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Baowaidan F, Zugail A, Lyoubi Y, Culty T, Lebdai S, Brassart E, Bigot P. Incidence and risk factors for urolithiasis recurrence after endourological management of kidney stones: A retrospective single-centre study. Prog Urol 2022; 32:601-607. [DOI: 10.1016/j.purol.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/07/2021] [Accepted: 02/16/2022] [Indexed: 10/18/2022]
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Magnier A, Lebdai S, Nedelcu C, Bigot P, Culty T. Fragmentation et extraction des reins polykystiques au cours de la néphrectomie cœlioscopique manuellement assistée : une étude observationnelle prospective. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Branchereau J, Prudhomme T, Bessede T, Verhoest G, Boissier R, Culty T, Matillon X, Defortescu G, Sallusto F, Terrier N, Drouin S, Karam G, Badet L, Timsit MO. [Living donor nephrectomy: The French guidelines from CTAFU]. Prog Urol 2021; 31:50-56. [PMID: 33423748 DOI: 10.1016/j.purol.2020.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To propose surgical recommendations for living donor nephrectomy. METHOD Following a systematic approach, a review of the literature (Medline) was conducted by the CTAFU regarding functional and anatomical assessment of kidney donors, including which side the kidney should be harvested from. Distinct surgical techniques and approaches were evaluated. References were considered with a predefined process to propose recommendations with the corresponding levels of evidence. RESULTS The recommendations clarify the legal and regulatory framework for kidney donation in France. A rigorous assessment of the donor is one of the essential prerequisites for donor safety. The impact of nephrectomy on kidney function needs to be anticipated. In case of modal vascularization of both kidneys without a relative difference in function or urologic abnormality, removal of the left kidney is the preferred choice to favor a longer vein. Mini-invasive approaches for nephrectomy provide faster donor recovery, less donor pain and shorter hospital stay than open surgery. CONCLUSION These French recommendations must contribute to improving surgical management of candidates for kidney donation.
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Affiliation(s)
- J Branchereau
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Nantes, 5, allée de lÎle-Gloriette, 44093 Nantes cedex 01, France
| | - T Prudhomme
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Toulouse, avenue du Pr-Jean-Poulhès, 31059 Toulouse, France
| | - T Bessede
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital de Bicêtre, université de Paris-Saclay, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - G Verhoest
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - R Boissier
- Service d'urologie et transplantation, hôpital de La Conception, université Aix-Marseille, 47, boulevard Baille, 13005 Marseille, France
| | - T Culty
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - X Matillon
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France
| | - G Defortescu
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - F Sallusto
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Toulouse, avenue du Pr-Jean-Poulhès, 31059 Toulouse, France
| | - N Terrier
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Grenoble Alpes, boulevard de la Chantourne, 38700 La Tronche, France
| | - S Drouin
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital de la Pitié-Salpêtrière, université Paris Sorbonne, 47, boulevard de l'Hôpital, 75013 Paris, France
| | - G Karam
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Nantes, 5, allée de lÎle-Gloriette, 44093 Nantes cedex 01, France
| | - L Badet
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France
| | - M-O Timsit
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; PARCC, INSERM, équipe labellisée par la Ligue Contre le Cancer, 56, rue Leblanc, université de Paris, 75015 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
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Drouin S, Defortescu G, Prudhomme T, Culty T, Verhoest G, Doerfler A, Goujon A, Branchereau J, Timsit MO. [Lower urinary tract symptoms and urinary incontinence in renal transplant recipients and candidates: The French guidelines from CTAFU]. Prog Urol 2021; 31:45-49. [PMID: 33423747 DOI: 10.1016/j.purol.2020.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To propose surgical recommendations for the management of lower urinary tract symptoms (LUTS) and urinary incontinence in kidney transplant recipients and candidates. METHOD Following a systematic approach, a review of the literature (Medline) was conducted by the CTAFU focusing on medical and surgical treatment of LUTS and urinary incontinence in kidney transplant recipients and candidates. References were assessed according to a predefined process to propose recommendations with levels of evidence. RESULTS Functional bladder capacity and bladder compliance are impaired during dialysis. LUTS, related to pre-kidney transplantion alterations, frequently improve spontaneously after kidney transplantation. LUTS secondary to benign prostatic hyperplasia (BPH) may be underestimated before kidney transplantation due to oliguria, low bladder compliance and low bladder capacity. In LUTS associated with BPH, anticholinergics require dosage adjustment with creatinine clearance. If surgery is indicated after kidney transplantation, procedure can be safely performed in the early post-transplant course after removal of ureteral stent. Surgical management of urinary incontinence does not seem to be associated with an icreased risk for infectious complications in kidney transplant recipients. Particular attention should be paid to the management of postvoid residual and bladder pressures in case of neurological bladder disease. Optimal care of neurological bladder should be provided prior to transplantation: with a cautious management, and despite an increased occurrence of febrile urinary tract infections, transplant survival is not compromised. CONCLUSION These recommendations must contribute to improve the management of lower urinary tract symptoms and urinary incontinence in kidney transplant patients and kidney transplant candidates.
