36 research outputs found
Intraparenchymal Renal Artery Pseudoaneurysm and Arteriovenous Fistula on a Solitary Kidney Occurring 38 Years after Blunt Trauma
Pseudoaneurysm and arteriovenous fistulae of the renal artery are rare complications of kidney trauma. They commonly result from open traumas and occur within days after the injury. Common symptoms include acute haematuria, pain, or hypertension. We report the case of a fifty-three-year-old man presenting with symptomatic complex chronic high flow kidney arteriovenous fistula with interposition of a pseudoaneurysmal pouch and arterial aneurysmal dilatation in a solitary left kidney 38 years after a blunt trauma. Those conditions were successfully treated by endovascular embolization followed by regular radiologic, biological, and clinical follow-up. To the best of our knowledge, few similar cases were reported more than 20 years after trauma. However, no case combining an arteriovenous fistula and a pseudoaneurysm revealing as late as 38 years after trauma was found. In addition, management of those conditions on a solitary kidney and outcomes has not been described. We believe that our case depicts the clinical presentation and management of this rare entity that should not be unrecognized due to its potential lethal implications
Anastomoses ureÌteÌrales laparoscopiques entre donneur et receveur post greffe de rein pour reflux veÌsico-ureÌteÌral ou steÌnose du greffon
Les complications ureÌteÌrales des patients greffeÌs reÌnaux sont classiquement traiteÌes par une reprise chirurgicale ouverte. Ce travail a voulu eÌvaluer la faisabiliteÌ de reconstructions ureÌteÌrales du greffon par voie mini-invasive. Nous avons revu les dossiers de tous les patients ayant beÌneÌficieÌ dâune telle intervention sur 3ans, et compareÌs leurs reÌsultats aÌ ceux des patients ayant beÌneÌficieÌ dâune approche classique par chirurgie ouverte. Les patients ayant pu beÌneÌficier dâune approche mini-invasive ont eu une peÌriode post- opeÌratoire plus simple (antalgie mieux controÌleÌe, retour vers une alimentation normale plus rapide, deÌpart de lâhoÌpital plus preÌcoce). LâefficaciteÌ des deux approches eÌtait similaire aÌ moyen terme. La seÌcuriteÌ de lâapproche mini-invasive eÌtait eÌquivalente (taux de complications identiques). Ce travail confirme la faisabiliteÌ des reconstructions ureÌteÌrales mini-invasive chez les patients greffeÌs, leur efficaciteÌ et leur seÌcuriteÌ. Elles offrent les avantages dâun abord mini-invasif avec des reÌsultats similaires aÌ une approche par chirurgie ouverte. Une comparaison plus large peut eÌtre faite avec dâautres indications de chirurgie reconstructive urologique. Tout comme notre travail, lâanalyse de plusieurs proceÌdures inteÌressant lâureteÌre (pyeÌloplastie, anastomoses ureÌteÌro-ureÌteÌrales, reÌimplantation ureÌteÌrales sur vessie psoiÌque avec ou sans flap selon Boari, ureÌteÌroplasties avec greffon de muqueuse buccale) de meÌme que celle dâautres proceÌdures de reconstruction (promontofixation, plastie du col veÌsical) ou dâonco-urologie (prostatectomie, cystectomie) semble eÌgalement pleÌbisciter une approche robotique, sans pour autant beÌneÌficier dâun niveau de preuve eÌleveÌ
Urologie
Les progrĂšs urologiques de cette derniĂšre annĂ©e restent, comme lâannĂ©e prĂ©cĂ©dente, sous le sceau des rapides avancĂ©es technologiques, notamment celles du laser et de la robotique. Cette derniĂšre va contribuer Ă faire Ă©voluer la chirurgie ambulatoire, notamment pour certaines interventions et sous-populations de malades porteurs dâun cancer du rein ou de la prostate. Elle est Ă©galement en train dâexercer une nouvelle percĂ©e dans le domaine de lâincontinence fĂ©minine, en ce qui concerne la mise en place du sphincter urĂ©tral artificiel. Enfin, un nouveau laser est sur le point dâoffrir sa polyvalence en termes de chirurgie endoscopique lithiasique ainsi que celle de lâhypertrophie bĂ©nigne de la prostate. Face Ă cette pression technologique, il faut rigoureusement valider Ă court et moyen termes les vĂ©ritables avantages espĂ©rĂ©s
Intraparenchymal Renal Artery Pseudoaneurysm and Arteriovenous Fistula on a Solitary Kidney Occurring 38 Years after Blunt Trauma.
