1
|
Saint F, Huyghe E, Methorst C, Priam A, Seizilles de Mazancourt E, Bruyère F, Faix A. [Infections and male infertility]. Prog Urol 2023; 33:636-652. [PMID: 38012909 DOI: 10.1016/j.purol.2023.09.015] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The role of urogenital infections in male infertility has long been the subject of debate. METHODS A bibliographic search limited to English-language literature on human subjects published before 5/2023 resulted in the selection of 189 articles. RESULTS Male infertility is often of multifactorial aetiology, and to optimise the prognosis it is important to manage all the factors that can be corrected, including infectious causes, which represent one of the most frequent aetiologies. The infectious agents involved in urogenital infections are most often bacterial or viral, and more rarely parasitic. They can infect the seminal tract, male accessory glands and/or testicles, and usually result in inflammation and increased oxidative stress. These infections reduce male fertility, in particular by altering spermogram parameters and increasing sperm DNA fragmentation. For these reasons, the search for a urogenital infection should be systematic, involving a careful history and clinical examination, ultrasound and systematic bacteriological tests guided by clinical findings. Aetiological treatment may be proposed depending on the picture and the germ involved. CONCLUSION This review should help the urologist to establish an accurate diagnosis of the form and extent of the infection, and enable him to define an appropriate therapeutic strategy, tailored to the patient, in order to obtain the best chances of improving male fertility.
Collapse
Affiliation(s)
- F Saint
- Service d'urologie-transplantation, CHU Amiens Picardie, Amiens, France; Laboratoire EPROAD EA 4669, université Picardie Jules-Verne, Amiens, France
| | - E Huyghe
- Département d'urologie, hôpital de Rangueil, CHU de Toulouse, Toulouse, France; Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; UMR DEFE, Inserm 1203, université de Toulouse, université de Montpellier, Montpellier, France.
| | - C Methorst
- Service de médecine de la reproduction, hôpital des 4 villes, Saint-Cloud, France
| | - A Priam
- Service d'urologie-transplantation, CHU Amiens Picardie, Amiens, France
| | | | - F Bruyère
- Urologie, CHRU de Tours, Tours, France
| | - A Faix
- Clinique Saint-Roch, 560, avenue du Colonel-Pavelet-dit-Villars, 34000 Montpellier, France
| |
Collapse
|
2
|
Priam A, Le Bozec A, Dias Meireles V, Saint F, Cabry R, Benkhalifa M, Demey B, Bosquet D. Human papillomavirus seminal carriage, spermogram abnormalities and male infertily: A french cohort study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00711-x] [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: 02/12/2023]
|
3
|
Leon P, Saint F, Audenet F, Roumiguié M, Allory Y, Loriot Y, Masson-Lecomte A, Pradère B, Seisen T, Traxer O, Xylinas E, Roupret M, Neuzillet Y. Recommandations du Comité de cancérologie de l’Association Française d’Urologie (CC-AFU) pour la bonne pratique des instillations intravésicales de mitomycine C, d’épirubicine et de BCG pour le traitement des tumeurs de la vessie n’infiltrant pas le muscle (TVNIM). Prog Urol 2022; 32:299-311. [DOI: 10.1016/j.purol.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/02/2022] [Accepted: 01/10/2022] [Indexed: 12/01/2022]
|
4
|
Audenet F, Sotto A, Roumiguié M, Allory Y, Andrejak C, Leon P, Loriot Y, Masson-Lecomte A, Pradère B, Seisen T, Traxer O, Xylinas E, Bruyère F, Roupret M, Saint F, Neuzillet Y. Recommandations des Comités de cancérologie (CC-AFU) et d’infectiologie (CI-AFU) de l’Association française d’urologie pour la prise en charge effets indésirables et complications du BCG. Prog Urol 2022; 32:165-176. [DOI: 10.1016/j.purol.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/02/2022] [Accepted: 01/10/2022] [Indexed: 12/01/2022]
|
5
|
Khadhra HB, Saint F, Trecherel E, Lapôtre-Ledoux B, Zerkly S, Ganry O. Relationship between socioeconomic status and prostate cancer (incidence, aggressiveness, treatment with curative intent, and mortality): a spatial analysis using population-based cancer registry data. Rev Epidemiol Sante Publique 2021; 69:329-336. [PMID: 34629211 DOI: 10.1016/j.respe.2021.07.007] [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: 05/13/2020] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Morbidity and mortality associated with prostate cancer in a given geographic area might be related to the level of socioeconomic deprivation. The Somme area (a region of northern France) is considered economically disadvantaged, with major territorial disparities. The aim of this study was to assess the impact of the socioeconomic level on prostate cancer, using data from a population-based cancer registry. METHODS The source of data on cases of prostate cancer between 2006 and 2010 was the Somme cancer registry (Amiens, France). Socioeconomic status was measured according to the European Deprivation Index (EDI), which was used to classify each geographical "IRIS" unit (the smallest sub-municipal geographical entity for which French census data are available) according to its level of social deprivation. For spatial analysis, we considered a hierarchical generalized linear model. RESULTS In the spatial analysis, prostate cancer incidence was higher in the less disadvantaged areas and treatment frequency with curative intent was lower in the most disadvantaged areas. Cancer aggressiveness and mortality were higher in the most disadvantaged areas: relative risk (RR) = 1.36; 95% CI: [1.09; 1.73] and RR=3.09 [1.70; 5.59], respectively. CONCLUSION Our results evidenced a significant association between socioeconomic deprivation and prostate cancer, with worse outcomes among men with the lowest socioeconomic status.