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Affiliation(s)
- S Drouin
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, Sorbonne université, , APHP-6, 47, boulevard de l'Hôpital, 75013 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - G Defortescu
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - T Prudhomme
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Toulouse, 9, place Lange, 31300 Toulouse, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - T Culty
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - G Verhoest
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, université Aix-Marseille, hôpital de la Conception, 47, boulevard Baille 13005 Marseille, France
| | - A Doerfler
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-le-Guilloux, 35000 Rennes, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - A Goujon
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, université Aix-Marseille, hôpital de la Conception, 47, boulevard Baille 13005 Marseille, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - J Branchereau
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Brugmann, place A. Van Gehuchten 4, 1020 Bruxelles, Belgique; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - M-O Timsit
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Nantes, 5, allée de l'Île Gloriette, 44093 Nantes cedex 01, France; PARCC, Inserm, équipe labellisée par la ligue contre le cancer, université de Paris, 56, rue Leblanc, 75015 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
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Tillou X, Doerfler A, Szabla N, Verhoest G, Defortescu G, Bessede T, Prudhomme T, Culty T, Bigot P, Bensalah K, Méjean A, Timsit MO. [Renal cell carcinoma of the kidney transplant: The French guidelines from CTAFU]. Prog Urol 2021; 31:24-30. [PMID: 33423743 DOI: 10.1016/j.purol.2020.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/20/2020] [Accepted: 04/24/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To propose recommendations for the management of renal cell carcinomas (RCC) of the renal transplant. METHOD Following a systematic approach, a review of the literature (Medline) was conducted by the CTAFU to evaluate prevalence, diagnosis and management of RCC arousing in the renal transplant. References were assessed according to a predefined process to propose recommendations with levels of evidence. RESULTS Renal cell carcinomas of the renal transplant affect approximately 0.2% of recipients. Mostly asymptomatic, these tumors are mainly diagnosed on a routine imaging of the renal transplant. Predominant pathology is clear cell carcinomas but papillary carcinomas are more frequent than in general population (up to 40-50%). RCC of the renal transplant is often localized, of low stage and low grade. According to tumor characteristics and renal function, preferred treatment is radical (transplantectomy) or nephron sparing through partial nephrectomy (open or minimally invasive approach) or thermoablation after percutaneous biopsy. Although no robust data support a switch of immunosuppressive regimen, some authors suggest to favor the use of mTOR inhibitors. CTAFU does not recommend a mandatory waiting time after transplantectomy for RCC in candidates for a subsequent renal tranplantation when tumor stage<T3 and low ISUP grade. CONCLUSION These French recommendations should contribute to improving the oncological and functional prognosis of renal transplant recipients by improving the management of RCC of the renal transplant.
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Affiliation(s)
- X Tillou
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - A Doerfler
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Brugmann, place A. Van Gehuchten 4, 1020 Bruxelles, Belgique
| | - N Szabla
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - G Verhoest
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - G Defortescu
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - T Bessede
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, université de Paris-Saclay, hôpital de Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - T Prudhomme
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Toulouse, 9, place Lange, 31300 Toulouse, France
| | - T Culty
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - P Bigot
- Service d'urologie et transplantation rénale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France; Comité de cancérologie de l'association française d'urologie (CCAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France
| | - K Bensalah
- Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France; Comité de cancérologie de l'association française d'urologie (CCAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France
| | - A Méjean
- Comité de cancérologie de l'association française d'urologie (CCAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Inserm, équipe labellisée par la ligue contre le cancer, université de Paris, PARCC, 56, rue Leblanc, 75015 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - M-O Timsit
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Inserm, équipe labellisée par la ligue contre le cancer, université de Paris, PARCC, 56, rue Leblanc, 75015 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
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Culty T, Goujon A, Defortescu G, Bessede T, Kleinclauss F, Boissier R, Drouin S, Branchereau J, Doerfler A, Prudhomme T, Matillon X, Verhoest G, Tillou X, Ploussard G, Rozet F, Méjean A, Timsit MO. [Localized Prostate cancer in candidates for renal transplantation and recipients of a kidney transplant: The French Guidelines from CTAFU]. Prog Urol 2021; 31:4-17. [PMID: 33423746 DOI: 10.1016/j.purol.2020.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/13/2020] [Accepted: 04/20/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To define guidelines for the management of localized prostate cancer (PCa) in kidney transplant (KTx) candidates and recipients. METHOD A systematic review (Medline) of the literature was conducted by the CTAFU to report prostate cancer epidemiology, screening, diagnosis and management in KTx candidates and recipients with the corresponding level of evidence. RESULTS KTx recipients are at similar risk for PCa as general population. Thus, PCa screening in this setting is defined according to global French guidelines from CCAFU. Systematic screening is proposed in candidates for renal transplant over 50 y-o. PCa diagnosis is based on prostate biopsies performed after multiparametric MRI and preventive antibiotics. CCAFU guidelines remain applicable for PCa treatment in KTx recipients with some specificities, especially regarding lymph nodes management. Treatment options in candidates for KTx need to integrate waiting time and access to transplantation. Current data allows the CTAFU to propose mandatory waiting times after PCa treatment in KTx candidates with a weak level of evidence. CONCLUSION These French recommendations should contribute to improve PCa management in KTx recipients and candidates, integrating oncological objectives with access to transplantation.
