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Prognostic significance of PI-RADS 5 lesions in patients treated by radical prostatectomy. World J Urol 2023; 41:1285-1291. [PMID: 36971827 DOI: 10.1007/s00345-023-04371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/04/2023] [Indexed: 03/29/2023] Open
Abstract
PURPOSE To analyse the pathological features and survival of patients with a PI-RADS 5 lesion on pre-biopsy MRI. METHODS We extracted from a European multicentre prospectively gathered database the data of patients with a PI-RADS 5 lesion on pre-biopsy MRI, diagnosed using both systematic and targeted biopsies and subsequently treated by radical prostatectomy. The Kaplan-Meier model was used to assess the biochemical-free survival of the whole cohort and univariable and multivariable Cox models were set up to study factors associated with survival. RESULTS Between 2013 and 2019, 539 consecutive patients with a PI-RADS 5 lesion on pre-biopsy MRI were treated by radical prostatectomy and included in the analysis. Follow-up data were available for 448 patients. Radical prostatectomy and lymph node dissection specimens showed non-organ confined disease in 297/539 (55%), (including 2 patients with a locally staged pT2 lesion and lymph node involvement (LNI)). With a median follow-up of 25 months (12-39), the median biochemical recurrence-free survival was 54% at 2 years (95% CI 45-61) and 28% at 5 years (95% CI 18-39). Among the factors studied, MRI T stage [T3a vs T2 HR 3.57 (95%CI 1.78-7.16); T3b vs T2 HR 6.17 (95% CI 2.99-12.72)] and PSA density (HR 4.47 95% CI 1.55-12.89) were significantly associated with a higher risk of biochemical recurrence in multivariable analysis. CONCLUSION Patients with a PI-RADS 5 lesion on pre-biopsy MRI have a high risk of early biochemical recurrence after radical prostatectomy. MRI T stage and PSA density can be used to improve patient selection and counselling.
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Miniaturized percutaneous nephrolithotomy versus retrograde intrarenal surgery in the treatment of lower pole renal stones. Prog Urol 2021; 32:77-84. [PMID: 34332831 DOI: 10.1016/j.purol.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/30/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Miniaturization of percutaneous nephrolithotomy techniques have led to their increased consideration for lower pole renal stones that can prove more challenging to reach using retrograde intrarenal surgery. The objectives of the present study were to evaluate and compare the outcomes of miniaturized percutaneous nephrolithotomy (miniPCNL) and retrograde intrarenal surgery (RIRS) for the treatment of lower pole renal stones. MATERIALS AND METHODS A retrospective study was performed in two academic urology departments between January 2016 and June 2019. Patients presenting with one or multiple stones of the lower calyx and/or renal pelvis, between 10 and 40mm based on CT-scan treated by miniPCNL or RIRS were included. RESULTS In all, 115 miniPCNL and 118 RIRS procedures were included. The rate of patients with no significant residual fragment (stone free rate) after the first procedure was higher in the miniPCNL group (69% vs. 52% P=0.01), especially for stones>20mm (63% vs. 24% respectively, P<0.001) and stones with a density≥1000HU (69% vs. 42% respectively, P=0.009). The higher stone free rate of miniPCNL was confirmed in multivariate analysis, adjusting for stone size and number of stones, OR 4.02 (95% CI 2.08-8.11, P<0.0001). The overall postoperative complication rate was higher in the miniPCNL group than in the RIRS group (23% vs. 11%, P=0.01). A second intervention for the treatment of residual fragments was necessary for 9.6% of patients in the miniPCNL group versus 30.5% of patients in the RIRS group (P<0.001). Pre-stenting rate and duration of ureteral drainage (2 [1-8] vs. 25 days [7-37], P<0.001) were lower in the miniPCNL group. CONCLUSIONS The stone free rate was higher after miniPCNL, especially for stones>20mm and with a density>1000 HU, but was associated with a higher risk of postoperative complications and a longer hospital stay. RIRS resulted in fewer complications at the cost of a higher retreatment rate and longer ureteral stenting. LEVEL OF EVIDENCE 3.
