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Lebdai S, Chevrot A, Doizi S, Pradère B, Barry Delongchamps N, Baumert H, Benchikh A, Della Negra E, Fourmarier M, Gas J, Misraï V, Rouscoff Y, Theveniaud PE, Vincendeau S, Wilisch J, Descazeaud A, Robert G. [Surgical and interventional management of benign prostatic obstruction: Guidelines from the Committee for Male Voiding Disorders of the French Urology Association]. Prog Urol 2021; 31:249-265. [PMID: 33478868 DOI: 10.1016/j.purol.2020.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/31/2020] [Revised: 11/24/2020] [Accepted: 12/04/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The aim of the Male Lower Urinary Tract Symptoms Committee (CTMH) of the French Urology Association was to propose an update of the guidelines for surgical and interventional management of benign prostatic obstruction (BPO). METHODS All available data published on PubMed® between 2018 and 2020 were systematically searched and reviewed. All papers assessing surgical and interventional management of adult patients with benign prostatic obstruction (BPO) were included for analysis. After studies critical analysis, conclusions with level of evidence and French guidelines were elaborated in order to answer the predefined clinical questions. RESULTS/GUIDELINES Offer a trans-uretral incision of the prostate to treat patients with moderate to severe lower urinary tract symptoms (LUTS) with a prostate volume<30cm3, without a middle lobe. TUIP increases the chances of preserving ejaculation. Propose mono- or bipolar trans-urethral resection of the prostate (TURP) to treat patients with moderate to severe LUTS with a prostate volume between 30 and 80cm3. Vaporization by Greenlight™ or by bipolar energy can be offered as an alternative to TURP. Offer a Greenlight™ laser vaporization to patients at risk of bleeding. Offer endoscopic prostate enucleation to surgically treat patients with moderate to severe LUTS as an alternative to TURP and open prostatectomy (OP). Minimally invasive prostatectomy is an alternative to OP in centers without access to adequate endoscopic procedures. Embolization of the prostatic arteries may be offered in the event of a contraindication or refusal of surgery for prostates with a volume>80cm3. Prostatic uretral lift is an alternative in patients interested in preserving their ejaculatory function and with a prostate volume<70cm3 without a middle lobe. Aquablation and Rezum™ are under evaluation and should be offered in research protocols. CONCLUSION Major changes in surgical management of BPO have occurred and aim at reducing morbidity and improving quality of life of patients.
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Affiliation(s)
- S Lebdai
- Service d'urologie, CHU d'Angers, Angers, France.
| | - A Chevrot
- Service d'urologie, CHU de Nîmes, Nîmes, France
| | - S Doizi
- Service d'urologie, hôpital européen Georges-Pompidou, Paris, France
| | - B Pradère
- Service d'urologie, CHU de Tours, Tours, France
| | | | - H Baumert
- Service d'urologie, hôpital Ambroise-Paré, Paris, France
| | - A Benchikh
- Service d'urologie, Clinique les Martinets, Versailles, France
| | - E Della Negra
- Service d'urologie, hôpital des Côtes d'Armor, Saint-Brieuc, France
| | - M Fourmarier
- Service d'urologie, hôpital Aix-en-Provence, Aix-en-Provence, France
| | - J Gas
- Service d'urologie, CHU de Toulouse, Toulouse, France
| | - V Misraï
- Service d'urologie, clinique Pasteur, Toulouse, France
| | - Y Rouscoff
- Service d'urologie, polyclinique Saint-Georges, Nice, France
| | - P E Theveniaud
- Service d'urologie, CHR de Metz Thionville, Metz, France
| | - S Vincendeau
- Service d'urologie, CHU de Rennes, Rennes, France
| | - J Wilisch
- Service d'urologie, hôpital privé Natecia, Lyon, France
| | - A Descazeaud
- Service d'urologie, CHU de Limoges, Limoges, France
| | - G Robert
- Service d'urologie, CHU de Bordeaux, Bordeaux, France
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Mathieu R, Lebdai S, Cornu J, Benchikh A, Azzouzi A, Delongchamps N, Dumonceau O, Faix A, Fourmarier M, Haillot O, Lukacs B, Misrai V, de La Taille A, Robert G, Descazeaud A. Perioperative and economic analysis of surgical treatments for benign prostatic hyperplasia: A study of the French committee on LUT. Prog Urol 2017; 27:362-368. [DOI: 10.1016/j.purol.2017.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 10/02/2016] [Accepted: 03/30/2017] [Indexed: 11/26/2022]