Collapse
Affiliation(s)
- H Ben Khadhra
- Somme Cancer Registry, Epidemiology, Hygiene and Public Health Department, Amiens University Medical Center, Amiens, France.
| | - F Saint
- Department of Urology and Transplantation, Amiens University Medical Center, Amiens, France; EPROAD EA 4669 Laboratory
| | - E Trecherel
- Somme Cancer Registry, Epidemiology, Hygiene and Public Health Department, Amiens University Medical Center, Amiens, France
| | - B Lapôtre-Ledoux
- Somme Cancer Registry, Epidemiology, Hygiene and Public Health Department, Amiens University Medical Center, Amiens, France
| | - S Zerkly
- Somme Cancer Registry, Epidemiology, Hygiene and Public Health Department, Amiens University Medical Center, Amiens, France
| | - O Ganry
- Somme Cancer Registry, Epidemiology, Hygiene and Public Health Department, Amiens University Medical Center, Amiens, France
| |
Collapse
|
6
|
de Lafforest S, Magnier A, Vallée M, Bey E, Le Goux C, Saint F, Therby A, Zahar JR, Sotto A, Bruyere F, Grammatico-Guillon L. FUrTIHF: French urinary tract infections in healthcare facilities - five-year historic cohort (2014-2018). J Hosp Infect 2021; 116:29-36. [PMID: 34166732 DOI: 10.1016/j.jhin.2021.04.035] [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: 01/26/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Urinary tract infections (UTIs) are common and diverse. Even when not severe, UTIs regularly lead to hospitalization, but their hospital burden remains unknown. This study aimed to estimate the national incidence of hospitalized UTIs in France. METHODS A historic five-year cohort of adult patients hospitalized with UTIs in France was extracted from the medico-administrative databases using an ICD-10 code algorithm built by a multidisciplinary team. The performance parameters were estimated blindly, by reviewing 1122 cases, using medical reports as the gold standard, giving a global predictive positive value of 70.4% (95% confidence interval 66.6-74.1). The national incidence of UTIs was then estimated. RESULTS A total of 2,083,973 patients with UTIs were hospitalized over the period, giving an adjusted incidence rate of ∼900 cases/100,000 inhabitants, stable over the period, higher in females and increasing with age; 1.2% were device-associated UTIs. Unspecific acute cystitis represented almost two-thirds of cases (63.5%); followed by pyelonephritis (23.6%) and prostatitis (12.4%). More than three-quarters of patients had at least one comorbid condition (76.8%). CONCLUSIONS This national cohort study is the first to date to estimate the incidence of UTI-related hospitalizations in France. UTIs represent a substantial burden of care. Further analysis will provide data for more informed goal-of-care discussions targeting each type of UTI, their management and outcomes.
Collapse
Affiliation(s)
- S de Lafforest
- EpiDcliC, unité de santé publique, SIMEES, CHRU de Tours, France; Faculté de médecine, Université de Tours, France; Equipe EA 7505 Education éthique santé, Université de Tours, France
| | - A Magnier
- CHU d'Angers, service d'urologie, Université Angers, France; Service d'urologie, CHRU de Tours, France
| | - M Vallée
- Department of Urology, Poitiers University Hospital, Université de Poitiers INSERM U1070, "Pharmacologie des Anti-Infectieux", Poitiers, France; CIAFU Comité d'infectiologie de l'Association Française d'Urologie, France
| | - E Bey
- CIAFU Comité d'infectiologie de l'Association Française d'Urologie, France; Urology and Andrology department, University Hospital of Nîmes, Nîmes, France
| | - C Le Goux
- CIAFU Comité d'infectiologie de l'Association Française d'Urologie, France; Urologie Hôpital Privé Nord Parisien, Tassigy, Sarcelles, France
| | - F Saint
- CIAFU Comité d'infectiologie de l'Association Française d'Urologie, France; Department of Urology and Transplantation, CHU Amiens-Picardie. EPROAD Laboratory EA 4669, Picardie Jules Verne University, France
| | - A Therby
- CIAFU Comité d'infectiologie de l'Association Française d'Urologie, France; CH Versailles, France
| | - J R Zahar
- CIAFU Comité d'infectiologie de l'Association Française d'Urologie, France; Infection Control Unit, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Bobigny, France; University Sorbonne Paris Nord, Bobigny, France
| | - A Sotto
- CIAFU Comité d'infectiologie de l'Association Française d'Urologie, France; Service de maladies infectieuses et tropicales, CHU de Nimes, Université de Nimes, France
| | - F Bruyere
- Faculté de médecine, Université de Tours, France; Service d'urologie, CHRU de Tours, France; CIAFU Comité d'infectiologie de l'Association Française d'Urologie, France
| | - L Grammatico-Guillon
- EpiDcliC, unité de santé publique, SIMEES, CHRU de Tours, France; Faculté de médecine, Université de Tours, France; CIAFU Comité d'infectiologie de l'Association Française d'Urologie, France.
| |
Collapse
|
7
|
Saint F, Masson-Lecomte A. Achieving disease free distal ureteral margin at the time of radical cystectomy: Why and for whom? (an overview of literature). Prog Urol 2021; 31:303-315. [PMID: 33593697 DOI: 10.1016/j.purol.2020.09.020] [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: 05/28/2020] [Revised: 08/28/2020] [Accepted: 09/20/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Achieving negative status of distal ureteral margin at the time of radical cystectomy (RC), and its therapeutic benefit, remains controversial. The aim of this review was to evaluate frequency, reliability and impact of positive distal ureteral margin after radical cystectomy for bladder cancer on upper tract recurrence, cancer specific and overall survival, and to identify best candidates for intraoperative frozen section analyses. MATERIAL AND METHODS A systemic review was performed following the PRISMA guideline. PubMed/Medline (with following terms; bladder cancer or cystectomy and frozen section or ureteral margin), and Cochrane Library were searched up to April 2020, to identify all papers evaluating distal ureteral margin and discussing clinical interest. Previous reviews and single case reports were excluded. RESULTS In total, thirty-two relevant studies were identified. Mean rate of positive ureteral frozen section after RC was close to 10% [1.1-25.4%]. Frozen section (FS) achieved a very good specificity [83-100%] and reserved sensibility [45-100%]. In many cases, an initial positive margin on FS can be converted to negative. Positive FS and/or PS (permanent section) were associated with upper urinary tract recurrence (UUTR). Conversion from positive FS to negative PS was associated with low UUTR frequency and better cancer survival in large retrospective studies. The relevant prognostic factor associated with positive FS and/or PS was CIS within the bladder. CONCLUSION FS should be recommended for patients with CIS within the bladder. Achieving negative FS/PS might be associated with lower rates of UUTR and better survival, for patients with higher life expectancy. Prospective randomized controlled studies need to be performed to provide definitive recommendations in this area.
