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Viegas V, Freton L, Richard C, Haudebert C, Khene ZE, Hascoet J, Verhoest G, Mathieu R, Vesval Q, Zhao LC, Bensalah K, Peyronnet B. Robotic YV plasty outcomes for bladder neck contracture vs. vesico-urethral anastomotic stricture. World J Urol 2024; 42:172. [PMID: 38506927 DOI: 10.1007/s00345-024-04814-8] [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: 08/06/2023] [Accepted: 01/16/2024] [Indexed: 03/22/2024] Open
Abstract
PURPOSE To compare the outcomes of patients undergoing robotic YV plasty for bladder neck contracture (BNC) vs. vesico-urethral anastomotic stricture (VUAS). METHODS A retrospective study included male patients who underwent robotic YV plasty for BNC after endoscopic treatment of BPH or VUAS between August 2019 and March 2023 at a single academic center. The primary assessed was the patency rate at 1 month post-YV plasty and during the last follow-up visit. RESULTS A total of 21 patients were analyzed, comprising 6 in the VUAS group and 15 in the BNC group. Patients with VUAS had significantly longer operative times (277.5 vs. 146.7 min; p = 0.008) and hospital stay (3.2 vs. 1.7 days; p = 0.03). Postoperative complications were more common in the VUAS group (66.7% vs. 26.7%; p = 0.14). All patients resumed spontaneous voiding postoperatively. Five patients (23.8%) who developed de novo stress urinary incontinence had already an AUS (n = 1) or required concomitant AUS implantation (n = 3), all of whom were in the VUAS group (83.3% vs. 0%; p < 0.0001). The proportion of patients improved was similar in both groups (PGII = 1 or 2: 83.3% vs. 80%; p = 0.31). Stricture recurrence occurred in 9.5% of patients in the whole cohort, with no significant difference between the groups (p = 0.50). Long-term reoperation was required in three VUAS patients, showing a statistically significant difference between the groups (p = 0.05). CONCLUSION Robotic YV plasty is feasible for both VUAS and BNC. While functional outcomes and stricture-free survival may be similar for both conditions, the perioperative outcomes were less favorable for VUAS patients.
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Affiliation(s)
- Vanessa Viegas
- Department of Urology, Hospital Universitario de La Princesa, Madrid, Spain.
| | - Lucas Freton
- Department of Urology, University of Rennes, Rennes, France
| | - Claire Richard
- Department of Urology, University of Rennes, Rennes, France
| | | | | | | | | | - Romain Mathieu
- Department of Urology, University of Rennes, Rennes, France
| | - Quentin Vesval
- Department of Urology, University of Rennes, Rennes, France
| | - Lee C Zhao
- Department of Urology, New York University, New York, USA
| | - Karim Bensalah
- Department of Urology, University of Rennes, Rennes, France
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Beaufils T, Berkane Y, Freton L, Richard C, Watier É, Qassemyar Q, Bertheuil N. A New Surgical Technique for Female-to-Male Top Surgery: The Posterioinferior Pedicle (PIPe) Approach. Aesthetic Plast Surg 2023; 47:2283-2294. [PMID: 37684416 DOI: 10.1007/s00266-023-03552-3] [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: 05/12/2023] [Accepted: 07/23/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION Most of the time, female-to-male (FtoM) chest surgery involves mastectomy techniques and free transplantation of the nipple-areola complex. With the increasing prevalence of gender dysphoria and the demand for female-to-male gender reassignment surgery, the need for FtM top surgery is also rising. To meet this demand, we present a new approach: the PIPe technique, based on a fasciocutaneous flap with a posteroinferior pedicle. MATERIALS AND METHODS All patients with FtoM gender dysphoria undergoing surgery using the posteroinferior pedicle flap technique in the Plastic Surgery Department at Rennes University Hospital Center were included. The procedure involved extensive liposuction of the lower internal and external mammary quadrants, followed by liposuction of deep tissues in the upper quadrants, except in the pedicle area. After removing skin from the lower quadrants down to the dermis and de-epithelializing the posteroinferior pedicle flap, the thoracic flap was lowered and the areola transposed. RESULTS From July 2022 to March 2023, fifteen patients underwent surgery, and their results were collected prospectively. The average age was 25 years, the mean weight was 76.6 kg, and the average BMI was 28.1 kg/m2. The average operating time was 102 min, and the mean weight excised was 459.5 g. The average length of hospital stay was 3.3 days, and the drainage duration was 2.4 days. No major complications were reported, and there were no cases of reintervention or recurrence. CONCLUSIONS Our study presents a novel surgical approach utilizing the posteroinferior pedicle technique. Its key benefit lies in the preservation of neurovascular function, which makes it an attractive option for patients seeking to retain nipple sensitivity. This procedure is reliable, reproducible, and recommended as a first-line treatment for grade II and III gynecomastia due to its low rate of major complications and favorable functional and aesthetic outcomes. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Tristan Beaufils
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, 16 Boulevard de Bulgarie, 35200, Rennes, France
| | - Yanis Berkane
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, 16 Boulevard de Bulgarie, 35200, Rennes, France
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- INSERM U1236, University of Rennes 1, Rennes, France
- SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital, Rennes, France
| | - Lucas Freton
- Department of Urology, Rennes University Hospital Center, Rennes, France
| | - Claire Richard
- Department of Urology, Rennes University Hospital Center, Rennes, France
| | - Éric Watier
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, 16 Boulevard de Bulgarie, 35200, Rennes, France
| | | | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, 16 Boulevard de Bulgarie, 35200, Rennes, France.
- INSERM U1236, University of Rennes 1, Rennes, France.
- SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital, Rennes, France.