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Elastic fusion biopsy versus systematic biopsy for prostate cancer detection: Results of a multicentric study on 1,119 patients. Actas Urol Esp 2019; 43:431-438. [PMID: 31155373 DOI: 10.1016/j.acuro.2019.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the accuracy of targeted and systematic biopsies for the detection of prostate cancer (PCa) and clinically significant PCa (csPCa) in the everyday practice, evaluating the need for additional systematic biopsies at the time of targeted biopsy. PATIENTS AND METHODS From our multicentric database gathering data on 2,115 patients who underwent fusion biopsy with Koelis™ system between 2010 and 2017, we selected 1,119 patients who received targeted biopsies (a median of 3 for each target), followed by systematic sampling of the prostate (12 to 14 cores). Overall and clinically significant cancer detection rate (CDR) of Koelis™ fusion biopsies were assessed, comparing target and systematic biopsies. Secondary endpoint was the identification of predictors of PCa detection. RESULTS The CDR of targeted biopsies only was 48% for all cancers and 33% for csPCa. The performance of additional, systematic prostate sampling improved the CDR of 15% for all cancers and of 12% for csPCa. PCa was detected in 35%, 69%, and 92% of patients with lesions scored as PI-RADS 3, 4 and 5, respectively. Elevated PI-RADS score and positive digital rectal examination were predictors of PCa, whereas biopsy-naïve status was associated with csPCa. CONCLUSION In the everyday practice target biopsy with Koelis™ achieves a good CDR for all PCa and csPCa, which is significantly improved by subsequent systematic sampling of the prostate. The outstanding outcomes of fusion biopsy are confirmed also in biopsy-naïve patients. Elevated PI-RADS score and positive digital rectal examination are strongly associated with presence of PCa.
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[The use of haemostatic agent: impact on perioperative outcomes of partial nephrectomy]. Prog Urol 2013; 23:317-22. [PMID: 23545006 DOI: 10.1016/j.purol.2012.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 06/29/2012] [Accepted: 10/22/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate impact of the use of haemostatic agent in partial nephrectomy on perioperative outcomes. MATERIAL AND METHODS We reviewed the files of patients candidates for partial nephrectomy in our center between 2005 and 2010. The use of haemostatic agent and surgical procedure data were noted. Perioperative outcomes in haemostatic agent group were compared with perioperative outcomes in conventional surgical haemostasis group. RESULTS Among the 131 patients included, haemostatic agent was used in 91 cases (69.5%). There was no statistically difference between the two groups on age, sex, BMI, ASA score, tumor size and RENAL score. The use of haemostatic agent was more frequent for patients operated with laparoscopy (10.7%, P=0.04). Concerning perioperative outcomes, there was no difference between the two groups on surgical complications, transfusions, conversion to radical nephrectomy and hospital stay. Median warm ischaemia time was comparable into the two groups. In multivariate analysis, haemorrhage, complications and transfusions were not predicted by the use of haemostatic agent. CONCLUSION Use of haemostatic agent in partial nephrectomy had no benefice on perioperative outcomes in our series. Rapport between utility and cost for these agents must be discussed in partial nephrectomy.
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Bilateral renal masses: pathologic concordance and impact of temporal presentation. MINERVA UROL NEFROL 2012; 64:287-293. [PMID: 23288216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The aim of this paper was to evaluate the pathologic concordance of bilateral renal masses and the influence of synchronous or asynchronous occurrence on patient long term survival. METHODS Thirty-one consecutive patients with bilateral synchronous (N.=17, 55.0%) or asynchronous (N.=14, 45.0%) renal masses were retrospectively reviewed from January 2000 to December 2010. We included all patients with confirmed diagnosis on pathologic examination of a specimen or a percutaneous biopsy and evidence of angiomyolipoma on CT. Survival was assessed using the Kaplan-Meier method. RESULTS. The first lesion was larger than the second (60 vs. 30 mm, P<0.001). Pathologic concordance rate between tumors was 87.1%. A clear cell carcinoma was associated with a papillary carcinoma in 3.2%, and an angiomyolipoma in 6.4%. Median time of occurrence of a metachronous lesion was 50 months (IQR: 24; 92). Disease-free survival at 5 and 10 years was 87.2% and 78.5%. No statistical difference in disease free survival was observed between synchronous and metachronous tumors. conclusion: Discordant pathology between bilateral renal masses is uncommon, with a slight probability of benign tumor. Occurrence of a metachronous tumor can exceed 10 years.