Collapse
Affiliation(s)
- F Saint
- EPROAD research laboratory (EA 4669), Amiens, France; Department of urology and transplantation, Picardie Jules-Verne university, Amiens, France.
| | - A Masson-Lecomte
- Department of urology and transplantation, Paris Diderot university, Saint-Louis hospital, Paris, France
| |
Collapse
|
8
|
Renoncourt T, Saint F, Bloch F. Mésusage des traitements de l’hypertrophie bénigne de la prostate chez le sujet âgé. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.126] [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: 10/23/2022]
|
9
|
Ziani I, Ibrahimi A, Lahlou L, De Sousa P, Saint F, sayegh HE, Benslimane L, Nouini Y. Facteurs pronostiques de micro-métastase ganglionnaire des tumeurs de vessie infiltrant le muscle chez une population marocaine en 2019. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.03.091] [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: 10/23/2022] Open
|
10
|
Goujon A, Schoentgen N, Betari R, Thoulouzan M, Vanalderwerelt V, Oumakhlouf S, Brichart N, Pradere B, Roumiguie M, Rammal A, Bensalah K, Fournier G, Bruyere F, Grise P, Joulin V, Manunta A, Saint F, Huyghe E, Nouhaud F, Peyronnet B. Prognostic factors after adrenalectomy for adrenal metastasis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33197-9] [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: 10/23/2022] Open
|
11
|
Goujon A, Schoentgen N, Betari R, Gryn A, Vanalderwerelt V, Oumakhlouf S, Toulouzan M, Brichart N, Pradere B, Soulie M, Fournier G, Saint F, Bensalah K, Bruyere F, Joulin V, Nouhaud F, Huygue E, Manunta A, Peyronnet B. Laparoscopic adrenalectomy for adrenal metastasis: Comparison of the transperitoneal vs. retroperitoneal approaches. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33188-8] [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] Open
|
12
|
Goujon A, Schoentgen N, Betari R, Thoulouzan M, Vanalderwerelt V, Oumakhlouf S, Brichart N, Pradere B, Roumiguie M, Rammal A, Soulie M, Fournier G, Bensalah K, Bruyere F, Grise P, Joulin V, Manunta A, Saint F, Huyghe E, Nouhaud FX, Peyronnet B. Prognostic factors after adrenalectomy for adrenal metastasis. Int Urol Nephrol 2020; 52:1869-1876. [PMID: 32419066 DOI: 10.1007/s11255-020-02496-w] [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: 01/28/2020] [Accepted: 05/04/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Very few studies have sought prognostic factors after adrenalectomy for metastasis. The aim of this study was to assess prognostic factors for oncological outcomes after adrenalectomy for adrenal metastasis. METHODS All adrenalectomies for metastases performed in seven centers between 2006 and 2016 were included in a retrospective study. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method. Prognostic factors for CSS and RFS were sought by Cox regression analyses. RESULTS 106 patients were included. The primary tumors were mostly renal (47.7%) and pulmonary (32.3%). RFS and CSS estimated rates at 5 years were 20.7% and 63.7%, respectively. In univariate analysis, tumor size (HR 3.83; p = 0.04) and the metastasis timing (synchronous vs. metachronous; HR 0.47; p = 0.02) were associated with RFS. In multivariate analysis, tumor size (HR 8.28; p = 0.01) and metastasis timing (HR 18.60; p = 0.002) were significant factors for RFS. In univariate analysis, the renal origin of the primary tumor (HR 0.1; p < 0.001) and the disease-free interval (DFI; HR 0.12; p = 0.02) were associated with better CSS, positive surgical margins with poorer CSS (HR 3.4; p = 0.01). In multivariate analysis, the renal origin of the primary tumor vs. pulmonary (HR 0.13; p = 0.03) and vs. other origins (HR 0.10; p = 00.4) and the DFI (HR 0.01; p = 0.009) were prognostic factors for CSS. CONCLUSION In this study, tumor size and synchronous occurrence of the adrenal metastasis were associated with poorer RFS. Renal origin of the primary tumor and longer DFI were associated with better CSS. These prognostic factors might help for treatment decision in the management of adrenal metastasis.
Collapse
Affiliation(s)
- A Goujon
- Department of Urology, CHU Rennes, Rennes, France.
| | | | - R Betari
- Department of Urology, CHU Amiens, Amiens, France
| | - M Thoulouzan
- Department of Urology, CHU Toulouse, Toulouse, France
| | | | | | - N Brichart
- Department of Urology, CH Orleans, Orléans, France
| | - B Pradere
- Department of Urology, CHU Tours, Tours, France
| | - M Roumiguie
- Department of Urology, CHU Toulouse, Toulouse, France
| | - A Rammal
- Department of Urology, CH Orleans, Orléans, France
| | - M Soulie
- Department of Urology, CHU Toulouse, Toulouse, France
| | - G Fournier
- Department of Urology, CHU Brest, Brest, France
| | - K Bensalah
- Department of Urology, CHU Rennes, Rennes, France
| | - F Bruyere
- Department of Urology, CHU Tours, Tours, France
| | - P Grise
- Department of Urology, CHU Rouen, Rouen, France
| | - V Joulin
- Department of Urology, CHU Brest, Brest, France
| | - A Manunta
- Department of Urology, CHU Rennes, Rennes, France
| | - F Saint
- Department of Urology, CHU Amiens, Amiens, France
| | - E Huyghe
- Department of Urology, CHU Toulouse, Toulouse, France
| | - F-X Nouhaud
- Department of Urology, CHU Rouen, Rouen, France
| | - B Peyronnet
- Department of Urology, CHU Rennes, Rennes, France
| |
Collapse
|
13
|
Bruyere F, Goux L, Bey E, Cariou G, Cattoir V, Saint F, Sotto A, Vallée M. [Urinary tract infections in adults: Comparison of the French and the European guidelines]. Prog Urol 2020; 30:472-481. [PMID: 32418735 DOI: 10.1016/j.purol.2020.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/29/2019] [Revised: 02/15/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Acute urinary tract infections (UTIs) in adult are now a major public health issue in terms of morbidity, mortality and in terms of costs for society. The latest French guidelines and the European Association of Urology guidelines differ in some points. The aim of this article is to compare the guidelines of these two societies in order to highlight their differences but also their common points in the management of UTIs. METHODS A comparative analysis of the latest French and European guidelines was carried out. The authors defined the following sub-sections: terminology, pyelonephritis, male UTIs, pregnancy urinary tract infections and cystitis. RESULTS AND CONCLUSION The guidelines of these two societies are not very different in terms of diagnostic and therapeutic management. The major differences are in the duration of antibiotic therapies, where French guidelines continue to recommend long term treatments where EAU sometimes recommends only 5 days of antibiotics, as in the case of simple acute pyelonephritis. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- F Bruyere
- Service d'urologie, CHRU de Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France; Service d'urologie, CHU de Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
| | - Le Goux
- Service d'urologie, CHU de Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Unité d'épidémiologie et hygiène hospitalière, CHU de Toulouse-Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse cedex 9, France
| | - E Bey
- Service d'urologie et de la transplantation rénale, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France
| | - G Cariou
- Cabinet d'urologie, 18, rue Fabre-d'Eglantine, 75012 Paris, France
| | - V Cattoir
- Service de bactériologie-hygiène hospitalière, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France
| | - F Saint
- Service d'urologie et de transplantation, CHU d'Amiens-Picardie, 80054 Amiens, France
| | - A Sotto
- Service des maladies infectieuses et tropicales, CHU de Nîmes, place du Pr-Debré, 30029 Nîmes cedex 09, France
| | - M Vallée
- Service d'urologie et de transplantations rénales, CHU La Milétrie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France; Inserm U1070, UFR médecine-pharmacie, pharmacologie des anti-infectieux, pôle biologie santé, université de Poitiers, 1, rue Georges-Bonnet, bâtiment B36 TSA 51106, 86073 Poitiers cedex 9, France
| |
Collapse
|
14
|
de Lafforest S, Magnier A, Saint F, Bruyère F, Grammatico-Guillon L. Incidence des infections urinaires hospitalisées en France : une cohorte historique (FURTHIF). Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.01.118] [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: 10/24/2022] Open
|
15
|
Lecuelle D, Basille D, Renard C, Saint F, Jounieaux V. Highly effective sirolimus therapy for abdominal lymphangioleiomyoma. Respir Med Res 2019; 75:32-34. [PMID: 31262426 DOI: 10.1016/j.resmer.2019.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 10/27/2022]
Affiliation(s)
- D Lecuelle
- Departments of urology and transplantation, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France
| | - D Basille
- Department of respiratory diseases and intensive care unit, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France.