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Seizilles de Mazancourt E, Khene Z, Sbizerra M, Kaulanjan K, Plassais C, Bardet F, Pinar U, Duquesne I, Margue G, Ali Benali N, Berchiche W, Gaillard C, Wandoren W, Manuguerra A, Dang VT, Mauger de Varennes A, Hulin M, Gaillard V, Dominique I, Michiels C, Grevez T, Felber M, Vallee M, Gondran-Tellier B, Freton L, Lannes F, Pradère B, Matillon X. Cut-off time for surgery and prediction of orchiectomy in spermatic cord torsion: a retrospective multicentric study over 15 years. World J Urol 2023; 41:3789-3794. [PMID: 37897515 DOI: 10.1007/s00345-023-04671-x] [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: 08/29/2023] [Accepted: 09/26/2023] [Indexed: 10/30/2023] Open
Abstract
PURPOSE Cut-off time to avoid orchiectomy relies on small series of patients. The objective was to determine the cut-off time to avoid orchiectomy in torsion of the spermatic cord in a large cohort. METHODS We performed a retrospective multicenter study (TORSAFUF cohort) of patients with suspected spermatic cord torsion between 2005 and 2019. All patients aged > 12 years who were suspected of having a torsion of the spermatic cord in 14 University Hospitals in France were included (n = 2986). Patients for whom data on pain duration were not available (n = 923) or for whom the final diagnosis was not torsion of the spermatic cord (n = 807) were excluded. The primary outcome was orchiectomy. The secondary outcomes were testicular survival time and the prediction of orchiectomy with the duration of pain. RESULTS 1266 patients were included with an orchiectomy rate of 12% (150 patients). The mean age was 21.5 years old in the salvage group and 23.7 years old in the orchiectomy group (p = 0.01), respectively. The median time from the onset of pain to surgery was 5.5 (IQR = 5) hours in the salvage group and 51.1 (IQR = 70) hours in the orchiectomy group (p < 0.0001). The risk of orchiectomy increased after a time cut-off of 6 h 30. A delay of 15 h 30 in pain duration was found to predict orchiectomy (sensitivity: 0.81; specificity: 0.87). CONCLUSIONS Pain duration can predict the probability of salvaging the testicles and performing orchiectomy. Rapid intervention should be recommended, regardless of the time elapsed from the onset of pain.
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Affiliation(s)
- Emilien Seizilles de Mazancourt
- Urology and Transplantation Surgery, Edouard Herriot Hospital, Lyon, France.
- Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France.
| | - Zinnedine Khene
- Department of Urology, Rennes University Hospital, Rennes, France
| | - Marc Sbizerra
- Department of Urology, Lyon Sud Hospital, Lyon, France
| | - Kevin Kaulanjan
- Department of Urology, Pointe A Pitre University Hospital, Guadeloupe, France
| | - Caroline Plassais
- Department of Urology, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Sorbonne Université, Paris, France
| | - Florian Bardet
- Department of Urology, Dijon University Hospital, Dijon, France
| | - Ugo Pinar
- Department of Urology, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Sorbonne Université, Paris, France
| | - Igor Duquesne
- Department of Urology, APHP, Hôpital Cochin, Université de Paris, Paris, France
| | - Gaelle Margue
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Nadia Ali Benali
- Department of Urology, Poitiers University Hospital, Poitiers, France
| | - William Berchiche
- Department of Urology, La Conception University Hospital, Marseille, France
| | | | - William Wandoren
- Department of Urology, Pointe A Pitre University Hospital, Guadeloupe, France
| | | | - Van Thi Dang
- Department of Urology, Toulouse University Hospital, Toulouse, France
| | | | - Maud Hulin
- Department of Urology, Reims University Hospital, Reims, France
| | - Victor Gaillard
- Department of Urology, Strasbourg University Hospital, Strasbourg, France
| | | | - Clement Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Tristan Grevez
- Department of Urology, Tours University Hospital, Tours, France
| | - Margaux Felber
- Department of Urology, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Sorbonne Université, Paris, France
| | - Maxime Vallee
- Department of Urology, Poitiers University Hospital, Poitiers, France
| | | | - Lucas Freton
- Department of Urology, Rennes University Hospital, Rennes, France
| | - François Lannes
- Department of Urology, La Conception University Hospital, Marseille, France
| | - Benjamin Pradère
- Department of Urology, Toulouse University Hospital, Toulouse, France
| | - Xavier Matillon
- Urology and Transplantation Surgery, Edouard Herriot Hospital, Lyon, France
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Baboudjian M, Lebacle C, Gondran-Tellier B, Hutin M, Olivier J, Ruggiero M, Panayotopoulos P, Dominique I, Millet C, Bergerat S, Freton L, Betari R, Matillon X, Chebbi A, Caes T, Patard PM, Szabla N, Sabourin L, Dariane C, Rizk J, Madec FX, Nouhaud FX, Rod X, Fiard G, Pradere B, Peyronnet B. Who Is at Risk of Death after Renal Trauma? An Analysis of Thirty-Day Mortality after 1,799 Cases of Renal Trauma. Urol Int 2023; 107:165-170. [PMID: 35390797 DOI: 10.1159/000521554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/06/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of the study was to report the 30-day mortality (30DM) after renal trauma and identify the risk factors associated with death. METHODS The TRAUMAFUF project was a retrospective multi-institutional study including all patients with renal trauma admitted to 17 French hospitals between 2005 and 2015. The included population focused on patients of all age groups who underwent renal trauma during the study period. The primary outcome was death within 30 days following trauma. The multivariate logistic regression model with a stepwise backward elimination was used to identify predictive factors of 30DM. RESULTS Data on 1,799 renal trauma were recorded over the 10-year period. There were 59 deaths within 30 days of renal trauma, conferring a 30DM rate of 3.27%. Renal trauma was directly involved in 5 deaths (8.5% of all deaths, 0.3% of all renal trauma). Multivariate stepwise logistic regression analysis revealed that age >40 years (odds ratio [OR] 2.18; 95% confidence interval [CI]: 1.20-3.99; p = 0.01), hemodynamic instability (OR 4.67; 95% CI: 2.49-9; p < 0.001), anemia (OR 3.89; 95% CI: 1.94-8.37; p < 0.001), bilateral renal trauma (OR 6.77; 95% CI: 2.83-15.61; p < 0.001), arterial contrast extravasation (OR 2.09; 95% CI: 1.09-3.96; p = 0.02), and concomitant visceral and bone injuries (OR 6.57; 95% CI: 2.41-23.14; p < 0.001) were independent predictors of 30DM. CONCLUSION Our large multi-institutional study supports that the 30DM of 3.27% after renal trauma is due to the high degree of associated injuries and was rarely a consequence of renal trauma alone. Age >40 years, hemodynamic instability, anemia, bilateral renal trauma, arterial contrast extravasation, and concomitant visceral and bone lesions were predictors of death. These results can help clinicians to identify high-risk patients.