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Affiliation(s)
- T Culty
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - A Goujon
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - G Defortescu
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - T Bessede
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital de Bicêtre, université de Paris-Saclay, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - F Kleinclauss
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHRU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - R Boissier
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital de La Conception, université Aix-Marseille, 47, boulevard Baille, 13005 Marseille, France
| | - S Drouin
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital de la Pitié-Salpêtrière, université Paris Sorbonne, 47, boulevard de l'Hôpital, 75013 Paris, France
| | - J Branchereau
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Nantes, 5, allée de l'Île-Gloriette, 44093 Nantes cedex 01, France
| | - A Doerfler
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Brugmann, place A. Van Gehuchten 4, 1020 Bruxelles, Belgique
| | - T Prudhomme
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Toulouse, 9, place Lange, 31300 Toulouse, France
| | - X Matillon
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France
| | - G Verhoest
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - X Tillou
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - G Ploussard
- Comité de cancérologie de l'Association française d'urologie (CCAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France
| | - F Rozet
- Comité de cancérologie de l'Association française d'urologie (CCAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Département d'urologie, institut Mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - A Méjean
- Comité de cancérologie de l'Association française d'urologie (CCAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - M-O Timsit
- Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; PARCC, INSERM, équipe labellisée par la Ligue Contre le Cancer, université de Paris, 56, rue Leblanc, 75015 Paris, France.
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7
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Bessede T, Branchereau J, Goujon A, Boissier R, Alezra E, Verhoest G, Culty T, Matillon X, Doerfler A, Tillou X, Sallusto F, Terrier N, Thuret R, Drouin S, Timsit MO. [Urinary stones in renal transplant recipients and donors: The French guidelines from CTAFU]. Prog Urol 2021; 31:57-62. [PMID: 33423749 DOI: 10.1016/j.purol.2020.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To define guidelines for the management of kidney stones in kidney transplant (KTx) donor or recipients. METHOD Following a systematic approach, a review of the literature (Medline) was conducted by the CTAFU to report kidney stone epidemiology, diagnosis and management in KTx donors and recipients with the corresponding level of evidence. RESULTS Prevalence of kidney stones in deceased donor is unknown but reaches 9.3% in living donors in industrialized countries. Except in Maastrich 2 donors, diagnosis is done on systematic pre-donation CT scan according to standard french procedure. No prospective study has compared therapeutic strategies available for the management of kidney stones in KTx donor: ureteroscopy or an extra corporeal lithotripsy in case of living donor prior to donation, ex vivo approach (pyelotomy or ureteroscopy), ureterocopy in the KTx recipient or surveillance. De novo kidney stones result from a lithogenesis process to be identified and treated in order to avoid recurrences. The context of solitary functional kidney renders the prevention of recurrence of great importance. Diagnosis is suspected when identification of a renal graft dysfunction, hematuria or urinary tract infection with renal pelvis dilatation. Stone size and location are determined by computed tomography. There are no prospective, controlled studies on kidney stone management in the KTx. The therapeutic strategies are similar to standard management in general population. CONCLUSION These French recommendations should contribute to improve kidney stones management in KTx donor and recipients.