| | - C Renard
- Department of radiology, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France
| | - F Saint
- Departments of urology and transplantation, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France; Research laboratory EPROAD (EA 4669), university Picardie Jules-Verne, 80000 Amiens, France; Biobanque de Picardie, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France
| | - V Jounieaux
- Department of respiratory diseases and intensive care unit, university hospital Amiens-Picardie, 80054 Amiens cedex 1, France
| |
Collapse
|
16
|
Saint F, Ben Khadra H, Saint F, Trecherel E, Lapotre-Ledoux B, Zerkly S, Ganry O. L’impact des inégalités socio-économiques sur l’incidence et la mortalité du cancer de la prostate. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.140] [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: 10/28/2022]
|
17
|
Peyronnet B, Schoentgen N, Betari R, Gryn A, Goujon A, Vanalderwerelt V, Oumakhlouf S, Thoulouzan M, Brichart N, Pradère B, Rammal A, Soulié M, Fournier G, Saint F, Bensalah K, Bruyère F, Joulin V, Nouhaud F, Huyghe E, Manunta A. L’origine de la tumeur primitive et la taille tumorale sont les deux facteurs pronostiques associés aux résultats oncologiques après surrénalectomie pour métastase surrénalienne. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.038] [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]
|
18
|
Saint F, Ben Khadhra H, Rose Robert F, Herpe Y, Sevestre H, Choukroun G, Ganry O, Amant C. Dosage urinaire de NGAL par l’automate Architect® : un nouveau marqueur pronostique pour le carcinome rénal. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.177] [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]
|
19
|
Ben Khadhra H, Saint F, Trecherel E, Lapotre-Ledoux B, Zerkly S, Ganry O. Social Deprivation, Waiting Time for Diagnosis and Therapeutic Management of Patients With Prostatic Cancer in the Somme Area, France. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.35400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: In France, prostate cancer is at the top of the list of the most common cancers in men. The morbidity and mortality of this cancer were found to be related to the geographic level of socioeconomic deprivation with a higher rate of mortality and more frequent aggressive cases among men with low socioeconomic level, this was associated with health disparities in the management of this cancer. Our study region is considered as an economically deprived area with a poverty rate significantly higher than the national average. Aim: The aim of our study was to assess the impact of the socioeconomic level on the incidence, mortality, aggressiveness and management of prostate cancer, using data from a population-based cancer registry. Methods: For this research, prostate cancer data, between 2006 and 2010, were obtained from the Somme area cancer registry. Social economic status was assessed using the European Deprivation Index (EDI). This index has been used to classify each geographical unit (IRIS) according to social deprivation. IRIS is the smallest submunicipal geographical entity for which census data are available. Each prostate cancer case was allocated to the corresponding IRIS by geolocalizing the addresses using geographic information system (GIS). For spatial analysis, hierarchical generalized linear modeling was fitted. To assess for spatial autocorrelation, Moran's I test was conducted and then spatial autocorrelation was modeled by a set of random effects that are assigned a conditional autoregressive (CAR) prior distribution. Results: A total of 2405 incident cases of prostate cancer were registered in the Somme area. The age-standardized rate was 98.2 cases per 100,000 person-years (PY). The standardized mortality rate was 28.1 deaths per 105 PY. The coefficient associated with the EDI obtained from the spatial analysis of prostate cancer incidence was negative (-0.348; 95% CI: −0.0831) which indicates that prostate cancer incidence was more important in the less deprived areas. The relative risk of prostate cancer mortality associated with the quintile 5 of the EDI relatively to quintile 1 was 3.09; 95% CI: [1.70-5.59]. For the aggressiveness, the coefficient associated with the EDI was 0.0493 with a 95% CI: [0.0162-0.0810], and the Q5/Q1 RR was equal to 1.36 95% CI: [1.09-1.73]. EDI estimated coefficient for proportion of cases who received curative treatment versus patients who received palliative treatment was −0.1089, 95 CI%: [−0.1505 to −0.0693]. EDI coefficient for waiting time was not significant. Conclusion: Our study showed a significant association between socioeconomic deprivation and prostate cancer with worse outcomes among men with the lowest socioeconomic status. Geographical differences in screening rate could explain this pattern. More in-depth research with a source data review is required to know precisely the determinism of this association and therefore adjust the eventual disparities.