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Affiliation(s)
- Michael Baboudjian
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception Academic Hospital, Marseille, France
| | - Cedric Lebacle
- Department of Urology, University of Paris Sud, CHU Bicetre, Paris, France
| | - Bastien Gondran-Tellier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception Academic Hospital, Marseille, France
| | - Marine Hutin
- Department of Urology, University of Montpellier, Montpellier, France
| | | | - Marina Ruggiero
- Department of Urology, University of Paris Sud, CHU Bicetre, Paris, France
| | | | | | - Clémentine Millet
- Department of Urology, University of Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Lucas Freton
- Department of Urology, University of Rennes, Rennes, France
| | - Reem Betari
- Department of Urology, University of Amiens, Amiens, France
| | | | - Ala Chebbi
- Department of Urology, University of Rouen, Rouen, France
| | - Thomas Caes
- Department of Urology, University of Lille, Lille, France
| | | | | | - Laura Sabourin
- Department of Urology, University of Clermont-Ferrand, Clermont-Ferrand, France
| | - Charles Dariane
- Department of Urology, University of Paris Descartes, Paris, France
| | - Jerome Rizk
- Department of Urology, University of Lille, Lille, France
| | | | | | - Xavier Rod
- Department of Urology, University of Nantes, Nantes, France
| | - Gaelle Fiard
- Department of Urology, University of Grenoble, Grenoble, France
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Freton L, Graffeille V, Khene Z, Hascoet J, Mathieu R, Vesval Q, Verhoest G, Bensalah K, Peyronnet B. YV plasty for vesico-urethral anastomosis stenosis by combined robotic and perineal approach and concomitant artificial urinary sphincter implantation. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01465-3] [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]
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6
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Haudebert C, Hascoet J, Bryckaert P.E, Freton L, Richard C, Khene Z.E, Voiry C, Samson E, Mathieu R, Verhoest G, Bensalah K, Manunta A, Peyronnet B. Robot-assisted intracorporeal Monti catheterizable channel. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01439-2] [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]
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7
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Bourgeno HA, Richard C, El Akri M, Hascoet J, Haudebert C, Freton L, Bensalah K, Mathieu R, Peyronnet B. Robot-assisted bladder neck artificial urinary sphincter implantation in male patient with spinal cord traumatism incontinence. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01445-8] [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: 02/12/2023]
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Toujani S, Tucker EJ, Akloul L, Mary L, Pimentel C, Launay E, Freton L, Jouve G, Henry C, Odent S, Belaud-Rotureau MA, Jaillard S. Pseudodicentric Chromosome Originating from an X-Autosome Translocation in a Male Patient with Cryptozoospermia. Cytogenet Genome Res 2022; 162:124-131. [PMID: 35609520 DOI: 10.1159/000524388] [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: 12/09/2021] [Accepted: 03/28/2022] [Indexed: 11/19/2022] Open
Abstract
Genetic factors are responsible for 15% of male infertility conditions. Numerical and structural chromosomal anomalies are validated genetic factors leading to spermatogenic quantitative defects, with a frequency depending on the severity of the phenotype. Among the structural chromosomal rearrangements, dicentric chromosomes are generally observed in robertsonian translocations or in cases of Y chromosome isodicentrics. In X-autosome translocations, male carriers are generally infertile, regardless of the position of the breakpoint, due to interrupted spermatogenesis. We report an infertile man bearing an unusual balanced (X;22) translocation, with a centromeric X breakpoint generating a derivative pseudodicentric chromosome psu dic(22;X). Extensive cytogenetic analyses were necessary to determine the precise nature of the derivative chromosome. The likely cause of the reproductive phenotype of the patient is discussed based on meiotic chromosomal conformation.
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Affiliation(s)
- Saloua Toujani
- Cytogenetics and Cell Biology Department, Rennes University Hospital, Rennes, France
| | - Elena J Tucker
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Linda Akloul
- Department of Clinical Genetics, Rennes University Hospital, Rennes, France
| | - Laura Mary
- Cytogenetics and Cell Biology Department, Rennes University Hospital, Rennes, France
| | - Céline Pimentel
- Department of Obstetric Gynecology and Human Reproduction, Rennes University Hospital, Rennes, France
| | - Erika Launay
- Cytogenetics and Cell Biology Department, Rennes University Hospital, Rennes, France
| | - Lucas Freton
- Department of Urology, Rennes University Hospital, Rennes, France
| | - Guilhem Jouve
- Department of Reproductive Biology, Rennes University Hospital, Rennes, France
| | - Catherine Henry
- Cytogenetics and Cell Biology Department, Rennes University Hospital, Rennes, France
| | - Sylvie Odent
- Department of Clinical Genetics, Rennes University Hospital, Rennes, France
| | - Marc-Antoine Belaud-Rotureau
- Cytogenetics and Cell Biology Department, Rennes University Hospital, Rennes, France.,Department of Reproductive Biology, Rennes University Hospital, Rennes, France.,Rennes 1 University, INSERM, EHESP, IRSET - UMR_S 1085, Rennes, France
| | - Sylvie Jaillard
- Cytogenetics and Cell Biology Department, Rennes University Hospital, Rennes, France.,Rennes 1 University, INSERM, EHESP, IRSET - UMR_S 1085, Rennes, France
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9
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Haudebert C, Richard C, Common H, Hascoet J, Bentellis I, Freton L, Voiry C, Samson E, Manunta A, Brucker B, Peyronnet B. Bandelette aponévrotique pubovaginale pour incontinence urinaire d’effort chez les femmes à risque de complications prothétiques. Prog Urol 2022; 32:500-508. [DOI: 10.1016/j.purol.2022.02.007] [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: 01/02/2022] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/26/2022]
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10
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Dang VT, Pradere B, de Varennes AM, Benali NA, Vallée M, Berchiche W, Gondran-Tellier B, Margue G, Michiels C, Gaillard C, Grevez T, Bardet F, Hulin M, Manuguerra A, Pinar U, Plassais C, Felber M, Wandoren W, Kaulanjan K, Dominique I, Sbizerra M, de Mazancourt ES, Matillon X, Duquesne I, Chabenes M, Gaillard V, Freton L, Lannes F, Khene ZE. Torsion of the spermatic cord in adults: a multicenter experience in adults with surgical exploration for acute scrotal pain with suspected testicular torsion. Asian J Androl 2022; 24:575-578. [PMID: 35322657 PMCID: PMC9809486 DOI: 10.4103/aja2021126] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Acute scrotal pain (ASP) requiring surgical exploration is common in the pediatric population, but little has been reported on this subject with regard to the adult population. The aim of this study was to investigate the demographic and clinical characteristics and outcomes of scrotal explorations performed on adult patients. Patients over 21 years of age who underwent surgical exploration for ASP with suspected testicular torsion (TT) at 14 French hospitals between January 2005 and December 2019 were included in this study. The main outcome measures were demographic characteristics, pathology found during scrotal exploration, and perioperative outcomes. Logistic regression was used to perform univariate and multivariate analyses to identify predictors of TT. Data for 1329 men were analyzed. The median age was 30 (interquartile range [IQR]: 25-35; range: 21-89) years. Regarding the clinical examination, 867 (65.2%) patients presented with an elevation of the testicle, 613 (46.1%) patients with scrotal edema or erythema, and 211 (15.9%) patients with nausea or vomiting. Operative findings identified TT in only 684 (51.5%) patients, epididymo-orchitis in 112 (8.4%) patients, a tumor in 16 (1.2%) patients, and no causes in 475 (35.7%) patients. Orchiectomy for nonviable testes was required in 101 (7.6%) patients. In multivariate analysis, an elevation of the testicle, erythema/swelling, and the presence of nausea/vomiting were found to be associated with the occurrence of TT. Testicular torsion is not exclusive to children and adolescents, so must be considered in males of any age with acute scrotal findings. However, one-third of scrotal explorations in adults did not lead to a diagnosis.