Pseudoaneurysm and arteriovenous fistulae of the renal artery are rare complications of kidney trauma. They commonly result from open traumas and occur within days after the injury. Common symptoms include acute haematuria, pain, or hypertension. We report the case of a fifty-three-year-old man presenting with symptomatic complex chronic high flow kidney arteriovenous fistula with interposition of a pseudoaneurysmal pouch and arterial aneurysmal dilatation in a solitary left kidney 38 years after a blunt trauma. Those conditions were successfully treated by endovascular embolization followed by regular radiologic, biological, and clinical follow-up. To the best of our knowledge, few similar cases were reported more than 20 years after trauma. However, no case combining an arteriovenous fistula and a pseudoaneurysm revealing as late as 38 years after trauma was found. In addition, management of those conditions on a solitary kidney and outcomes has not been described. We believe that our case depicts the clinical presentation and management of this rare entity that should not be unrecognized due to its potential lethal implications
Intraparenchymal Renal Artery Pseudoaneurysm and Arteriovenous Fistula on a Solitary Kidney Occurring 38 Years after Blunt Trauma
Pseudoaneurysm and arteriovenous fistulae of the renal artery are rare complications of kidney trauma. They commonly result from open traumas and occur within days after the injury. Common symptoms include acute haematuria, pain, or hypertension. We report the case of a fifty-three-year-old man presenting with symptomatic complex chronic high flow kidney arteriovenous fistula with interposition of a pseudoaneurysmal pouch and arterial aneurysmal dilatation in a solitary left kidney 38 years after a blunt trauma. Those conditions were successfully treated by endovascular embolization followed by regular radiologic, biological, and clinical follow-up. To the best of our knowledge, few similar cases were reported more than 20 years after trauma. However, no case combining an arteriovenous fistula and a pseudoaneurysm revealing as late as 38 years after trauma was found. In addition, management of those conditions on a solitary kidney and outcomes has not been described. We believe that our case depicts the clinical presentation and management of this rare entity that should not be unrecognized due to its potential lethal implications
Traitement mĂ©dicamenteux des troubles mictionnels de lâhomme : lâessentiel pour le mĂ©decin gĂ©nĂ©raliste
En raison de lâimportante prĂ©valence des troubles mictionnels masculins et du dĂ©veloppement dâune pharmacothĂ©rapie de mieux en mieux ciblĂ©e, le praticien interniste-gĂ©nĂ©raliste se trouve depuis plus dâune dĂ©cennie en premiĂšre ligne pour leur prise en charge mĂ©dicamenteuse. Dans la perspective dâamĂ©liorer cette gestion partagĂ©e, nous prĂ©sentons les deux principaux syndromes obstructif et irritatif, ainsi que leur traitement pharmacologique, afin de pĂ©renniser le transfert de connaissances et la coordination entre le praticien-gĂ©nĂ©raliste et lâurologue
Contraception masculineâ: quelles options actuellement disponiblesâ?
La contraception masculine ne reprĂ©sente quâune faible proportion de la contraception mondiale. Pourtant, des moyens sĂ»rs et efficaces existent et sont disponibles avec un taux dâĂ©chec faible, comme la vasectomie ou, dans une moindre mesure, le prĂ©servatif. Dâautres mĂ©thodes dites naturelles telles que lâabstinence pĂ©riodique ou le retrait sont utilisĂ©es malgrĂ© leur efficacitĂ© moindre. Enfin, certaines mĂ©thodes sont en cours dâĂ©valuation ou de dĂ©veloppement comme les contraceptions thermique, hormonale et non hormonale. Bien que certains rĂ©sultats prĂ©liminaires soient encourageants, lâefficacitĂ© de ces mĂ©thodes reste variable et parfois difficilement reproductible. Elle nĂ©cessite encore des contrĂŽles et validations concernant leur sĂ»retĂ© pour une utilisation Ă long terme.Male contraception plays a small role in global contraception. However, safe and effective means exist and are available with a low failure rate, such as vasectomy or to a lesser extent, condoms. Other so-called natural methods are used despite being less effective, such as periodic abstinence or withdrawal. Finally, new methods are currently being evaluated or developed, such as thermal contraception, hormonal and non-hormonal contraception. Although preliminary results are encouraging, the effectiveness of these methods remains variable and sometimes difficult to reproduce, and still requires controls and validation regarding their safety over long-term use
Thérapies ciblées en oncologie digestive
Targeted therapies are relatively new molecules available for the oncologist. These drugs target a specific step of the cellular development and interfere with the intracellular signalization pathways. Amongst all others, EGF- and VEGF-pathways are currently targeted by these selective therapies. Modulating EGF and VEGF significantly improves overall survival and progression-free survival for many advanced or metastatic tumors as colorectal cancer, gastric cancer, gastrointestinal stromal tumors or hepatocellular carcinoma. Targeted therapies have a specific action site, a simple administration mode and are relatively well tolerated. In the future these molecules will probably be used "Ă la carte" for tumors that appear to be refractory to other drugs
Histologic Confirmation of a Biochemical Recurrence After Radical Prostatectomy by Performing 3-Dimensional Transrectal Ultrasonography-guided Biopsy With Fusion to Magnetic Resonance Imaging
To obtain a histologic confirmation of biochemical recurrence after radical prostatectomy, which still remains a challenge. Historically, biopsy protocols have been designed but have provided rather unsatisfactory results. We report the first case of histologic confirmation of a biochemical recurrence in the prostatectomy bed by performing 3-dimensional transrectal ultrasonography-guided biopsy with fusion to magnetic resonance images
Intraparenchymal Renal Artery Pseudoaneurysm and Arteriovenous Fistula on a Solitary Kidney Occurring 38 Years after Blunt Trauma
Pseudoaneurysm and arteriovenous fistulae of the renal artery are rare complications of kidney trauma. They commonly result from open traumas and occur within days after the injury. Common symptoms include acute haematuria, pain, or hypertension. We report the case of a fifty-three-year-old man presenting with symptomatic complex chronic high flow kidney arteriovenous fistula with interposition of a pseudoaneurysmal pouch and arterial aneurysmal dilatation in a solitary left kidney 38 years after a blunt trauma. Those conditions were successfully treated by endovascular embolization followed by regular radiologic, biological, and clinical follow-up. To the best of our knowledge, few similar cases were reported more than 20 years after trauma. However, no case combining an arteriovenous fistula and a pseudoaneurysm revealing as late as 38 years after trauma was found. In addition, management of those conditions on a solitary kidney and outcomes has not been described. We believe that our case depicts the clinical presentation and management of this rare entity that should not be unrecognized due to its potential lethal implications