Collapse
Affiliation(s)
| | - F. Saint
- North Tunisia Cancer Registry, Tunis, Tunisia
| | | | | | - S. Zerkly
- North Tunisia Cancer Registry, Tunis, Tunisia
| | - O. Ganry
- North Tunisia Cancer Registry, Tunis, Tunisia
| |
Collapse
|
20
|
Prudhomme T, Becquart N, Gryn A, Gas J, Cordonnier C, Thoulouzan M, Duly Bouhanick B, Bennet A, Soulié M, Saint F, Huyghe E. Facteurs prédictifs de persistance de l’hypertension artérielle après surrénalectomie dans l’adénome de Conn. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.229] [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: 10/18/2022]
|
21
|
Forzini T, Lecuelle D, Alezra E, Becquart N, Haraux É, Saint F, De Sousa P. Facteurs de risque d’échec d’insertion de gaine d’accès urétérale : étude sur 594 procédures. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.173] [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: 10/18/2022]
|
22
|
Saint F, Rose-Robert F, Herpe Y, de Sousa P, Sevestre H, Choukhroun G, Amant C. ARCHITECT® urine-Neutrophil Gelatinase-Associated Lipocalin (uNGAL) essay: New prognostic marker for clear cell Renal Cell Carcinoma (ccRCC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx508.019] [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: 11/12/2022] Open
|
23
|
Duboureau H, Achkar K, Stephan R, Schmit JL, Saint F. [Ecology and fluoroquinolon resistance profiles in febrile urinary tract infections (FUTI) after prostate needle biopsy: A retrospective study in 466 biopsies]. Prog Urol 2017; 27:345-350. [PMID: 28478906 DOI: 10.1016/j.purol.2017.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 03/12/2017] [Accepted: 03/31/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The biopsies of prostate are the reference examination to assert the diagnosis of prostate cancer. Even if the urinary infectious complications are rare thanks to the systematic oral antibiotic prophylaxis, they may still be serious. The SPILF (Society of Infectious Pathology and French language) published in 2014, an important increase of the resistances in fluoroquinolones for Escherichia coli (3 to 25%), whereas this is the most bacterium frequently found in the urinary infections (70-80%). The objectives of this study were to estimate the indicence of the febrile urinary tract infections after prostate needle biopsy and to define the ecology and the profile of E. coli's resistance. METHODS A total of 466 transrectal ultrasound-guided needle prostate biopsy were included in the study from 2012 to 2015. All the patients were taken care according to the recommendations of the AFU (Ouzzane et al., 2011). We estimated, for all the inclusive patients, if they had presented a clinic sign of urinary infection like fever or burning which suggestive of an urinary infection, and having a urines and blood culture, in the next 30 days the realization of the medical exam. RESULTS Among 466 realized biopsies, seven patients developed a febril urinary tract infection (1.5%) [prostatitis (n=6), orchitis (n=1)]. Five infections to E. coli were identified; two were resistant for fluoroquinolones (40%). No germ was able to be identified for two patients. CONCLUSION The infectious complications post-biopsy of prostate are rare (1.5%). E. coli is the germ most frequently identified with 40% of resistance with fluoroquinolones. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- H Duboureau
- Service d'urologie, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France; Service de pathologie infectieuse, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - K Achkar
- Service d'urologie, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - R Stephan
- Laboratoire de biologie, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - J L Schmit
- Centre hospitalier de Creil, 61000 Creil, France; Service de pathologie infectieuse, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - F Saint
- Service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue René-Laënnec, 80480 Salouël-Amiens, France; Laboratoire HeRVI (EA3801), université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France; Biobanque de Picardie, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France.
| |
Collapse
|
24
|
Saint F, Prader R, Cordonnier C, Choukroun G, Elesper N, Desailloud R. [Long-term blood pressure outcome after unilateral adrenalectomy for primary hyperaldosteronism]. Prog Urol 2017; 27:389-394. [PMID: 28259701 DOI: 10.1016/j.purol.2017.01.006] [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: 02/15/2016] [Revised: 09/26/2016] [Accepted: 01/31/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate long-term results of adrenalectomy for primary aldosteronism (PA) and to identify prognostic factors associated. METHODS Exhaustive retrospective review of all consecutive patients undergoing adrenalectomy for PA between 2002 and 2013 in our department. All patients underwent preoperative: clinical evaluation (age, sex, height, weight, systolic and diastolic BP under treatment, identification of anti-hypertension treatment), biological evaluation (potassium, renin, aldosterone) and radiological evaluation (CT and/or MRI). Blood pressure was assessed postoperatively at 1 month, 1 year, then at the date of the latest news. The patients were classified into three categories: cured (no antihypertensive therapy in postoperative associated with strictly lower blood pressures of 140/90mmHg), improved (decreased number of drugs or number unchanged but with better blood pressure control), and refractory (no change in the number of drug and blood pressure, or deterioration of one or other of these two parameters). RESULTS We evaluated 43 patients, 23 men and 20 women, with a median follow-up of 74.4 months [16.8 to 141]. Pathological analysis described 34 adenomas (79%), 7 hyperplasias (16%) (5 micro-nodular and 2 macro-nodular) and 2 adrenocortical carcinoma (5%). The postoperative long-term assessment found 20% of cured patients (n=8), 65% of improved (n=26) and 15% of refractory (n=6). Prognostic factors associated with favorable long-term blood pressure outcome were those typically associated with ARS score [preoperative number of anti-hypertension drugs (P=0.005), BMI<25kg/m2 (P=0.009), and duration of hypertension (P=0.007)]. CONCLUSION Adrenalectomy for PA is a long-term effective treatment for blood pressure control. Prognostic factors associated with long-term success are those conventionally described in ARS score. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- F Saint
- Service d'urologie - transplantation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France; Laboratoire de recherche HeRVI EA3801, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France; Centre de ressources biologiques, biobanque de Picardie, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France.
