateral or bilateral ileal ureter replacement, corresponding to 25 kidneys. The grade III early postoperative complication rate was 9.5% (two cases) mainly consisting of bleeding. No grade IV or V complications were observed. With a mean follow-up of 85 months, long-term morbidity essentially consisted of infectious complications. No patients developed anastomotic strictures. Mean serum creatinine was 116.3μmol/L preoperatively, 105.6μmol/L one month postoperatively and 112.2μmol/L at last follow-up. Renal function was generally preserved or even improved, except for patients with preoperative renal failure. CONCLUSION Ileal ureter replacement is a surgical alternative associated with low morbidity and satisfactory long-term functional results. LEVEL OF EVIDENCE 3.
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Loubersac T, Branchereau J, Rigaud J, Le Normand L, Perrouin-verbe M. Cystostomie continente de type mitrofanoff associée à une entéro-cystoplastie d’agrandissement par voie cœlioscopique robot-assistée. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mesnard B, Leroy M, Hunter J, Kervella D, Timsit M, Badet L, Glemain P, Prudhomme T, Dantal J, De Vergie S, Bouchot O, Rigaud J, Karam G, Giral M, Branchereau J. Transplantations rénales à partir de donneurs décédés par arrêt circulatoire contrôlé M3 et non contrôlé M2 : un impact sur les complications urinaires ? Étude multicentrique de 317 transplantations DDAC. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Graveleau A, Pere M, Kerleau C, Morelon E, Badet L, Ladriere M, Hubert J, Legendre C, Mejean A, Timsit M, Sicard A, Albano L, Perrouin-Verbe M, De Vergie S, Bouchot O, Glemain P, Blancho G, Rigaud J, Karam G, Branchereau J. Identification des facteurs de risque d’échec des troisièmes transplantations rénales, analyse multicentrique de 269 greffes. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Loubersac T, Glémain P, Perrouin-Verbe M, Rigaud J, Chelghaf I, Bouteille C, Paret F, Delforge X, Camby C, Guinot A, De Napoli S, Faraj S, Leclair M. Efficacité et faisabilité de la mini néphrolithotomie percutanée < 15 F (miniNLPC) dans la prise en charge des calculs rénaux complexes en urologie pédiatrique : expérience initiale d’un centre tertiaire d’urologie pédiatrique français. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Allenet C, De Vergie S, Perrouin-verbe M, Branchereau J, Rigaud J. Curage latéro-aortique laparoscopique robot-assistée pour récidive ganglionnaire lombo-aortique d’une tumeur testiculaire gauche. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Loubersac T, Perrouin-Verbe M, Rigaud J, Glémain P. Fermeture d’une fistule urétéro-vésico-vaginale avec réimplantation urétéro-vésicale sous coelioscopie robot-assistée. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jeanne-Julien A, Cantarovich D, Guillot-Gueguen C, Blancho G, de Vergie S, Chelghaf I, Bouchot O, Perrouin-Verbe M, Glemain P, Rigaud J, Karam G, Branchereau J. Transplantation de pancréas isolé, toujours une réelle alternative au pancréas artificiel et à la transplantation d’îlots ? Résultats d’une série de 45 patients. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Batard T, Mesnard B, Rigaud J, Branchereau J, Glemain P, Karam G, Bouchot O, Perrouin Verbe B, Le Normand L, Perrouin Verbe M. Long-term functional outcomes and complications of augmentation enterocystoplasty in adult patients with neurogenic bladder: A single-center experience in a multidisciplinary team. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33041-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Loubersac T, Branchereau J, Bouchot O, Rigaud J, Glemain P, Karam G, Le Normand L, Perrouin-Verbe MA. Robot-assisted laparoscopic continent cutaneous urinary diversion (Mitrofanoff and Yang-Monti conduits) in a consecutive series of 8 adult patients. Surgical technique and initial outcomes: A Mitrofanoff with bladder augmentation procedure. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34240-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Paret F, Leclair M, Branchereau J, Karam G, Rigaud J, Lenormand L, Perrouin Verbe M. Long term results of artificial urinary sphincter implantation for stress urinary incontinence in children: A monocentric retrospective study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33994-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Mesnard B, Leroy M, Karam G, Neri F, Glemain P, Perrouin-Verbe M, De Vergie S, Bouchot O, Rigaud J, Cantarovich D, Blancho G, Giral M, Branchereau J. Kidney transplantation from extended-criteria donors: An increased risk of ureteral and urinary complications? Study from 10279 patients. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33659-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Grevez T, Lavalle E, Broudeur L, Karam G, Rigaud J, Buschler M, Bruyère F, Branchereau J. Intérêt de l’héparinothérapie peropératoire au cours des transplantations rénales réalisées avec un rein prélevé sur donneur vivant, étude comparative multicentrique. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Allenet C, De Vergie S, Rigaud J. Adénomectomie prostatique laparoscopique robot-assistée selon la technique de MILLIN. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mesnard B, Leroy M, Karama G, Glemain P, Perrouin-Verbe M, De Vergie S, Bouchot O, Rigaud J, Giral M, Branchereau J. Transplantation rénale avec donneurs à critères élargis : une augmentation du risque de complications urétérales ? Étude à partir de 10 279 patients. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chelly S, Drillaud N, Fouassier M, De Vergie S, Perrouin-Verbe M, Rigaud J, Trossaert M, Branchereau J. Évaluation de la morbidité dans le cancer de la prostate localisé des patients porteurs d’une hémophile de type A, de type B ou d’une maladie de von Willebrand. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Loubersac T, Hétet JF, Colls P, Rigaud J, Supiot S. Radiothérapie de rattrapage des cancers de prostate après échec de la cryothérapie. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nédélec M, Glémain P, Rigaud J, Karam G, Thuret R, Badet L, Kleinclauss F, Timsit MO, Branchereau J. [Renal transplantation on vascular prosthesis]. Prog Urol 2019; 29:603-611. [PMID: 31447181 DOI: 10.1016/j.purol.2019.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/29/2019] [Accepted: 06/13/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION In front of a very calcified aortoiliac axis, renal transplantation with implantation of the artery on vascular prosthesis can be proposed. This rare intervention is considered difficult and morbid. The main objective of this work was to evaluate the overall and specific survival of the transplant in this situation. The secondary objective was the study of the complications and the evolution of the transplant's renal function. MATERIAL AND METHODS From a multicenter retrospective data collection of the DIVAT cohort (6 centers) added with data from 4 other transplant centers, we studied transplants with prosthetic arterial anastomosis. RESULTS Thirty four patients was included. The median duration of follow-up was 2.5 years. 4 patients died in the month following transplantation, 16 were hemodialysis and 9 were transfused. The median survival of the transplant was 212 days. Functional arrests of the transplant were mostly associated with nephrological degradation and return to dialysis (about 80%) while 10% were related to a death of the recipient directly attributable to renal transplantation. The surgical complications of the transplantation were marked by one arterial stenosis, one fistula and 4 urinary stenoses. CONCLUSION Thus, renal transplantation with arterial anastomosis on vascular prosthesis, on selected patients, offers an alternative to dialysis. A national compendium of transplanted patients on vascular prosthesis would allow a long-term follow-up of transplant's survival and define selection criteria prior to this kind of surgery. LEVEL OF EVIDENCE 3.
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Broudeur L, Karam G, Chelghaf I, De Vergie S, Rigaud J, Perrouin Verbe MA, Branchereau J. Feasibility and safety of laparoscopic living donor nephrectomy in case of right kidney and multiple-renal artery kidney: a systematic review of the literature. World J Urol 2019; 38:919-927. [PMID: 31129713 DOI: 10.1007/s00345-019-02821-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 05/21/2019] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To access the current status of the security and feasibility of right kidney (RK) and multiple-renal artery (MRA) laparoscopic living donor nephrectomy (LLDN) which are more challenging compared to left kidney (LK) and single renal artery (SRA) because of a shorter renal vein and more complex vascular anatomy. METHODS We did a systematic review of the literature according to the PRISMA recommendations, reporting RK or MRA donor nephrectomy performed with a laparoscopic technique compared to LK or SRA kidney LLDN. The identified and analyzed primary outcomes of interest were operating time (OT), warm ischemia time (WIT), rate of conversion and transfusion, donor length of stay (LOS), delayed graft function (DGF) and rate of graft loss (GL). RESULTS 16 comparative studies (1397 cases) of RK-LLDN and 12 comparative studies including 15 series (993 cases) of MRA-LLDN were selected. For RK-LLDN review, conversion rate was 0.8% and blood transfusion rate 0.2%, only one case of graft venous thrombosis was reported, OT was shorter in four studies and there was no any difference of DGF and GL rate compared to LK-LLDN. For MRA-LLDN review, conversion rate was 1.3% and blood transfusion rate 1.1%, OT and WIT were longer compared to SRA-LLDN, there were more ureteral complications in two studies, and no difference in terms of vascular complications and graft loss rate. CONCLUSION RK-LLDN and MRA-LLDN would be similar to LK-LLDN and SRA-LLDN in terms of feasibility and safety for the donor as well as graft function results for RK-LLDN.
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Ricard H, Léon G, Le Normand L, Rigaud J, Levesque A, Branchereau J, Bouchot O, Perrouin-Verbe M. Résultats fonctionnels à moyen terme et complications après l’implantation de ballonnets pro-act® pour incontinence urinaire d’effort chez l’homme après prostatectomie radicale. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Baron M, Marie-Aimée P, Hedli O, Le Normand L, Levesque A, Rigaud J. Gestion de la récidive d’incontinence urinaire après ablation de bandelette sous-urétrale pour douleur pelvienne ou périnéale. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Batard T, Karam G, Glemain P, Le Normand L, Perrouin-Verbe M, Nedellec M, Bouchot O, Lefevre M, De Vergie S, Martin-Lefevre L, Dantal J, Rigaud J, Branchereau J. Transplantations rénale à partir de DDACM3, presque aussi bien que le donneur vivant ! Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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