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Affiliation(s)
- Van Thi Dang
- Department of Urology, Toulouse University Hospital, Toulouse 31000, France,
Correspondence: Dr. VT Dang ()
| | - Benjamin Pradere
- Department of Urology, Medical University of Vienna, Vienna 1090, Austria
| | | | - Nadia Ali Benali
- Department of Urology, Poitiers University Hospital, Poitiers 86000, France
| | - Maxime Vallée
- Department of Urology, Poitiers University Hospital, Poitiers 86000, France
| | - William Berchiche
- Department of Urology, Marseille North Hospital, Marseille 13000, France
| | | | - Gaelle Margue
- Department of Urology, Bordeaux University Hospital, Bordeaux 33000, France
| | - Clément Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux 33000, France
| | - Charles Gaillard
- Department of Urology, Tours University Hospital, Tours 37000, France
| | - Tristan Grevez
- Department of Urology, Tours University Hospital, Tours 37000, France
| | - Florian Bardet
- Department of Urology, Dijon University Hospital, Dijon 21000, France
| | - Maud Hulin
- Department of Urology, Reims University Hospital, Reims 51000, France
| | | | - Ugo Pinar
- Department of Urology, Hôpitaux Universitaires Pitie-Salpetriere, AP-HP, Paris 75013, France
| | - Caroline Plassais
- Department of Urology, Hôpitaux Universitaires Pitie-Salpetriere, AP-HP, Paris 75013, France
| | - Margeux Felber
- Department of Urology, Hôpitaux Universitaires Pitie-Salpetriere, AP-HP, Paris 75013, France
| | - William Wandoren
- Department of Urology, Pointe à Pitre University Hospital, Guadeloupe 97000, France
| | - Kévin Kaulanjan
- Department of Urology, Pointe à Pitre University Hospital, Guadeloupe 97000, France
| | - Ines Dominique
- Department of Urology, Lyon University Hospital, Lyon 69000, France
| | - Marc Sbizerra
- Department of Urology, Lyon University Hospital, Lyon 69000, France
| | | | - Xavier Matillon
- Department of Urology, Lyon University Hospital, Lyon 69000, France
| | - Igor Duquesne
- Department of Urology, Cochin Hospital, AP-HP, Paris 75000, France
| | - Maxime Chabenes
- Department of Urology, Grenoble University Hospital, Grenoble 38000, France
| | - Victor Gaillard
- Department of Urology, Strasbourg University Hospital, Strasbourg 67000, France
| | - Lucas Freton
- Department of Urology, Rennes University Hospital, Rennes 35000, France
| | - Francois Lannes
- Department of Urology, Marseille North Hospital, Marseille 13000, France
| | - Zine-Eddine Khene
- Department of Urology, Rennes University Hospital, Rennes 35000, France
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11
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Baloche P, Szabla N, Freton L, Hutin M, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayotopoulos P, Betari R, Matillon X, Chebbi A, Caes T, Patard PM, Brichart N, Sabourin L, Dariane C, Baboudjian M, Gondran-Tellier B, Lebacle C, Madec FX, Nouhaud FX, Rod X, Fiard G, Pradere B, Peyronnet B. Impact of Hospital Volume on the Outcomes of Renal Trauma Management. EUR UROL SUPPL 2022; 37:99-105. [PMID: 35243394 PMCID: PMC8883196 DOI: 10.1016/j.euros.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Some health care systems have set up referral trauma centers to centralize expertise to improve trauma management. There is scant and controversial evidence regarding the impact of provider’s volume on the outcomes of trauma management. Objective To evaluate the impact of hospital volume on the outcomes of renal trauma management in a European health care system. Design, setting, and participants A retrospective multicenter study, including all patients admitted for renal trauma in 17 French hospitals between 2005 and 2015, was conducted. Intervention Nephrectomy, angioembolization, or nonoperative management. Outcome measurements and statistical analysis Four quartiles according to the caseload per year: low volume (eight or fewer per year), moderate volume (nine to 13 per year), high volume (14–25/yr), and very high volume (≥26/yr). The primary endpoint was failure of nonoperative management defined as any interventional radiology or surgical procedure needed within the first 30 d after admission. Results and limitations Of 1771 patients with renal trauma, 1704 were included. Nonoperative management was more prevalent in the very-high- and low-volume centers (p = 0.02). In a univariate analysis, very high hospital volume was associated with a lower risk of nonoperative management failure than low (odds ratio [OR] = 0.54; p = 0.05) and moderate (OR = 0.48; p = 0.02) hospital volume. There were fewer nephrectomies in the high- and very-high-volume groups (p = 0.003). In a multivariate analysis, very high volume remained associated with a lower risk of nonoperative management failure than low (OR = 0.48; p = 0.04) and moderate (OR = 0.42; p = 0.01) volume. Study limitations include all the shortcomings inherent to its retrospective multicenter design. Conclusions In this multicenter study, management of renal trauma varied according to hospital volume. There were lower rates of nephrectomy and failure of nonoperative management in very-high-volume centers. These results raise the question of centralizing the management of renal trauma, which is currently not the case in our health care system. Patient summary In this study, management of renal trauma varied according to hospital volume. Very-high-volume centers had lower rates of nephrectomy and failure of nonoperative management.