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MESH Headings
- Adenoma, Oxyphilic/diagnostic imaging
- Adenoma, Oxyphilic/mortality
- Adenoma, Oxyphilic/pathology
- Adenoma, Oxyphilic/surgery
- Aged
- Angiomyolipoma/diagnostic imaging
- Angiomyolipoma/mortality
- Angiomyolipoma/pathology
- Angiomyolipoma/surgery
- Biopsy
- Carcinoma, Papillary/diagnostic imaging
- Carcinoma, Papillary/mortality
- Carcinoma, Papillary/pathology
- Carcinoma, Papillary/surgery
- Carcinoma, Renal Cell/diagnostic imaging
- Carcinoma, Renal Cell/mortality
- Carcinoma, Renal Cell/pathology
- Carcinoma, Renal Cell/surgery
- Disease-Free Survival
- Female
- Humans
- Kaplan-Meier Estimate
- Kidney Neoplasms/diagnosis
- Kidney Neoplasms/mortality
- Kidney Neoplasms/pathology
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Neoplasm Staging
- Neoplasms, Multiple Primary/diagnostic imaging
- Neoplasms, Multiple Primary/mortality
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Second Primary/diagnostic imaging
- Neoplasms, Second Primary/mortality
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/surgery
- Nephrectomy/methods
- Retrospective Studies
- Time Factors
- Tomography, X-Ray Computed
- Tumor Burden
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6
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Abstract
BACKGROUND Prostate brachytherapy consists in placing radioactive seeds for tumour destruction under transrectal ultrasound imaging (TRUS) control. It requires prostate delineation from the images for dose planning. Because ultrasound imaging is patient- and operator-dependent, we have proposed to fuse MRI data to TRUS data to make image processing more reliable. The technical accuracy of this approach has already been evaluated. METHODS We present work in progress concerning the evaluation of the approach from the dosimetry viewpoint. The objective is to determine what impact this system may have on the treatment of the patient. Dose planning is performed from initial TRUS prostate contours and evaluated on contours modified by data fusion. RESULTS For the eight patients included, we demonstrate that TRUS prostate volume is most often underestimated and that dose is overestimated in a correlated way. However, dose constraints are still verified for those eight patients. CONCLUSIONS This confirms our initial hypothesis.
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7
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[Urology imaging: imaging of germ cell tumors of the testis]. Prog Urol 2003; 13:969-84. [PMID: 14763392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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8
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[Urology imaging: MRI of the urinary tract]. Prog Urol 2003; 13:795-805. [PMID: 14763382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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9
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[Urology imaging: positron emission imaging]. Prog Urol 2003; 13:807-12. [PMID: 14763383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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10
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[Urology imaging: imaging of adrenal incidentaloma]. Prog Urol 2003; 13:921-30. [PMID: 14763389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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11
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[Urology imaging: imaging of vascular ports for hemodialysis]. Prog Urol 2003; 13:1065-77. [PMID: 14763397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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12
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[Urology imaging: contribution of imaging in benign prostatic hypertrophy]. Prog Urol 2003; 13:1049-61. [PMID: 14763396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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13
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[Urology imaging: intravenous urography]. Prog Urol 2003; 13:763-6. [PMID: 14763376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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14
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[Urology imaging: lymphography-cavography]. Prog Urol 2003; 13:769-70. [PMID: 14763378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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15
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[Urology imaging: imaging and urinary calculi]. Prog Urol 2003; 13:993-1021. [PMID: 14763394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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16
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[Urology imaging: contribution of imaging in kidney transplantation]. Prog Urol 2003; 13:1093-114. [PMID: 14763399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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17
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[Urology imaging: imaging of female pelvic prolapse]. Prog Urol 2003; 13:1117-26. [PMID: 14763400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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18
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[Urology imaging: ultrasonography]. Prog Urol 2003; 13:773-81. [PMID: 14763380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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19
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[Urology imaging: contribution of imaging in upper urinary tract tumors]. Prog Urol 2003; 13:931-45. [PMID: 14763390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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20
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[Urology imaging: contribution of imaging in penile tumors]. Prog Urol 2003; 13:985-90. [PMID: 14763393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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21
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[Urology imaging: contribution of imaging in urinary tract infections]. Prog Urol 2003; 13:1025-45. [PMID: 14763395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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22
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[Urology imaging: tomodensitometry]. Prog Urol 2003; 13:783-94. [PMID: 14763381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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23
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[Urology imaging: interventional imaging in urology]. Prog Urol 2003; 13:813-25. [PMID: 14763384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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24
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[Urology imaging: contribution of imaging in bladder injuries]. Prog Urol 2003; 13:1145-8. [PMID: 14763402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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25
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[Urology imaging: testicular and penile injuries]. Prog Urol 2003; 13:1157-60. [PMID: 14763404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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26
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[Urology imaging: RPU-antegrade opacification-MRUC]. Prog Urol 2003; 13:771-2. [PMID: 14763379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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27
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[Urology imaging: radiologic evaluation of urethral injuries]. Prog Urol 2003; 13:1149-56. [PMID: 14763403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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28
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[Urology imaging: imaging and erectile dysfunction]. Prog Urol 2003; 13:1163-6. [PMID: 14763405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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29