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Affiliation(s)
- T Bessede
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, université Paris Saclay, hôpital de Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - J Branchereau
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Nantes, 5, allée de l'Ile Gloriette, 44093 Nantes cedex 01, France
| | - A Goujon
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - R Boissier
- Service d'urologie et transplantation, université Aix-Marseille, hôpital de la Conception, 47, boulevard Baille, 13005 Marseille, France
| | - E Alezra
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - G Verhoest
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - T Culty
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - X Matillon
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital Edouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France
| | - A Doerfler
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Brugmann, place A. Van Gehuchten 4, 1020 Bruxelles, Belgique
| | - X Tillou
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - F Sallusto
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Toulouse, 9, place Lange, 31300 Toulouse, France
| | - N Terrier
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Grenoble Alpes, boulevard de la Chantourne, 38700 La Tronche, France
| | - R Thuret
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Lapeyronie, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34070 Montpellier, France
| | - S Drouin
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, université Paris Sorbonne, hôpital de la Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris, France
| | - M-O Timsit
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Inserm, équipe labellisée par la ligue contre le cancer, université de Paris, PARCC, 56, rue Leblanc, 75015 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
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Baowaidan F, Zugail A, Lyoubi Y, Culty T, Lebdai S, Brassart E, Bigot P. Facteurs de risque de récidive lithiasique après prise en charge urologique des calculs. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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Aubert C, Rolley C, Mauny M, Heuveline J, Silve E, Humeau M, Le Corre V, Lebdai S, Brassart E, Culty T, Baize N, Rousselet MC, Nedelcu C, Aubé C, Bouvier A, Bigot P. [Impact of partial nephrectomy in a hybrid operating room on the activity of kidney cancer surgery]. Prog Urol 2020; 30:288-295. [PMID: 32234422 DOI: 10.1016/j.purol.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 02/01/2020] [Accepted: 02/13/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Partial nephrectomy (NP) after embolization of tumor vessels (NPESH) in a hybrid room combines embolization of tumor vessels and enucleation of the tumor under laparoscopy in the same operative time. The purpose of this study was to assess the impact of the use of NPESH in the management of patients treated with surgery for a localized kidney tumor. MATERIAL AND METHODS Using the uroCCR database, we included all consecutive patients operated in a university hospital for localized kidney tumor. From 2011 to May 2015, patients were treated by Standard Partial Nephrectomy (NPS) Laparoscopic or Open and from May 2015 to May 2019 by NPESH. We evaluated characteristics of patients, tumors, perioperative data and complications. These data were compared by Student and Khi2 tests. RESULTS 87 NPS were performed during Period 1 and 137 NPS were performed during period 2. The ASA score of patients undergoing NPESH was higher than NPS (P<0.0001). The tumor complexity and median tumor size were similar in the two groups (P=0.852 and P=0.48). The complication rate for NPS and NPESH was 55.2% and 33.6% (P=0.002). There were less severe complications in the NEPSH group (P=0.012). The median length of stay was 8 and 4 days for the NPS and NPESH groups (P<0.0001). Positive surgical margins were 2 (2.3%) and 6 (4.6%) for the NPS and NPESH group (P=0.713). DISCUSSION NPESH is an efficient technique compared to NPS. It seems to be an interesting alternative to limit renal ischemia, complication rate and length of stay for the management of localized kidney tumors.
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Affiliation(s)
- C Aubert
- Service d'urologie, CHU de Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - C Rolley
- UTTIOM, unité transversale de thérapeutiques innovantes en oncologie médicale, CHU de Angers, 4, rue Larrey, 49933 Angers, France
| | - M Mauny
- Faculté de médecine d'Angers, 49000 Angers, France
| | - J Heuveline
- Faculté de médecine d'Angers, 49000 Angers, France
| | - E Silve
- Faculté de médecine d'Angers, 49000 Angers, France
| | - M Humeau
- Faculté de médecine d'Angers, 49000 Angers, France
| | - V Le Corre
- Service d'urologie, CHU de Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - S Lebdai
- Service d'urologie, CHU de Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - E Brassart
- Service d'urologie, CHU de Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - T Culty
- Service d'urologie, CHU de Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - N Baize
- UTTIOM, unité transversale de thérapeutiques innovantes en oncologie médicale, CHU de Angers, 4, rue Larrey, 49933 Angers, France
| | - M C Rousselet
- Département d'anatomopathologie, CHU de Angers, 4, rue Larrey, 49933 Angers, France
| | - C Nedelcu
- Service de radiologie, CHU de Angers, 4, rue Larrey, 49933 Angers, France
| | - C Aubé
- Service de radiologie, CHU de Angers, 4, rue Larrey, 49933 Angers, France
| | - A Bouvier
- Service de radiologie, CHU de Angers, 4, rue Larrey, 49933 Angers, France
| | - P Bigot
- Service d'urologie, CHU de Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
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10
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Segalen T, Lebdai S, Panayotopoulos P, Culty T, Brassart E, Riou J, Azzouzi AR, Bigot P. Double J stenting evaluation after ureteroscopy for urolithiasis. Prog Urol 2019; 29:589-595. [PMID: 31506249 DOI: 10.1016/j.purol.2019.08.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 06/17/2019] [Accepted: 08/07/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES During ureteroscopy for urolithiasis, postoperative ureteral drainage with double J stent is frequently used. It may reduce acute postoperative pain and late ureteral stenosis. Double J stent can have negative impact on life quality. After uncomplicated intervention, double J stent is not mandatory. Objective of our study was to evaluate pain and complications after ureteroscopy with or without stent. METHODS We retrospectively analyzed ureteroscopy performed between May 2014 and January 2017. Interventions were compared regarding ureteral drainage with double J stent or not. Our primary outcome was early postoperative pain evaluated with an oral pain scale form 1 to 10 on day one after intervention. Clinical characteristics, per- and postoperative data were collected. We also looked for risks factors of complications. RESULTS Three hundred and sixty-six interventions were included, 259 (70.8%) with and 107 (29.2%) without double J stent. Stone burden was higher in stented group (18.3 vs 9.4mm, P<0.0001). Patients without postoperative stents had more ureteral preparation with double J stent (78.5% vs 62.5%, P=0.0032) and had more ambulatory interventions (75.7% vs 52.5%, P<0.0001). Postoperative pain was not different (22% vs 17.75%, P=0.398). Complication rate was similar (29% vs 20.5%, P=0.1181), so was rehospitalization rate (0.8% vs 0.9%, P=1). In multivariate analysis, complications factors were unprepared ureter, experienced surgeons and access sheath. CONCLUSION Not stenting after ureteroscopy do not increase pain or complications. Stenting should not be used after uncomplicated interventions for centimetric stones. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- T Segalen
- Department of urology, Angers university hospital, 4, rue Larrey, 49000 Angers, France.