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Freton L, Graffeille V, Khene Z, Hascoet J, Verhoest G, Mathieu R, Vesval Q, Zhao L, Bensalah K, Peyronnet B. Robotic YV plasty for bladder neck vs. vesico-urethral anastomotic stricture. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00938-1] [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: 11/04/2022]
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13
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Richard C, Brucker B, Hascoet J, Drain A, Rosenblum N, Sussman R, Freton L, Zhao L, Peyronnet B. Dorsal onlay lingual mucosa graft urethroplasty for female urethral stricture. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01304-5] [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: 12/01/2022]
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14
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Richard C, Peyonnet B, Drain A, Hascoet J, Rosenblum N, Sussman R, Freton L, Zhao L, Nitti V, Brucker B. Dorsal onlay oral mucosa graft urethroplasty for female urethral stricture. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00941-1] [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: 11/04/2022]
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15
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Haudebert C, Hascoet J, Freton L, Khene ZE, Dosin G, Voiry C, Samson E, Richard C, Neau AC, Drouet A, Mathieu R, Bensalah K, Verhoest G, Manunta A, Peyronnet B. Cystectomy and ileal conduit for neurogenic bladder: Comparison of the open, laparoscopic and robotic approaches. Neurourol Urodyn 2021; 41:601-608. [PMID: 34962653 DOI: 10.1002/nau.24855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/17/2021] [Accepted: 11/15/2021] [Indexed: 11/09/2022]
Abstract
AIM The objective of the present study was to compare the outcomes of open versus laparoscopic versus robotic cystectomy and ileal conduit for neurogenic lower urinary tract dysfunction (NLUTD). METHODS The charts of all patients who underwent cystectomy and ileal conduit for NLUTD between January 2004 and November 2020 in an academic center were retrospectively reviewed. The approach was either open, laparoscopic or robot-assisted depending on the period (i.e., three consecutive era). For the robotic approach, the diversion was done either intracorporeally or extracorporeally. We compared the perioperative and late postoperative outcomes between the three groups. RESULTS After exclusion of 10 patients with non-neurogenic benign conditions, 126 patients were included over the study period. The most frequent neurological conditions were multiple sclerosis (36.5%) and spinal cord injury (25.4%). The approach was open, laparoscopic or robot-assisted in 31 (24.6%), 26 (20.6%) and 69 (54.7%) cases respectively. Seventy-two patients experienced a 90-day postoperative complication (57.1%) of which 22 had a major complication (Clavien 3 or higher, 17.5%) including one death (0.8%). The rate of major postoperative complications was significantly lower in the robotic group (23% vs. 23% vs. 10%; p = 0.049) while the rate of overall complications was comparable across the three groups (58.1% vs. 53.9% vs. 60.6%; p = 0.84). After a median follow-up of 23 months, 22 patients presented a late complication (17.6%), mainly incisional hernia (5; 4%) and uretero-ileal stricture (9; 7.2%). The rate of late complications did not differ significantly between the three approaches. CONCLUSION Cystectomy and ileal conduit for neurogenic bladder is associated with a relatively high perioperative morbidity. The robot-assisted approach may decrease the risk of major postoperative complications.
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Affiliation(s)
| | | | - Lucas Freton
- Department of Urology, University of Rennes, Rennes, France
| | | | - Gilles Dosin
- Department of Urology, University of Rennes, Rennes, France
| | - Caroline Voiry
- Department of Physical Medicine and Rehabilitation, University of Rennes, Rennes, France
| | - Emmanuelle Samson
- Department of Physical Medicine and Rehabilitation, University of Rennes, Rennes, France.,Referral Center for Spina Bifida, NeuroSphinx Network, Rennes, France
| | - Claire Richard
- Department of Urology, University of Rennes, Rennes, France
| | - Anne-Cécile Neau
- Department of Anesthesiology, University of Rennes, Rennes, France
| | - Anais Drouet
- Department of Anesthesiology, University of Rennes, Rennes, France
| | - Romain Mathieu
- Department of Urology, University of Rennes, Rennes, France
| | - Karim Bensalah
- Department of Urology, University of Rennes, Rennes, France
| | | | - Andréa Manunta
- Department of Urology, University of Rennes, Rennes, France.,Referral Center for Spina Bifida, NeuroSphinx Network, Rennes, France
| | - Benoit Peyronnet
- Department of Urology, University of Rennes, Rennes, France.,Referral Center for Spina Bifida, NeuroSphinx Network, Rennes, France
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Richard C, Pourchasse M, Freton L, Esvan M, Ravel C, Peyronnet B, Mathieu R, Chhor S. Male contraception: What do women think? Prog Urol 2021; 32:276-283. [PMID: 34924309 DOI: 10.1016/j.purol.2021.11.003] [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: 10/06/2021] [Revised: 10/29/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Women currently bear the most responsibility in contraception, with a wide choice of methods, while only a few existing male contraceptives are available. However, it has been shown that men are willing to get involved in birth control and to control their own fertility. Our research was focused on female population and a survey was carried out to explore women's perceptions of male contraception. METHODS An observational quantitative cross-sectional study using a self-administered-questionnaire was carried out between November 2019 and February 2020. All women aged from 16-years-old to menopause completing the questionnaire were included. Descriptive statistical analyses were conducted, qualitative variables were expressed as counts and frequency. RESULTS In total, 379 interpretable completed questionnaires were included. Among the women, 69.7% were in favour of letting men deal with contraception, without referring to a specific method. After having been made aware of the medical information concerning existing male contraceptives and those in development, the proportion of women in favour dropped to 46.7%. The most acceptable method for a majority of women was the male pill, which is still being developed. The majority (78.4%) of the women in our survey felt insufficiently informed about male contraception. DISCUSSION In our study, women seemed to want to share contraceptive responsibility with men, but the lack of information and of acceptable contraception methods available remained an obstacle. Although larger-scale studies are needed to confirm these results, the development of a wider range of male contraception methods seems to be what both men and women have long been expecting.
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Affiliation(s)
- C Richard
- Department of Urology, University of Rennes, Rennes, France.