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[Urology imaging: contribution of imaging in prostatic cancer]. Prog Urol 2003; 13:843-84. [PMID: 14763387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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30
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[Urology imaging: renal cancer]. Prog Urol 2003; 13:885-919. [PMID: 14763388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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31
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[Urology imaging: contribution of imaging in bladder tumors]. Prog Urol 2003; 13:947-68. [PMID: 14763391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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32
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[Urology imaging: pre-transplantation assessment]. Prog Urol 2003; 13:1079-92. [PMID: 14763398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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33
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[Urology imaging: imaging and Peyronie's disease]. Prog Urol 2003; 13:1167-8. [PMID: 14763406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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34
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[Urology imaging: renal arteriography]. Prog Urol 2003; 13:767-8. [PMID: 14763377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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35
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[Urology imaging: risk of exposure to X rays]. Prog Urol 2003; 13:829-36. [PMID: 14763385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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36
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[Urology imaging: iodinated contrast agents]. Prog Urol 2003; 13:837-40. [PMID: 14763386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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37
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[Urology imaging: contribution of medical imaging in renal and ureteral injuries]. Prog Urol 2003; 13:1129-43. [PMID: 14763401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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38
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[Urology imaging: integral digital environment in urology. PACS]. Prog Urol 2003; 13:1171-6. [PMID: 14763407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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39
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[Management of oncocytoma in transplanted kidney]. Prog Urol 2001; 11:91-4. [PMID: 11296656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The authors report a case of oncocytoma arising in a transplanted kidney. The diagnostic and therapeutic management is discussed and compared to the limited data reported in the literature on this subject. Immunosuppression of renal transplant recipients does not appear to increase the incidence of graft tumours, but, in the authors' opinion, modifies the conservative attitude generally proposed for this type of tumour.
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40
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[Puerperal thrombophlebitis of the ovarian vein revealed by renal colic]. Prog Urol 1999; 9:313-8. [PMID: 10370958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The authors report the clinical case of a young woman with thrombophlebitis of the right ovarian vein following delivery by caesarean section, initially presenting in the form of renal colic. In the light of a review of the literature, they recall the pathophysiological mechanisms of ovarian thrombophlebitis and the various features observed on imaging examinations. The most frequent clinical features are also described. The authors emphasize the potential, but rare severity of this disease, characterized by the risk of pulmonary embolism, and its treatment, which is usually medical.
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41
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[Current studies of combined radiotherapy-hormone therapy in localized and locally advanced prostatic cancers]. Cancer Radiother 1998; 2:783-6. [PMID: 9922789 DOI: 10.1016/s1278-3218(99)80024-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In locally advanced prostate cancer three clinical randomized trials have shown that external irradiation combined with LHRH analogue with or without antiandrogen improved survival: disease-free survival, local recurrence-free survival, metastasis-free survival (P < 0.001). EORTC trial 22863 alone has shown a significant improvement of overall survival (P = 0.001), with an LHRH analogue (goserilin acetate, zoladex) started the first day of irradiation and followed every 4 weeks for 3 years; for RTOG trial 85-31 the same LHRH analogue started during the last week of irradiation and given until relapse increases survival of patients with poor differentiated tumours with gleason score ranging from 8 to 10 (P = 0.03). In locally confined prostate carcinoma randomized trials are ongoing to assess the impact of conventional irradiation or three dimensional conformal radiotherapy with or without adjuvant hormonotherapy.
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42
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Comparison between the reactivities of fresh, preserved at 4 degrees C and cryopreserved abdominal aortae of the rabbit. Transplant Proc 1998; 30:2847-8. [PMID: 9745591 DOI: 10.1016/s0041-1345(98)00835-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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43
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Inter-regulated balance between gelatinases and tissue inhibitor (TIMP-1) in isolated human glomeruli. Ren Fail 1998; 20:201-9. [PMID: 9574444 DOI: 10.3109/08860229809045103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Leukocyte infiltration inside glomeruli necessitates basement membrane collagen i.v. breakdown and leads to mesangiolysis, cell proliferation and extracellular matrix synthesis during the repair process as observed in the course of acute glomerulonephritis, vasculitis and acute graft rejection. Two matrix metalloproteinases, MMP-2 and MMP-9 gelatinases, are expressed and co-secreted in balance with the tissue inhibitor of metalloproteinases-1 (TIMP-1) by activated neutrophils as well as by glomerular cells and are aimed to control basement membrane collage i.v. deposition. Using a conventional double mesh sieving method, pure populations of glomeruli were isolated from fresh human cortex specimen and maintained in short-term cultures. ELISA, zymography and immunoblotting of conditioned serum-free media revealed glomerular MMP-2, MMP-9 and TIMP-1 secretion and activity while reverse transcription-polymerase chain reaction amplification of cellular RNA demonstrated glomerular transcripts coding for these enzymes and their inhibitor. When purified neutrophils were allowed to adhere onto Transwell apparatus in contact with glomerular suspensions, neutrophil 92 kDa gelatinase seemed apparently inhibited mainly because the production of TIMP-1 was enhanced on both sides of the insert. Glomerular 72 kDa and 92 kDa gelatinases were activated shortly (1 to 6 h) after neutrophils had interacted with glomeruli and furthermore upon activation by inflammatory or vasoactive mediators such as phorbol. Decreased neutrophil MMP-9 activity together with reduced MMP-9 mRNA levels and protracted TIMP-1 transcription and secretion during cell-cell interaction could participate to cell detachment from degraded basement membranes and to increased collagen i.v. deposition leading to glomerulosclerosis after initial glomerular injury by inflammatory cells.