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Lebdai S, Azzouzi AR, Delongchamps NB, Benchikh A, Campeggi A, Cornu JN, Dumonceau O, Faix A, Fourmarier M, Haillot O, Lukacs B, Mathieu R, Misrai V, Robert G, de La Taille A, Descazeaud A. Aspects médicoéconomiques des traitements médicamenteux de l’hypertrophie bénigne de la prostate : une revue de la littérature du Comité des troubles mictionnels de l’homme de l’Association française d’urologie. Prog Urol 2016; 26:129-36. [PMID: 26643518 DOI: 10.1016/j.purol.2015.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 10/27/2015] [Accepted: 10/30/2015] [Indexed: 12/01/2022]
Affiliation(s)
- S Lebdai
- Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
| | - A R Azzouzi
- Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | | | - A Benchikh
- Service d'urologie, hôpital Bichat - Claude-Bernard, groupe des hôpitaux universitaires Paris-Nord-Val-de-Seine, université Denis-Diderot Paris-VII, 75018 Paris, France
| | - A Campeggi
- Service d'urologie, CHU Mondor, 75000 Paris, France
| | - J-N Cornu
- Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France
| | - O Dumonceau
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - A Faix
- Clinique mutualiste Beausoleil, 34070 Montpellier, France
| | - M Fourmarier
- Service d'urologie, centre hospitalier Aix-en-Provence, 13616 Aix-en-Provence, France
| | - O Haillot
- Service d'urologie, CHU de Tours, 37044 Tours, France
| | - B Lukacs
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - R Mathieu
- Service d'urologie, hôpital Pontchaillou, CHU de Rennes, 35000 Rennes, France
| | - V Misrai
- Service d'urologie, clinique Pasteur, 31300 Toulouse, France
| | - G Robert
- Service d'urologie, université Bordeaux-Segalen, CHU de Bordeaux, 33076 Bordeaux, France
| | | | - A Descazeaud
- Service de chirurgie urologique, CHU de Limoges, 87042 Limoges, France
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Pommier JD, Ben Lasfar N, Van Grunderbeeck N, Burdet C, Laouénan C, Rioux C, Pierre-Audigier C, Meybeck A, Choudat L, Benchikh A, Nguyen S, Bouvet E, Yeni P, Yazdanpanah Y, Joly V. Complications following intravesical bacillus Calmette-Guerin treatment for bladder cancer: a case series of 22 patients. Infect Dis (Lond) 2015; 47:725-31. [PMID: 26077036 DOI: 10.3109/23744235.2015.1055794] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intravesical bacillus Calmette-Guerin (BCG) therapy is an effective and widely used treatment for superficial bladder carcinoma. Local complications are frequent whereas systemic complications are rare but can be serious, and their management is not well known. METHODS We describe retrospectively the records of 22 patients treated in 3 infectious disease departments, for complications related to intravesical BCG therapy as treatment of bladder cancer. RESULTS All the patients were male, with a median age of 68 years (range 56-88). Complications occurred after a median of 5 instillations (range 1-11) and were observed within 24 h following BCG instillation for 14 patients. Common symptoms were fever (n = 20), impaired general condition (n = 14), and shortness of breath (n = 7). Six patients had a systemic septic reaction leading to transfer into the intensive care unit for five of them. Lung infiltration was the most frequent presentation (n = 11). Mycobacterium bovis was isolated from only two patients, but histology showed the presence of a granuloma in nine patients. Antimycobacterial treatment was initialized in 17 patients; the outcome was favorable in 16 patients, with a median length of symptoms resolution of 22.5 days (range 5-425 days). Eleven patients received corticosteroids in addition to specific treatment and had a more rapid improvement. One patient died with disseminated BCGitis proved by biopsy. CONCLUSIONS Complications following intravesical BCG therapy are rare but can be severe and fatal. Histology seems to be the method that contributes most in confirmation of the diagnosis. Antimycobacterial therapy is effective, and probably more efficient when combined with corticosteroids, but the regimen and duration of the treatment are not standardized.