| | - R Prader
- Service d'urologie - transplantation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - C Cordonnier
- Service d'anatomie et cytologie pathologiques, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - G Choukroun
- Service de néphrologie, médecine interne, dialyse, transplantation et réanimation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - N Elesper
- Service de néphrologie, médecine interne, dialyse, transplantation et réanimation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - R Desailloud
- Service d'endocrinologie, maladies métaboliques, diabétologie et nutrition, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| |
Collapse
|
25
|
Becquart N, Lecuelle D, Lipsker A, Cordonnier C, Belkahia R, Saint F. Facteurs pronostiques d’instabilité hémodynamique peropératoire des phéochromocytomes. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.101] [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: 10/20/2022]
|
26
|
Eric A, Audenet F, Beaugerie A, Le guilchet T, Saint F, Timsit M, Mejean A. Résultats oncologiques de la néphrectomie partielle dans le traitement des tumeurs rénales de stade pT3a. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.095] [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: 10/20/2022]
|
27
|
Dominique I, Ruffion A, Matillon X, Freton L, Betari R, Dariane C, Millet C, Ruggiero M, Chebbi A, Olivier J, Langouet Q, Bergerat S, Panayotopoulos P, Caes T, Patard P, Szabla N, Brichart N, Sabourin L, Guleryuz K, Lebacle C, Rizk J, Madec F, Nouhaud F, Pradere B, Saint F, Fiard G, Peyronnet B. Complications rénales à long terme des traumatismes rénaux : résultats de l’étude multicentrique nationale Traumafuf. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.260] [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]
|
28
|
Affiliation(s)
- A Lipsker
- Service d'urologie-transplantation, CHU d'Amiens-Picardie, avenue Laënnec, Salouël, 80 480 Amiens, France
| | - E Demailly
- Service d'urologie-transplantation, CHU d'Amiens-Picardie, avenue Laënnec, Salouël, 80 480 Amiens, France
| | - T Forzini
- Service d'urologie-transplantation, CHU d'Amiens-Picardie, avenue Laënnec, Salouël, 80 480 Amiens, France
| | - E Alezra
- Service d'urologie-transplantation, CHU d'Amiens-Picardie, avenue Laënnec, Salouël, 80 480 Amiens, France
| | - F Saint
- Service d'urologie-transplantation, CHU d'Amiens-Picardie, avenue Laënnec, Salouël, 80 480 Amiens, France
| |
Collapse
|
29
|
Lecuelle D, Saint F, Schmit J, Forzini T. Écologie et profils de résistance des infections bactériennes sur sondes urinaires chez le patient hospitalisé. Prog Urol 2015; 25:776. [DOI: 10.1016/j.purol.2015.08.123] [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: 10/22/2022]
|
30
|
Betari R, Meynier J, Viart L, Forzini T, Hakami F, Saint F. Évaluation rétrospective à moyen terme du succès thérapeutique de la bandelette sous-urétrale Monarc®. Prog Urol 2015; 25:841. [DOI: 10.1016/j.purol.2015.08.250] [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]
|
31
|
Alezra E, Lasselin J, Forzini T, François T, Viart L, Saint F. [Prognostic factors for severe infection after flexible ureteroscopy: Clinical interest of urine culture the day before surgery?]. Prog Urol 2015; 26:65-71. [PMID: 26482456 DOI: 10.1016/j.purol.2015.09.008] [Citation(s) in RCA: 12] [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: 02/18/2015] [Revised: 08/22/2015] [Accepted: 09/04/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The objectives of this study have been to determine prognostic factors for acute pyelonephritis (AP) after flexible ureteroscopy (FU), to assess the frequency of readmission for AP and to study the usefulness of urinalysis the day before surgery. METHODS Between 2010 and 2013, 266 patients have had at least one ureteroscopy (n=325). All infectious complications and unplanned readmissions within the month after FU were retrospectively evaluated. Several data have been collected: age, sex, BMI, surgical indication (calculis or tumor), number of previous ureteroscopies, number of previous surgeries for calculis, stones number, size and location, bilateral interventions, operating time, preoperative ureteral stenting, postoperative stenting, hospitalization stay, urine culture the day before surgery (j-1) and prescription of antibiotic therapy the week before FU. Correlation between these variables and acute pyelonephritis (AP) the month following the USSR was tested (StatView 4.5, SAS Institute) (P<0.05 significant). RESULTS We observed 24 postoperative APs (7.4%), 17 prior to hospital discharge and 7 requiring rehospitalization. In univariate analysis, the significant prognostic factors of postoperative AP have been: stone size (>14 mm) (P=0.03); operating time (70 minutes) (P<0.005); positive day - 1 urine culture (P<0.001); antibiotics treatment the week before FU (P<0.001). In multivariate analysis, antibiotics prescription during the week before USSR remained significant (P<0.002; RR 5.8 [1.9-15]). CONCLUSION Acute pyelonephritis requiring unplanned admission after ureteroscopy is a rare complication (2.4%). Urinalysis one day before ureteroscopy could allow early antibiotic therapy and may reduce 63% of unplanned hospital admissions for acute pyelonephritis. LEVEL OF EVIDENCE 5.
Collapse
Affiliation(s)
- E Alezra
- HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France.
| | - J Lasselin
- HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France
| | - T Forzini
- HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA 3801, laboratoire de recherche, université de Picardie Jules-Verne, CHU d'Amiens, 80054 Amiens, France
| | - T François
- HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France
| | - L Viart
- HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France; Laboratoire d'anatomie et d'organogénèse, université de Picardie Jules-Verne, CHU d'Amiens, 80054 Amiens, France
| | - F Saint
- HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA 3801, laboratoire de recherche, université de Picardie Jules-Verne, CHU d'Amiens, 80054 Amiens, France; Biobanque de Picardie, université de Picardie Jules-Verne, CHU d'Amiens, 80054 Amiens, France
| |
Collapse
|
32
|
Viart L, Peltier J, Forzini T, Page C, Foulon P, Saint F, Havet E. [Persistent Müllerian ducts syndrome: one case of late hypofertility]. Morphologie 2015; 99:23-28. [PMID: 25708641 DOI: 10.1016/j.morpho.2015.01.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 12/16/2014] [Accepted: 01/02/2015] [Indexed: 06/04/2023]
Abstract
We report the case of a 35-year-old patient with a syndrome of persistent Müllerian ducts (PMDS) of the female type (group A). The diagnosis was made in adulthood during an infertility workup. Clinical examination revealed an empty scrotum, a normal penis and bilateral inguinal cystic masses. The spermogram found azoospermia. Imaging using MRI and tomotensidometry found the presence of an uterus, two fallopian tubes and two inguinal positions of polycystic testes. A surgical management was performed for surgical testicular biopsy. Histological examination then found a cystic formation of multi-celled mesothelial origin, with atrophic testis Sertoli cell involution and without sperm. PMDS is a rare form of pseudo-internal hermaphroditism characterized by the presence in a man of the uterus, fallopian tubes and upper vagina with external male genitalia and virilized characters. About 200 cases are reported in the literature. The diagnosis is often made in children intraoperatively during a cure of testicular ectopia. The karyotype is 46 XY type. The pathogenesis is related to a deficiency of anti-Müllerian hormone (AMH) or tissue resistance to its action by receptor abnormalities. The regression of the Müllerian duct derivatives can give three types of PMDS : masculine type, feminine type and a transverse type. Surgical treatment is difficult but necessary because of the risk of infertility and ectopic testicular degeneration.