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Critical cooling and warming rates to avoid ice crystallization in small pieces of mammalian organs permeated with cryoprotective agents. Cryobiology 1996; 33:436-46. [PMID: 8764852 DOI: 10.1006/cryo.1996.0044] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Measurements were made by differential scanning calorimetry on small pieces of rabbit kidney permeated with 2, 3-butanediol containing mainly the levo- and dextro-isomers. The critical cooling rates necessary to vitrify the pieces of organ, and the corresponding critical warming rates which are required to avoid crystallization in the vitrified samples, were determined. The dynamic method used for these determinations is described. The glass-forming tendency and the stability of the amorphous state were both greater in the kidney tissue samples than in the bulk cryoprotective solution. This result is discussed in the context of the lowering of the freezing point of water in emulsions and the promotion of supercooling in hydrogels and porous materials. In corresponding experiments with rat hearts impregnated with 1,2-propanediol, only the critical warming rate was reduced.
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Cryopreservation of organs: NMR follow-up of cryoprotectant perfusion in rabbit kidneys. Transplant Proc 1996; 28:346-8. [PMID: 8644255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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46
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[Organ cryopreservation: current status of research carried out in Grenoble]. Prog Urol 1995; 5:927-31; discussion 931-2. [PMID: 8777399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
After discussing the problem of organ cryopreservation and reviewing the current data available on this subject, the Grenoble project is presented. Physical and biological studies have been combined with experimentation of autologous renal transplantation in rabbits to assess the functional value of the retransplanted organ after treatment and cooling. Renal resistances are measured during perfusion of the kidney with the cryoprotective solution. In order to verify the homogeneity of the cryoprotector concentration in the organ, on NMR spectral imaging test has been developed. A new rapid imaging method now allows real time monitoring of concentration variations during perfusion. In addition to concentration and homogeneity, analysis of local spectra also provides information about the local temperature de the kidney.
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47
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Cold and warm renal ischemia and postoperative survival in rabbits with autotransplanted kidneys. Transplant Proc 1995; 27:2874-6. [PMID: 7482951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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48
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[Kidney injuries due to skiing]. Prog Urol 1995; 5:361-9. [PMID: 7670511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
From 1974 to 1993, the authors admitted 212 patients with renal trauma to their department. A large proportion of these cases were due to skiing accidents. Based on a retrospective study of 78 patients admitted to the Grenoble urology department, the authors describe the features of this trauma. 91% of patients were males with a mean age of 27.5 years, with 9% of type III trauma. Treatment was surgical in 55% of cases. Total nephrectomy was performed in 21% of patients. Partial nephrectomy was performed in 25.5% of cases, with a morbidity of 45%, predominantly consisting of fistulas.
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49
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Placebo-Controlled Evaluation of the Efficacy and Tolerability of Permixon® in Benign Prostatic Hyperplasia after Exclusion of Placebo Responders. Clin Drug Investig 1995. [DOI: 10.2165/00044011-199509050-00007] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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50
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[Influence of kidney procurement techniques on urologic and vascular complications of the transplantation]. JOURNAL DE RADIOLOGIE 1994; 75:9-13. [PMID: 8151549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Surgical complications of renal transplantation, rejection and infectious diseases are factors contributing to poor renal graft survival. Factors directly concerning the donor can be involved in graft failure: age, medical history, causes of donor brain death. Urologic or arterial anatomic variations are often the source of difficult surgical conditions during renal transplantation. Technical errors during graft procurement must be avoided such as excess of traction or coagulation. Failure in perfusion preservation. As few renal grafts are available, it is thus essential to obtain optimal conditions to avoid failure in cadaver donor graft linked to technical errors during organ procurement.
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