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Affiliation(s)
- J D Pommier
- Infectious and Tropical Diseases Department, Bichat Hospital, AP-HP , Paris , France
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Descazeaud A, Barry Delongchamps N, Cornu JN, Azzouzi A, Buchon D, Benchikh A, Coloby P, Dumonceau O, Fourmarier M, Haillot O, Lebdai S, Mathieu R, Misrai V, Saussine C, de La Taille A, Robert G. Guide de prise en charge en médecine générale des symptômes du bas appareil urinaire de l’homme liés à une hyperplasie bénigne de la prostate. Prog Urol 2015; 25:404-12. [DOI: 10.1016/j.purol.2015.02.008] [Citation(s) in RCA: 9] [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: 01/04/2015] [Revised: 02/17/2015] [Accepted: 02/26/2015] [Indexed: 11/25/2022]
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Lebdai S, Rahmène Azzouzi A, Delongchamps NB, Benchikh A, Campeggi A, Cornu JN, Dumonceau O, Faix A, Fourmarier M, Haillot O, Lukacs B, Mathieu R, Misrai V, Robert G, de La Taille A, Descazeaud A. [Evaluation of the impact of CTMH guidelines on the management of benign prostatic hyperplasia]. Prog Urol 2014; 25:47-53. [PMID: 25453357 DOI: 10.1016/j.purol.2014.09.049] [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: 06/16/2014] [Revised: 09/19/2014] [Accepted: 09/24/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The French guidelines on the management of benign prostatic hyperplasia (BPH) have been published in 2012 by the LUTS committee of the French Urological Association. The aim of this study was to evaluate the impact of these guidelines on the BPH management by French urologists. MATERIAL AND METHODS A questionnaire has been distributed by email to 1141 urologists members of the French Association of Urologists in November 2013. RESULTS We collected 222 responses (response rate: 19%). The guidelines have been read by 73% of the urologists. The guidelines were followed most of the time by 76% of them, 11% followed them systematically and 4.5% did not follow them. The new terminology was used by 28 to 52% according to the items. The symptoms were evaluated by the IPSS score (33%), by interrogatory alone (64%) or by neither of them (3%). Prostate volume was not systematically taken for account in the treatment strategy by 57% of the urologists. Sexual function was assessed systematically by 28% of the urologists, 11% used a questionnaire (IIEF: 92%). PSA was tested respectively by 70 and 51% of the urologists at the initial evaluation and the follow-up. After introduction of a monotherapy, 56% of the urologists evaluated the efficacy at 3 months. CONCLUSION The French guidelines for the management of benign prostatic hyperplasia (BPH) by the LUTS committee of the French Urological Association were well known and used by French urologists. Some improvements can be expected for the use of the IPSS score, the evaluation of the sexual function, and the use of the new terminology. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- S Lebdai
- Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
| | - A Rahmène Azzouzi
- Service d'urologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | | | - A Benchikh
- Service d'urologie, hôpital Bichat - Claude-Bernard, groupe des hôpitaux universitaires Paris-Nord-Val-de-Seine, université Denis-Diderot, Paris-VII, 75018 Paris, France
| | - A Campeggi
- Service d'urologie, CHU Mondor, 75000 Paris, France
| | - J N Cornu
- Service d'urologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie - Paris-6, 75020 Paris, France
| | - O Dumonceau
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - A Faix
- Clinique mutualiste Beausoleil, 34070 Montpellier, France
| | - M Fourmarier
- Service d'urologie, centre hospitalier d'Aix-en-Provence, 13616 Aix-en-Provence, France
| | - O Haillot
- Service d'urologie, CHU de Tours, 37044 Tours, France
| | - B Lukacs
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - R Mathieu
- Service d'urologie, hôpital Pontchaillou, CHU de Rennes, 35000 Rennes, France