Collapse
Affiliation(s)
- L Viart
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France; Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France.
| | - J Peltier
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - T Forzini
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France
| | - C Page
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - P Foulon
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - F Saint
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France
| | - E Havet
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| |
Collapse
|
33
|
Lasselin J, Viart L, Lasselin-Boyard P, Raynal G, Saint F. [Flexible ureteroscope damages. Evaluation of university hospital service equipment]. Prog Urol 2015; 25:265-73. [PMID: 25687651 DOI: 10.1016/j.purol.2015.01.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 09/30/2014] [Revised: 01/02/2015] [Accepted: 01/13/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate predictors of flexible ureterorenoscopes breakage and damage of their optical beam. MATERIALS AND METHODS Retrospective survey, single center on 393 interventions with 4 flexible ureterorenoscopes between January 2009 and March 2013. We analyzed factors linked to patient, pathology and surgical technique. RESULTS We identified 21 major accidents, a breakage rate of 5.34% and 76 pixels losses in the maintenance of endoscopes and 10 during the procedure. The only statistically significant predictor of loss was the cumulative duration of operating time since the last repair (P=0.04, OR=1.001 [1-1001]). For lesions of the optical beam between the procedures, parameters appearing as significant were the ureterorenoscope model (P=0.01, OR=2.558, 95% CI [1229-5326]), the use of instruments by the working channel: the laser (P=0.02, OR=2.06, 95% CI [1109-3827]), or the use of endoluminal graspers (P=0.007, OR=0.467, 95% CI [0269-0809]). Intraoperatively, the number of open or laparoscopic surgery (P=0.007, OR=3.105, 95% CI [1364-7068]), duration of intervention (P=0.01, OR=1.023, 95% CI [1.006-1041]) and the cumulative duration of intervention (P=0.003, OR=1.001, 95% CI [1-1002]) appeared to be statistically significant. CONCLUSION The only predictor of loss of equipment under repair was the cumulative duration of operation time. It has not been demonstrated any difference between ureterorenoscopes. It was during the endoscopes disinfection that the majority of optical beam lesions take place.
Collapse
Affiliation(s)
- J Lasselin
- Service d'urologie transplantation, CHU d'Amiens, avenue Laennec, 80480 Salouel, France.
| | - L Viart
- Service d'urologie transplantation, CHU d'Amiens, avenue Laennec, 80480 Salouel, France
| | - P Lasselin-Boyard
- Service de rhumatologie, CHU d'Amiens, place Victor-Pauchet, 80000 Amiens, France
| | - G Raynal
- Service d'urologie transplantation, CHU d'Amiens, avenue Laennec, 80480 Salouel, France
| | - F Saint
- Service d'urologie transplantation, CHU d'Amiens, avenue Laennec, 80480 Salouel, France
| |
Collapse
|
34
|
Forzini T, Viart L, Alezra E, Saint F. [Erosive complications of mid urethral slings (MUS): 10 years of surgical experience]. Prog Urol 2015; 25:240-8. [PMID: 25617074 DOI: 10.1016/j.purol.2014.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 04/25/2014] [Revised: 12/07/2014] [Accepted: 12/18/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Evaluation of the diagnostic and therapeutic management of erosive complications after mid urethral sling (MUS) procedure: vaginal erosions (VE), bladder (BE) and urethral (UE). METHODS Retrospective monocentric study concerning cohort of patients undergoing surgery from January 2002 to January 2013 supported for erosive complications of MSU: TVT (Tension-free Vaginal Tape) or TOT (Trans-Obturateur Tape). RESULTS Sixteen patients were diagnosed for erosive complications: 7 VE, 6 BE and 3 UE. Dyspareunia and vaginal discharge were observed in 86% patients (n=6/7) with VE. Conservative treatment by vaginal approach was systematically performed in cases of vaginal erosion. After removal of material, 100% dyspareunia were corrected. Postoperative continence was maintained in 57% of patients (n=4/7). Urinary infection was the main symptom of patients with BE. Severe dysuria was present in 66% of patients with a UE (n=2/3). First-line therapy by endoscopic treatment was performed in 77% of patients (n=7/9) with a BE or UE. A second surgery was required in 42% of patients treated with endoscopic first-line therapy (n=3/7) because of a new exposure of MUS. Three of nine patients recurred their incontinence after first-line therapy (33%). CONCLUSION The removal of device exposed vaginally in case VE systematically corrected symptoms with about 60% of continence. In case of BE or UE, endoscopic treatment in first-line therapy was rarely definitive (42%) and recurrence of incontinence appeared in 30% cases.
Collapse
Affiliation(s)
- T Forzini
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France; Laboratoire de recherche HeRVI (EA 3801), CURS-CHU Amiens-Picardie, 150, avenue de la Croix-Jourdain, 80480 Salouël, France.
| | - L Viart
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France; Laboratoire d'anatomie et d'organogénèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - E Alezra
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France
| | - F Saint
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France; Laboratoire de recherche HeRVI (EA 3801), CURS-CHU Amiens-Picardie, 150, avenue de la Croix-Jourdain, 80480 Salouël, France
| |
Collapse
|
35
|
Viart L, Forzini T, Saint F. Évaluation prospective du risque infectieux de la neuromodulation sacrée S3 (NMS3) : l’anti-bioprophylaxie pour quels patients ? Prog Urol 2014; 24:839. [DOI: 10.1016/j.purol.2014.08.124] [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]
|
36
|
Forzini T, Viart L, Alezra É, Saint F. Évolution de la prise en charge thérapeutique des varicocèles : analyse des données nationales de codage de 2006 à 2013. Prog Urol 2014; 24:861. [DOI: 10.1016/j.purol.2014.08.171] [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]
|
37
|
Alezra E, Lasselin J, Viart L, Forzini T, François T, Raynal G, Saint F. Facteurs favorisants les ré-hospitalisations précoces pour infection sévère après urétéroscopie souple : Intérêt de l’ECBU systématique la veille de l’intervention. Prog Urol 2014; 24:839-40. [DOI: 10.1016/j.purol.2014.08.125] [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: 11/24/2022]
|
38
|
Malaterre J, Viart L, Forzini T, Saint F. Évolution de l’activité chirurgicale liée à l’incontinence urinaire d’effort au regard du vieillissement de la population féminine Française. Prog Urol 2014; 24:798-9. [DOI: 10.1016/j.purol.2014.08.038] [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]
|
39
|