| | - S Lebdai
- Department of urology, Angers university hospital, 4, rue Larrey, 49000 Angers, France
| | - P Panayotopoulos
- Department of urology, Angers university hospital, 4, rue Larrey, 49000 Angers, France
| | - T Culty
- Department of urology, Angers university hospital, 4, rue Larrey, 49000 Angers, France
| | - E Brassart
- Department of urology, Angers university hospital, 4, rue Larrey, 49000 Angers, France
| | - J Riou
- MINT, université d'Angers, Inserm U1066, CNRS 6021, université Bretagne Loire, 49000 Angers cedex, France
| | - A R Azzouzi
- Department of urology, Angers university hospital, 4, rue Larrey, 49000 Angers, France
| | - P Bigot
- Department of urology, Angers university hospital, 4, rue Larrey, 49000 Angers, France
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11
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Szabla N, Benbouzid S, Larre S, Gaudez F, Matillon X, Thuret R, Valeri A, Blanchereau J, Timsit M, Boutin J, Culty T, Bensadoun H, Salomon L, Neuzillet Y, Bouillet S, Terrier N, Lechevallier E, Verhoest G, Sallusto F, Tillou X. Une étude nationale des traitements conservateurs des tumeurs du greffon rénal : vers les thérapies ablatives. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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12
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Chelly S, Culty T, Bessede T, Parier B, Sayegh J, Panayotopoulos P, Grison P, Mougin J, Brassier M, Brassart E, Lebdai S, Bigot P, Azzouzi R. Traitement des calculs du greffon rénal par urétéroscopie souple ex-vivo sur machine de perfusion. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Fortier E, Baize N, Culty T, Brassart E, Lebdai S, Grison P, Panayotopoulos P, Mougin J, Azzouzi A, Bigot P. Prise charge onco-urologique des cancers du rein métastatique dans un service d’urologie. Bilan d’activité à 2 ans. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Delbarre B, Bigot P, Azzouzi A, Memanteau J, Panayotopoulos P, Grison P, Mougin J, Lebdai S, Brassart E, Culty T. Étude de l’évolution de la fonction rénale après néphrectomie cœlioscopique avec embolisation sélective des vaisseaux tumoraux. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Branchereau J, Timsit MO, Neuzillet Y, Bessède T, Thuret R, Gigante M, Tillou X, Codas R, Boutin J, Doerfler A, Sallusto F, Culty T, Delaporte V, Brichart N, Barrou B, Salomon L, Karam G, Rigaud J, Badet L, Kleinklauss F. Management of renal transplant urolithiasis: a multicentre study by the French Urology Association Transplantation Committee. World J Urol 2017; 36:105-109. [DOI: 10.1007/s00345-017-2103-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022] Open
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16
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Chahwan C, Doerfler A, Brichart N, Bouyé S, Culty T, Iselin C, Pfister C, Sallusto F, Salomon L, Verhoest G, Viart L, Tillou X. Prostate cancer before renal transplantation: A multicentre study. Prog Urol 2017; 27:166-175. [DOI: 10.1016/j.purol.2017.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/08/2017] [Accepted: 01/24/2017] [Indexed: 12/26/2022]
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17
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Tillou X, Timsit MO, Sallusto F, Culty T, Verhoest G, Doerfler A, Thuret R, Kleinclauss F. [Polycystic kidney disease and kidney transplantation]. Prog Urol 2016; 26:993-1000. [PMID: 27665410 DOI: 10.1016/j.purol.2016.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 08/22/2016] [Accepted: 08/22/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To perform a state of the art about autosomal dominant polykystic kidney disease (ADPKD), management of its urological complications and end stage renal disease treatment modalities. MATERIAL AND METHODS An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords (MESH): "autosomal dominant polykystic kidney disease", "complications", "native nephrectomy", "kidney transplantation". Publications obtained were selected based on methodology, language, date of publication (last 10 years) and relevance. Prospective and retrospective studies, in English or French, review articles; meta-analysis and guidelines were selected and analyzed. This search found 3779 articles. After reading titles and abstracts, 52 were