| | - V Misrai
- Service d'urologie, clinique Pasteur, 31300 Toulouse, France
| | - G Robert
- Service d'urologie, CHU de Bordeaux, université Bordeaux-Segalen, 33076 Bordeaux, France
| | | | - A Descazeaud
- Service de chirurgie urologique, CHU de Limoges, 87042 Limoges, France
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Lebdai S, Haillot O, Azzouzi A, Benchikh A, Campeggi A, Cornu JN, Delongchamps N, Dumonceau O, Faix A, Fourmarier M, Lukacs B, Mathieu R, Misrai V, Robert G, de La Taille A, Descazeaud A. Traitement de l’incontinence urinaire masculine non neurologique par hyperactivité vésicale : une revue de la littérature du CTMH de l’AFU. Prog Urol 2014; 24:588-94. [DOI: 10.1016/j.purol.2014.01.002] [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] [Received: 12/03/2013] [Revised: 01/02/2014] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
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de La Motte Rouge T, Pouessel D, Benchikh A, Dubosq F, Durand X, Gillion N, Plantade A, Alexandre I, Thibault F. 7021 POSTER Multidisciplinary Management of Castration Resistant Prostate Cancer (CRPC) in France – a Survey Comparing Practices and Assessing Collaboration Between Urologists and Oncologists. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71972-4] [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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Caremel R, Bernhard JC, Bigot P, Koutlidis N, Xylinas E, Faïs PO, Rouache L, Genevois S, Mazzola C, Bessede T, Gosseine PN, Celhay O, Faivre D'Arcier B, Benchikh A, Pignot G, Guillotreau J. [Results of an investigation by questionnaire into interest in neuro-urology of urology residents]. Prog Urol 2010; 20:458-63. [PMID: 20538211 DOI: 10.1016/j.purol.2009.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 08/21/2009] [Accepted: 10/05/2009] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate the interest borne towards neuro-urology within the community of the urology residents. MATERIALS AND METHODS Between January and May 2009, all urology residents received an anonymous questionnaire by e-mail estimating their interest for neuro-urology. The analyzed data were: epidemiologic data; participation in theoretical learning and training courses practices; interest and investment in the speciality; opinion on the current formation. The qualitative variables were compared by the chi-2 test. P values <0,05 were considered significant. RESULTS The rate of answer was 45,3 %. The middle age was 28,7+/-2,3 years. Ninety-two (70,7 %) of the 130 urologist residents questioned wished to exert full-time or divided in a hospital structure. They were 40 % to have a multidisciplinary neuro-urology staff, and 80 % were in a service which dealt with suffering patients of neurological bladder. The percentage of urologist residents interested by neuro-urology was 69,2 %, and 61,5 % of them wished to practice this activity in their future exercise. This wish was significantly higher for those resulting from the ENC (p<0,05), for those wishing to exert at the hospital (p<0,01) and for those who practice urology at a level of expertise in neuro-urology (p<0,01). The theoretical and practical teaching of neuro-urology were considered as being insufficient for respectively 73,9 % and 64,2 % of the urologist residents. In contrast, the average note allotted to the neuro-urology module of the ECU was of 7,47 out of 10. CONCLUSION Neuro-urology seems to be particularly attractive for the urologist residents, and many wished to integrate it in their future exercise. The motivation was more important for those who wished to carry out a career in hospital. Even if the quality of the teaching was very noted, their modalities were considered to be insufficient by most of them.
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Affiliation(s)
- R Caremel
- Service d'urologie, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France.
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