Francois T, Alezra E, Viart L, Forzini T, Saint F. Facteurs pronostiques de recoupes urétérales positives lors de la cystectomie pour tumeur vésicale. Prog Urol 2014; 24:805-6. [DOI: 10.1016/j.purol.2014.08.052] [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]
|
40
|
Lasselin J, Viart L, Saint F, Raynal G. Sinistralite des ureterorenoscopes souples. Évaluation du parc materiel d’un service universitaire. Prog Urol 2014; 24:795. [DOI: 10.1016/j.purol.2014.08.030] [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: 11/26/2022]
|
41
|
Ferre A, Amant C, Ourouda R, Viart L, Gallet M, Sonnet P, Saint F. Étude de l’activité anti-angiogénique des ségétalines (Sp1 et SA) sur les lignées tumorales A-498 et 786-O de cancer du rein. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.008] [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: 11/27/2022]
|
42
|
François T, Alezra E, Kikassa J, Saint F, Raynal G. Opinion des médecins généralistes de l’Oise concernant le cancer de la prostate et son dépistage par le PSA. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.050] [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: 11/26/2022]
|
43
|
Surga N, Viart L, Soria J, Ferre A, Colombel M, Saint F. Évaluation de la morbidité et du statut ganglionnaire par le curage élargi lors de la prostatectomie totale pour cancer de prostate à haut risque de d’Amico. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.189] [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]
|
44
|
Francois T, Alezra E, Kikassa JC, Saint F, Raynal G. [Screening of prostate cancer seen by general practitioners]. Prog Urol 2013; 23:1407-11. [PMID: 24274945 DOI: 10.1016/j.purol.2013.04.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 04/22/2013] [Accepted: 04/25/2013] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The screening of prostate cancer was recently the subject of international studies and debates in France. We decided to study the vision of the screening, in particular by the PSA, which have the general practitioners. METHODS We sent a questionnaire to 456 general practitioners of Oise (French department) to be returned in an anonymous way on the prostate cancer, PSA, the economic impact of the PSA and we asked whether the doctors realized the screening or not, if they were favorable to it and for which reasons. RESULTS We received 38% of answers. Eighty-one percent of the general practitioners considered that prostate cancer is frequent, 72% that it evolved slowly and 55% that it affected old men. For 79% of the general practitioners, the patients were asking for a screening by PSA. Eighty-eight percent thought that they had to be in front line of the screening, 58% that the functional consequences of the screening were satisfactory. Fifty-seven percent of the general practitioners realized the screening in a systematic way and 88% were favorable to it. CONCLUSION The general practitioners of Oise remained favorable for the greater part to the screening of prostate cancer and the patients applicants in spite of various debates.
Collapse
Affiliation(s)
- T Francois
- Chirurgie générale, UPJV, chemin du Thil, 80000 Amiens, France.
| | | | | | | | | |
Collapse
|
45
|
Alezra E, Fretin J, Saint F, Raynal G. Complication vasculaire d’une pyélonéphrite aiguë. Prog Urol 2013; 23:364-7. [DOI: 10.1016/j.purol.2012.11.001] [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: 10/29/2012] [Revised: 11/01/2012] [Accepted: 11/06/2012] [Indexed: 10/27/2022]
|
46
|
Galliot I, Le Gall S, Rigaud J, Saint F, Colombel M, Guy L, Wallerand H, Fantoni JC, Staerman F, Irani J, Soulie M, Pfister C. Traitement d’entretien par BCG-thérapie des tumeurs de vessie n’infiltrant pas le muscle (TVNIM) : résultats à un an de l’étude multicentrique URO-BCG-4. Prog Urol 2013; 23:336-46. [DOI: 10.1016/j.purol.2012.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 12/11/2012] [Accepted: 12/23/2012] [Indexed: 11/24/2022]
|
47
|
Viart L, Elalouf V, Petit J, Al Khedr A, Kristkowiak P, Saint F. Facteurs pronostiques d’urétéro-hydronéphrose (UHN) chez les patients atteints de sclérose en plaques (SEP). Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.271] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
48
|
Bozzini G, Nison L, Colin P, Ouzzane A, Yates DR, Audenet F, Pignot G, Arvin-Berod A, Merigot O, Guy L, Irani J, Saint F, Gardic S, Gres P, Rozet F, Neuzillet Y, Ruffion A, Roupret M. Influence of preoperative hydronephrosis on the outcome of urothelial carcinoma of the upper urinary tract after nephroureterectomy: the results from a multi-institutional French cohort. World J Urol 2012; 31:83-91. [DOI: 10.1007/s00345-012-0964-4] [Citation(s) in RCA: 19] [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: 08/14/2012] [Accepted: 09/24/2012] [Indexed: 11/28/2022] Open
|
49
|
Alezra É, François T, Kikassa JC, Saint F, Raynal G. Évolution de la prise en charge chirurgicale des pathologies prostatiques : analyse nationale du codage. Prog Urol 2012; 22:711-7. [DOI: 10.1016/j.purol.2012.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 07/12/2012] [Accepted: 07/15/2012] [Indexed: 11/16/2022]
|
50
|
Surga N, Spinoit AF, Viart L, Tillou X, Saint F, Petit J. [Radical retropubic prostatectomy (RRP) without postoperative bladder catheter: study about 14 cases]. Prog Urol 2011; 21:470-2. [PMID: 21693358 DOI: 10.1016/j.purol.2010.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 06/17/2010] [Accepted: 10/03/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To report the feasibility of radical retropubic prostatectomy (RRP) without postoperative bladder catheter. MATERIAL & METHODS We report our experience in 14 patients (mean age 62 [48-75]) who underwent radical retropubic prostatectomy for localised prostatic adenocarcinoma from May 2006 to January 2010. The surgical technique was performed as classically described, without bladder neck preservation (tennis-racket closure), with or without nerve sparing (JP). The criteria that led us not to drain were the satisfactory urethral length, a tension-free anastomosis performed on a bladder catheter with separate sutures, and a lack of anastomotic leack after bladder filling with 200cc. RESULTS The mean hospital stay was 4 days (3-8). Ten patients (71.4%) needed intermittent bladder catherism four times (1-11) before starting micturitions, without any technical difficulties. No anastomic leack was reported. Nine patients (64.3%) were continent leaving the hospital. With a mean follow-up of 30 months (5-48), all of 14 patients (100%) were perfectly continent. No anastomotic stricture was reported. CONCLUSION RRP without postoperative bladder catheter was feasible, with no other early or late complication associated. Early and late continence were perfect (100% at 2 years).
Collapse
Affiliation(s)
- N Surga
- Service d'urologie-transplantation, CHU Hôpital-Sud, université Picardie-Jules-Verne, avenue R.-Laënnec, Salouël, 80054 Amiens cedex 1, France.
| | | | | | | | | | | |
Collapse
|