included in the text, based on their relevance. RESULTS ADPKD is the most inherited renal disease, leading to end stage renal disease requiring dialysis or renal transplantation in about 50% of the patients. Many urological complications (gross hematuria, cysts infection, renal pain, lithiasis) of ADPKD required urological management. The pretransplant evaluation will ask the challenging question of native nephrectomy only in case of recurrent kidney complications or large kidney not allowing graft implantation. The optimum timing for native nephrectomy will depend on many factors (dialysis or preemptive transplantation, complication severity, anuria, easy access to transplantation, potential living donor). CONCLUSION Pretransplant management of ADPKD is challenging. A conservative strategy should be promoted to avoid anuria (and its metabolic complications) and to preserve a functioning low urinary tract and quality of life. When native nephrectomy should be performed, surgery remains the gold standard but renal arterial embolization may be a safe option due to its low morbidity.
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Affiliation(s)
- X Tillou
- Service d'urologie et transplantation, CHU Côte de Nacre, 14000 Caen, France
| | - M-O Timsit
- Service d'urologie, hôpital européen Georges-Pompidou, 75015 Paris, France; Université Paris Descartes, 75006 Paris, France
| | - F Sallusto
- Département d'urologie et transplantation, CHU de Toulouse, 31400 Toulouse, France
| | - T Culty
- Service d'urologie, CHU d'Angers, 49100 Angers, France
| | - G Verhoest
- Service d'urologie, CHU de Rennes, 35000 Rennes, France
| | - A Doerfler
- Service d'urologie et transplantation, CHU Côte de Nacre, 14000 Caen, France
| | - R Thuret
- Service d'urologie, CHU Lapeyronie, 34000 Montpellier, France; Université de Montpellier, 34000 Montpellier, France
| | - F Kleinclauss
- Service d'urologie et transplantation, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France; Université de Franche-Comté, 25000 Besançon, France; Inserm UMR 1098, 25000 Besançon, France.
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18
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Augusto JF, Garnier AS, Demiselle J, Langs V, Picquet J, Legall R, Sargentini C, Culty T, Poli C, Ammi M, Ducancelle A, Chevailler A, Duveau A, Subra JF, Sayegh J. Hypogammaglobulinemia and risk of severe infection in kidney transplant recipients. Transpl Infect Dis 2016; 18:741-751. [PMID: 27509578 DOI: 10.1111/tid.12593] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 05/30/2016] [Accepted: 06/24/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recent data have outlined a link between hypogammaglobulinemia (HGG) and infection risk and suggested that HGG correction may decrease post-transplant infections. METHODS We analyzed the risk factors of HGG and the relationship between HGG and the risk of severe infection in a cohort of 318 kidney transplant recipients (KTR) who were transplanted between 2003 and 2013. Immunoglobulin (Ig) concentration was measured prospectively at day 15 (D15), month 6 (M6), month 12 (M12), and month 24 (M24) post transplant. RESULTS The prevalence of IgG HGG was 56% and 36.8% at D15 and M6, respectively. Age was the sole identified risk factors for D15 IgG HGG (odds ratio [OR] 1.02, P = 0.019). Risk factors for M6 IgG HGG were the presence of D15 IgG HGG (OR 6.41, P < 0.001) and treatment of acute rejection (OR 2.63, P = 0.014). Most infections occurred between D15 and M6 post transplant. Only age (hazard ratio 1.03, P < 0.001) was identified as a risk factor of infection between D15 and M6 post transplant. Survival free of infection (overall infections and bacterial or viral infections) did not differ significantly between patients with or without D15 IgG HGG. Only septicemia occurring between M6 and M12 post transplant was more frequently observed in patients with HGG. The low prevalence of severe HGG (<400 mg/dL) did not allow conclusions on the infectious risk associated with this patient subgroup. CONCLUSIONS This study does not support the existence of a strong link between post-transplant HGG and the risk of severe infections in KTR. Correction of HGG to minimize the risk of severe infections in KTR is thus questionable and needs to be reevaluated in prospective studies.