| | - M Pourchasse
- Department of General Medicine, University of Rennes, Rennes, France
| | - L Freton
- Department of Urology, University of Rennes, Rennes, France
| | - M Esvan
- Clinical Investigation Department, University of Rennes, Rennes, France
| | - C Ravel
- CECOS, University of Rennes, Rennes, France
| | - B Peyronnet
- Department of Urology, University of Rennes, Rennes, France
| | - R Mathieu
- Department of Urology, University of Rennes, Rennes, France
| | - S Chhor
- Department of General Medicine, University of Rennes, Rennes, France; Clinical Investigation Department, University of Rennes, Rennes, France
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Ali Benali N, Pradère B, Lannes F, Thi Dang V, Mauger de Varennes A, Gaillard C, Berchiche W, Margue G, Bardet F, Manuguerra A, Pinar U, Duquesne I, Plassais C, Wandoren W, Hulin M, Khene ZE, Vallée M, Michiels C, Chabenes M, Gaillard V, Felber M, Kaulanjan K, Dominique I, Sbizerra M, Seizilles de Mazancourt E, Freton L, Gondran-Tellier B, Matillon X. TORSAFUF - Surgical exploration for torsion of spermatic cord suspicion and risk factors for unnecessary surgery: Results of a French nationwide retrospective study on 2940 patients. Prog Urol 2021; 32:92-100. [PMID: 34920923 DOI: 10.1016/j.purol.2021.10.011] [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: 07/10/2021] [Revised: 10/10/2021] [Accepted: 10/31/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUNDS Spermatic cord torsion is a frequent urological emergency that mostly concerns teenagers and young adults. This study aimed to determine the clinical and surgical characteristics of young adults who had scrotal exploration for suspected spermatic cord torsion and to identify clinical risk factors associated with needless scrotal exploration. METHODS We retrospectively collected national data from patients aged 12years and older who underwent a surgical exploration for suspicion of torsion of the spermatic cord between 2005 and 2019 in 17 hospitals. We analyzed demographics, surgical and postoperative characteristics in our population. We compared the cohort according to the intraoperative diagnosis of torsion or not. RESULTS In total, 2940 had surgical exploration: 1802 (61.3%) patients had torsion of the spermatic cord and 1138 (38.7%) had another diagnosis. In multivariate analysis, age (OR: 1.04; 95% CI: 1.01-1.06; P=0.005), medical history of cryptorchism (OR: 4.14; 95% CI: 1.05-16.31; P=0.042) and VAS pain score (OR: 0.91; 95% CI: 0.83-0.98; P=0.018) were risk factors significantly associated with unnecessary surgical exploration. The rate of complications in the 90days after surgery was 11% in the "torsion" group, and 9.7% in the "non-torsion" group (P=0.28). CONCLUSION Scrotal exploration without intraoperative diagnosis of torsion was performed in 40% of our cohort. VAS pain score and cryptorchism history can help for the diagnosis but scrotal exploration remains the way to diagnose spermatic cord torsion and should be performed on the slightest suspicion, even after 24hours of symptoms, as the chances for testicular salvage remains around 50%.
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Affiliation(s)
- N Ali Benali
- Department of Urology, Poitiers University Hospital, Poitiers, France.
| | - B Pradère
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - F Lannes
- Department of Urology, Nord University Hospital, Marseille, France
| | - V Thi Dang
- Department of Urology, Toulouse University Hospital, Toulouse, France
| | | | - C Gaillard
- Department of Urology, Tours University Hospital, Tours, France
| | - W Berchiche
- Department of Urology, Nord University Hospital, Marseille, France
| | - G Margue
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - F Bardet
- Department of Urology, Dijon University Hospital, Dijon, France
| | - A Manuguerra
- Department of Urology, Nancy University Hospital, Nancy, France
| | - U Pinar
- Department of Urology, Hôpitaux Universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - I Duquesne
- Department of Urology, Hôpitaux Universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - C Plassais
- Department of Urology, Hôpitaux Universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - W Wandoren
- Department of Urology, Pointe-à-Pitre University Hospital, Pointe-à-Pitre, Guadeloupe
| | - M Hulin
- Department of Urology, Reims University Hospital, Reims, France
| | - Z-E Khene
- Department of Urology, Rennes University Hospital, Rennes, France
| | - M Vallée
- Department of Urology, Poitiers University Hospital, Poitiers, France; Poitiers University, INSERM U1070, "Pharmacologie des Anti-Infectieux", UFR Médecine-Pharmacie, Pôle Biologie Santé, Poitiers, France
| | | | - C Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - M Chabenes
- Department of Urology, Grenoble University Hospital, Grenoble, France
| | - V Gaillard
- Department of Urology, Strasbourg University Hospital, Strasbourg, France
| | - M Felber
- Department of Urology, Nancy University Hospital, Nancy, France
| | - K Kaulanjan
- Department of Urology, Pointe-à-Pitre University Hospital, Pointe-à-Pitre, Guadeloupe
| | - I Dominique
- Department of Urology, Lyon Sud University Hospital, Lyon, France
| | - M Sbizerra
- Department of Urology, Lyon Sud University Hospital, Lyon, France
| | | | - L Freton
- Department of Urology, Rennes University Hospital, Rennes, France
| | | | - X Matillon
- Department of Urology, Lyon Sud University Hospital, Lyon, France
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Haudebert C, Hascoet J, Richard C, Freton L, Graffeille V, Common H, Voiry C, Samson E, Manunta A, Brucker B, Peyronnet B. Bandelette aponévrotique pubovaginale pour incontinence urinaire d’effort chez la femme : une technique utile chez des patientes sélectionnées. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.091] [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: 10/19/2022]
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19
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Freton L, Richard C, Zhao L, Graffeille V, Thenault R, Hascoet J, Verhoest G, Khene Z, Bensalah K, Mathieu R, Peyronnet B. Plastie YV de sténose d’anastomose urétrovésicale par voie combinée robotique et périnéale associé à la pose d’un sphincter urinaire artificiel. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Richard C, Pourchasse M, Freton L, Esvan M, Ravel C, Peyronnet B, Mathieu R, Chhor S. Contraception masculine : qu’en pensent les femmes ? Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Baloche P, Szabla N, Freton L, Hutin M, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayotopoulos P, Betari R, Matillon X, Chebbi A, Caes T, Patard P, Brichart N, Dariane C, Lebacle C, Gondran-Tellier B, Pradere B, Peyronnet B. Y a-t-il un effet centre dans la prise en charge des traumatismes du rein ? Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Haudebert C, Hascoet J, Bryckaert P, Richard C, Freton L, Khene Z, Voiry C, Samson E, Mathieu R, Verhoest G, Bensalah K, Manunta A, Peyronnet B. Cystostomie continente de type Mitrofanoff (appendicovésicostomie) par voie cœlioscopique robot-assistée. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.025] [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: 10/19/2022]
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Freton L, Graffeille V, Zhao L, Richard C, Hascoet J, Jeanne Julien A, Manunta A, Bensalah K, Mathieu R, Peyronnet B. Greffe de muqueuse buccale par voie robotique transvésicale pour récidive de sclérose de col vésical. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.030] [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: 10/19/2022]
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Haudebert C, Common H, Richard C, Hascoet J, Freton L, Manunta A, Samson E, Voiry C, Brucker B, Peyronnet B. Bandelette pubovaginale aponévrotique de fascia lata pour l’incontinence urinaire d’effort de patientes obèses. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Haudebert C, Richard C, Manunta A, Khene Z, Graffeille V, Hascoet J, Verhoest G, Bensalah K, Mathieu R, Peyronnet B, Freton L. Réalignement endoscopique précoce des ruptures urétrales post-traumatiques chez l’Homme. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.053] [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: 10/19/2022]
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Richard C, Peyronnet B, Drain A, Rosenblum N, Hascoet J, Sussman RD, Freton L, Zhao LC, Nitti VW, Brucker BM. Dorsal Onlay Oral Mucosa Graft Urethroplasty for Female Urethral Stricture. Urology 2021; 158:215-221. [PMID: 34537197 DOI: 10.1016/j.urology.2021.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe and assess the outcomes of dorsal onlay oral mucosa graft urethroplasty for female urethral stricture. METHODS We retrospectively reviewed the charts of all female patients who underwent dorsal onlay oral (buccal or lingual) mucosa urethroplasty for urethral stricture between 2011 and 2020 at two academic institutions. The primary endpoint was clinical success defined as any subjective improvement in LUTS self-assessed by the patients 1-3 months after catheter removal. Four surgeons performed the urethroplasties using a standardized technique: suprameatal incision, dissection and longitudinal opening of the dorsal aspect of the urethra, harvest of the oral mucosa graft, graft onlay sutured into the urethral opening. RESULTS Nineteen patients were included. The clinical success rate was 94.7% at 1-3 months and 90.9% at 1 year. After a median follow-up of 12 months (range 1-49) there was one recurrence (5.3%), clinical success was achieved in 17 patients (89.5%) and both the maximum urinary flow rate and post void residual were significantly improved (15.2 vs 7.4 ml/s preoperatively; P = .008 and 71.5 vs 161.1 ml preoperatively; P = .001 respectively). The de novo stress urinary incontinence rate was 15.7% at 1-3 months and 9.1% at 1 year. CONCLUSION Dorsal onlay oral mucosa graft urethroplasty for female urethral stricture appears feasible across multiple surgeons and is associated with a low perioperative morbidity, satisfactory functional outcomes and a low recurrence rate. Other series with larger sample size and longer follow-up are needed to confirm these findings.