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Affiliation(s)
- J-F Augusto
- LUNAM Université, Angers, France. .,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France.
| | - A-S Garnier
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J Demiselle
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - V Langs
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J Picquet
- LUNAM Université, Angers, France.,Département de Chirurgie Vasculaire, Université Angers, CHU Angers, Angers, France
| | - R Legall
- LUNAM Université, Angers, France.,Département d'Anesthésie et Réanimation, Université Angers, CHU Angers, Angers, France
| | - C Sargentini
- LUNAM Université, Angers, France.,Département d'Anesthésie et Réanimation, Université Angers, CHU Angers, Angers, France
| | - T Culty
- LUNAM Université, Angers, France.,Service d'Urologie, Université Angers, CHU Angers, Angers, France
| | - C Poli
- LUNAM Université, Angers, France.,Laboratoire d'Immunologie, Université d'Angers, CHU Angers, Angers, France
| | - M Ammi
- LUNAM Université, Angers, France.,Département de Chirurgie Vasculaire, Université Angers, CHU Angers, Angers, France
| | - A Ducancelle
- LUNAM Université, Angers, France.,Laboratoire de Virologie, Université d'Angers, CHU Angers, Angers, France
| | - A Chevailler
- LUNAM Université, Angers, France.,Laboratoire d'Immunologie, Université d'Angers, CHU Angers, Angers, France
| | - A Duveau
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J-F Subra
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
| | - J Sayegh
- LUNAM Université, Angers, France.,Service de Néphrologie-Dialyse-Transplantation, Université Angers, CHU Angers, Angers, France
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Tillou X, Chahwan C, Brichart N, Bouyé S, Culty T, Iselin C, Pfister C, Sallusto F, Salomon L, Verhoest G, Viart L, Doerfler A. 724 Prostate cancer before renal transplantation: A multicenter study. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/s1569-9056(16)60726-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cerruti A, Lebdai S, Martin F, Hoarau N, Chautard D, Culty T, Azzouzi AR, Bigot P. [Do postoperative drainage types modify outcomes after retrograde intrarenal surgery?]. Prog Urol 2015; 25:331-5. [PMID: 25748790 DOI: 10.1016/j.purol.2015.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/29/2014] [Accepted: 01/23/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The aim of the current study was to evaluate if the postoperative drainage type modified the outcomes after retrograde flexible ureteroscopy (f-URS) and intracorporeal lithotripsy f-URS for intrarenal stones. MATERIAL AND METHODS We retrospectively analyzed 162 procedures of f-URS for intrarenal stones between January 2010 and January 2013 at a single institute. Independent-sample t-tests and chi-square tests were used for comparisons of means and proportions between patients with ureteral stent or double pigtail stents. RESULTS There were 86 males (52.8%) and 77 females (47.3%) with a mean age of 52.8 ± 17 years. Double pigtail stents and ureteral stents were used in 117 (72.2%) and 45 (27.8%) cases, respectively. Cases with postoperative double pigtail stents had a longer operative time (96.2 ± 35 min vs 81.2 ± 5 min; P = 0.018) and were less often operated by an experienced surgeon (P = 0.001). Length of hospital staying (P = 0.804), postoperative complication (P = 0.148) and stone free status (P = 0.116) were not different between postoperative drainage by double pigtail and ureteral stents. CONCLUSION Postoperative drainage by double pigtail stent was used more often by surgeons in the beginning of their RIRS experience and was associated with longer operation time. Nevertheless, the postoperative drainage type did not modify the outcomes regarding the postoperative complication rate, the length of hospital staying and the stones free rate.
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Affiliation(s)
- A Cerruti
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - S Lebdai
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - F Martin
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - N Hoarau
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - D Chautard
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - T Culty
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - A R Azzouzi
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - P Bigot
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France.