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Affiliation(s)
- Claire Richard
- Department of Urology, University of Rennes, Rennes, France
| | | | - Alice Drain
- Department of Urology, New York University Langone Health, New York, NY
| | - Nirit Rosenblum
- Department of Urology, New York University Langone Health, New York, NY
| | | | - Rachael D Sussman
- Department of Urology, MedStar Georgetown University Hospital, Washington, DC
| | - Lucas Freton
- Department of Urology, University of Rennes, Rennes, France
| | - Lee C Zhao
- Department of Urology, New York University Langone Health, New York, NY
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Peyronnet B, Lethuillier V, Berthelot LP, Richard C, Haudebert C, Voiry C, Freton L, Hascoet J, Manunta A. PD06-06 IMPACT OF ROBOTIC ARTIFICIAL URINARY SPHINCTER IMPLANTATION IN FEMALE PATIENTS ON QUALITY OF LIFE AND PATIENTS-REPORTED OUTCOMES. J Urol 2021. [DOI: 10.1097/ju.0000000000001974.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Richard C, Hascoet J, Haudebert C, Rigole H, Freton L, Samson E, Voiry C, Peyronnet B. [Female voiding dysfunction: Clean intermittent catheterization is not the only option]. Prog Urol 2021; 31:924-930. [PMID: 34456140 DOI: 10.1016/j.purol.2021.08.033] [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: 08/01/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
Female voiding dysfunction exists but are largely underdiagnosed, especially in France. They can result from two different mechanisms: detrusor underactivity or bladder outlet obstruction, with very different pathophysiology and therapeutic management. There are many different therapeutic options, including surgical treatments, to offer as alternative to clean intermittent catheterization which are often burdensome for patients. Seeking voiding dysfunction in female patients with lower urinary tract symptoms and searching for their etiology to tackle it could lead to a paradigm change in these women: from standardized treatment to individualized treatment. In their practice, nurses can detect warning symptoms suspect of voiding dysfunction, and have thus a role to play in the improvement of patients' screening, education other healthcare providers, and management of female voiding dysfunction.
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Affiliation(s)
- C Richard
- Service d'urologie, CHU de Rennes, 2, rue Henri Le Guilloux, 35000 Rennes, France.
| | - J Hascoet
- Service d'urologie, CHU de Rennes, 2, rue Henri Le Guilloux, 35000 Rennes, France
| | - C Haudebert
- Service d'urologie, CHU de Rennes, 2, rue Henri Le Guilloux, 35000 Rennes, France
| | - H Rigole
- Service de médecine physique et réadaptation, CHU de Rennes, Rennes, France
| | - L Freton
- Service d'urologie, CHU de Rennes, 2, rue Henri Le Guilloux, 35000 Rennes, France
| | - E Samson
- Service de médecine physique et réadaptation, CHU de Rennes, Rennes, France
| | - C Voiry
- Service de médecine physique et réadaptation, CHU de Rennes, Rennes, France
| | - B Peyronnet
- Service d'urologie, CHU de Rennes, 2, rue Henri Le Guilloux, 35000 Rennes, France
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29
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Pinar U, Freton L, Gondran-Tellier B, Vallée M, Dominique I, Felber M, Khene ZE, Fortier E, Lannes F, Michiels C, Grevez T, Szabla N, Bardet F, Kaulanjan K, Seizilles de Mazancourt E, Matillon X, Pradere B. Educational program in onco-urology for young urologists: What are their needs? Prog Urol 2021; 31:755-761. [PMID: 34154958 DOI: 10.1016/j.purol.2021.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/11/2021] [Revised: 03/15/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The emergence of new communication media such as digital contents are progressively replacing more traditional medias in the field of educational programs. Our purpose was to assess urologist in training aspirations regarding urological education. METHODS Members of a national urologist in training association were sent an anonymous online questionnaire regarding their medical formation in the field of urology. Responders interest for urological sub-specialty or education support (new tools and traditional support) were evaluated through a 5-point Likert scale. RESULTS Overall, 109 young urologists (26%) responded to the survey. Most of the respondents worked during their training in an academic hospital (n=89, 82%). The three favorite tools for training chosen by the responders were: videos, workshop or masterclass, and podcasts (responders very interested were respectively n=64 (58.7%), n=50 (45.9%), and n=49 (45%)). E-mail newsletters were reported as the less useful educational tool by participants (n=38, 34.9%). Participants were very interested in improving their surgical skills and their radiological knowledge. Responders who were the most attracted by PCa were much more looking to improve their systemic treatment and radiological knowledges. CONCLUSIONS Urologic-oncology was a priority regarding education for urologists in training. A majority of participants expressed a lack in their surgical education, revealing a reduced OR access and underlining utilization of new tools such as simulation. New digital contents such as social media or podcast achieved high interest for the participants, instead of more traditional media. There is a need that educational content evolve and uses new digital media. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- U Pinar
- GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, Sorbonne université, 75013 Paris, France
| | - L Freton
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - B Gondran-Tellier
- Department of urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - M Vallée
- Department of Urology, Poitiers University Hospital, Poitiers, France
| | - I Dominique
- Department of Urology, groupe hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - M Felber
- GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, Sorbonne université, 75013 Paris, France
| | - Z-E Khene
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - E Fortier
- Department of Urology, Montpellier University Hospital, Montpellier, France
| | - F Lannes
- Department of urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - C Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - T Grevez
- Department of Urology, CHRU de Tours, Francois-Rabelais University, France
| | - N Szabla
- Department of Urology and Transplantation, Caen University Hospital, Caen, France
| | - F Bardet
- Department of Urology, Dijon University Hospital, Dijon, France
| | - K Kaulanjan
- Department of Urology, CHU de Pointe-à-Pitre, Guadeloupe, France
| | - E Seizilles de Mazancourt
- Department of Urology and Transplantation, Edouard-Herriot Hospital, Hospices civils de Lyon, Lyon, France