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Hoarau N, Martin F, Lebdai S, Chautard D, Culty T, Azzouzi A, Bigot P. Impact de l’urétéroscopie souple et de la lithotripsie intrarénales sur la fonction rénale. Prog Urol 2014; 24:887. [DOI: 10.1016/j.purol.2014.08.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Culty T, Timsit MO, Neuzillet Y, Badet L, Kleinclauss F. Complications urologiques de la transplantation rénale. Prog Urol 2014; 24:723-32. [DOI: 10.1016/j.purol.2014.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 05/24/2014] [Accepted: 06/03/2014] [Indexed: 10/25/2022]
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Branchereau J, Timsit M, Neuzillet Y, Ctafu, Bessede T, Tillou X, Thuret R, Codas R, Boutin J, Doerfler A, Sallusto F, Culty T, Delaporte V, Brichart N, Van Agt S, Michaud S, Rode J, Billault C, Barrou B, Salomon L, Karam G, Badet L, Kleinclauss F. Prise en charge des calculs sur transplants rénaux : une étude multicentrique du CTAFU. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Garnier AS, Onno C, Villemain F, Videcoq M, Picquet J, Culty T, Sayegh J. Reprise immédiate de la fonction rénale après transplantation d’un greffon issu de donneur décédé après arrêt cardiaque : deux observations. Nephrol Ther 2013. [DOI: 10.1016/j.nephro.2013.07.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ammi M, Bigot P, Chautard D, Larre S, Culty T, Pinon C, Azzouzi A. Stimulation transcutanée du nerf tibial : évaluation d’une option thérapeutique dans la prise en charge de l’hyperactivité vésicale résistante aux anticholinergiques. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Benchikh El Fegoun A, El Atat R, Culty T, Hupertan V, Ravery V. Les sténoses post-traumatiques de l’urètre : résultats à dix ans et facteurs pronostiques d’échec. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Billault C, Vaessen C, Van Glabeke E, Culty T, Arzouk N, Dumitru L, Ourahma S, Robert J, Richard F, Barrou B. Systematic microbiological tests in kidney transplantation and their value in predicting posttransplantation infection. Transplant Proc 2009; 41:666-8. [PMID: 19328951 DOI: 10.1016/j.transproceed.2008.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Immunosuppressive therapy has many side effects among which is an increased infectious risk for the recipient. Transmission of pathogens from the graft to the recipient has not been well evaluated; there are no guidelines regarding the need for microbiological tests on the graft prior to transplantation. We routinely performed such tests to evaluate the risk and determine whether a patient should receive preemptive antibiotic therapy after transplantation. We herein have reported our preliminary results. MATERIALS AND METHODS We reviewed 150 consecutive renal transplantations from cadaveric heart-beating donors. Microbiological tests were systematically performed not only on the preservation solution, but also on graft artery, vein, ureter, and perirenal fat. We reviewed the recipient's medical history for clinically significant infectious episodes in the first month after transplantation. RESULTS Thirty-one percent of all microbiological tests were positive with 23 patients showing multiple positive tests, 74% of which were concordant. We documented 3 cases of direct graft-to-recipient pathogen transmission, all of which presented with 3 positive concordant tests. Graft culture prior to transplantation is often positive, but in more than half of the cases positive tests are either isolated or discordant. We only treated patients with concordant test results; no adverse consequence was observed among the untreated patients. Transmission occurred only in patients with at least 3 concordant tests. CONCLUSIONS Multiple microbiological tests on the graft prior to transplantation seemed useful to determine which patients would benefit from preemptive antibiotic therapy. Further studies may help to define which microbiological tests are the most important.
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Affiliation(s)
- C Billault
- Service d'Urologie, Hopital de la Pitié-Salpêtrière, Paris, France.
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Abstract
The 2006 annual American Urological Association (AUA) meeting took place in Atlanta from 20-25th of May. Four hundred and seventy nine abstracts (27.8%) were dedicated to the prostate cancer. The aim of this study is to summarise the most debated topics and to highlight the most original research. The main topics this year were obesity, ethnicity, PSA kinetic, surgical margins, robot and adjuvant therapy.
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Affiliation(s)
- T Culty
- Service d'urologie, CHU de la Pitié-Salpêtrière, 47-83, boulevard de Hôpital, 75651 Paris 13, France.
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Culty T, Molinie V, Lebret T, Savareux L, Souid M, Delahousse M, Botto H. TSC2/PKD1 contiguous gene syndrome in an adult. MINERVA UROL NEFROL 2006; 58:351-4. [PMID: 17268401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
A 48-year-old woman with a history of autosomal-dominant polycystic kidney disease (ADPKD), was found to have multiple renal angiomyolipomas on a pathological examination after nephrectomy. The clinical and pathological presentation is consistent with the diagnosis of TSC2/PKD1 contiguous gene syndrome, caused by the simultaneous loss of TSC2 and PKD1, the two major genes for tuberous sclerosis complex and ADPKD.
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Affiliation(s)
- T Culty
- Department of Urology, CHU Pitié-Salpétrière, Paris, France.
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Abstract
Scrotal traumas are rare. Most are blunt traumas caused by a direct blow on the scrotum. The testicle is projected against the pubic arch. Early surgical investigation has considerably improved the prognosis of testicular trauma, and reduced orchidectomy rate. ULtrasonography has also improved the management of scrotal trauma. But there is a controversy about accuracy of ultrasonography in predicting presence or absence of testicular disruption. ULtrasonography should not challenge the dogma regarding systematic surgical investigation of hematocele and enlarged scrotum. Long term outcomes (testicular atrophy, infertility) may be more frequent as previously thought and should be detected.
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Affiliation(s)
- T Culty
- Service d'urologie, Hôpital Bichat, 46, rue Henri-Huchard, 75877 Paris, France
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