| | - X Matillon
- Department of Urology and Transplantation, Edouard-Herriot Hospital, Hospices civils de Lyon, Lyon, France
| | - B Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
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Prudhomme T, Matillon X, Dengu F, de Mazancourt E, Pinar U, Gondran-Tellier B, Freton L, Vallée M, Dominique I, Felber M, Khene ZE, Fortier E, Lannes F, Michiels C, Grevez T, Szabla N, Bardet F, Kaulanjan K, Pradère B, Deschamps JY, Branchereau J. Residents and patients benefit from surgical simulation on a live porcine model, could we consider it as ethical? Prog Urol 2021; 31:618-626. [PMID: 34158220 DOI: 10.1016/j.purol.2021.01.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/16/2021] [Accepted: 01/29/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The objective was to evaluate, by self-questionnaire, the feeling of participants in surgical training sessions on a live porcine model. METHODS A computerized questionnaire (GoogleForm ©) was sent to the members of the French Association of Urologists-in-Training (AFUF) (fellows and residents). Only questionnaires from Urologists-in-training who had participated in surgical training sessions were included. The sessions consisted of performing surgeries such as laparoscopic nephrectomies or laparoscopic cystectomies. RESULTS Overall, 198 met the inclusion criteria. A total of 36.4% (72/198) of the participants were fellows and 63.6% (126/198) were residents. According to the participants, the main interest of sessions was to be able to train for emergency situations. A total of 79.8% (158/198) of the participants wanted surgical simulation to become compulsory. To their opinion, the main advantage of surgical simulation on a live porcine model was: technical progress in 87.4% (173/198) of cases. A total of 13.1% (26/198) of the participants found it was unethical to perform the first technical procedures on live animal models. A total of 65.7% (130/198) of the participants considered that there is currently no system of substitution. CONCLUSION For the participants, surgical training on a live porcine model allows technical progress while training for serious emergency situations. Surgeons and patients could benefit from this risk-free mock surgical scenario. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- T Prudhomme
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, 44093 Nantes, France; Centre de Recherche en Transplantation et Immunologie (CRTI), UMR1064, INSERM, Université de Nantes, Nantes, France; Department of Urology, Kidney Transplantation and Andrology, Toulouse University Hospital, Toulouse, France.
| | - X Matillon
- Department of Urology and Transplantation, Hospices civils de Lyon, Lyon, France
| | - F Dengu
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - E de Mazancourt
- Department of Urology and Transplantation, Hospices civils de Lyon, Lyon, France
| | - U Pinar
- Department of Urology, University Paris Saclay, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - B Gondran-Tellier
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - L Freton
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - M Vallée
- Department of Urology, Poitiers University Hospital, Poitiers, France
| | - I Dominique
- Department of Urology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - M Felber
- Department of Urology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Z-E Khene
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - E Fortier
- Department of Urology, Montpellier University Hospital, Montpellier, France
| | - F Lannes
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - C Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - T Grevez
- Department of Urology, Tours University Hospital, Tours, France
| | - N Szabla
- Department of Urology and Transplantation, Caen University Hospital, Caen, France
| | - F Bardet
- Department of Urology, Dijon University Hospital, Dijon, France
| | - K Kaulanjan
- Department of Urology, Pointe à Pitre University Hospital, Guadeloupe, France
| | - B Pradère
- Department of Urology, Tours University Hospital, Tours, France
| | - J-Y Deschamps
- Emergency and Critical Care Unit, ONIRIS, School of Veterinary Medecine, La Chantrerie, Nantes, France
| | - J Branchereau
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, 44093 Nantes, France; Centre de Recherche en Transplantation et Immunologie (CRTI), UMR1064, INSERM, Université de Nantes, Nantes, France; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
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Freton L, Khene ZE, Richard C, Mathieu R, Alimi Q, Duval E, Vassal L, Bertheuil N, Aillet S, Bonnet F, Ravel C, Guenego A, Travers D, Morel-Journel N, Hascoet J, Peyronnet B. [Self-assessment of healthcare workers regarding the management of trans people in a university hospital]. Prog Urol 2021; 31:1108-1114. [PMID: 34147357 DOI: 10.1016/j.purol.2021.03.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Trans people face more barriers when seeking healthcare than the cisgender population probably due to a lack of knowledge, education and comfort of healthcare workers. The purpose of this study was to assess the knowledge and comfort felt by healthcare professionals in managing trans people in a French university hospital. METHODS A self-questionnaire was emailed to healthcare professionals working in departments usually involved in the care of trans people in a French university hospital "not specialized" in medical and surgical gender transition. The questionnaire included demographic questions and Likert scales regarding their knowledge and comfort in taking care of trans people. Responses on the 7-point Likert scales were categorized into "low", "medium" and "high" groups, and responses on the 5-point Likert scales were categorized into "in favour", "neutral" and "against" groups. RESULTS One hundred and two (29%) healthcare professionals answered the questionnaire. Half worked in surgical departments (urology, plastic surgery, gynecology), 24% worked in medical departments (endocrinology, reproductive medicine, cytogenetics) and 26% worked in psychiatry. The majority (60.3%) rated their level of knowledge as "low" and 39.7% as "medium". Sixteen percent rated their level of comfort in managing trans people as "low", 72.5% as "medium" and 11.5% as "high". A majority (77.5%) were in favor of having the costs of gender transition care covered by the national health insurance system, 16.4% were neutral and 6% were against this idea. Feelings about surgical and hormonal gender transition were overwhelmingly (96.4%) in favour or neutral and 91% were willing to get more training and education to manage trans people. CONCLUSION The lack of comfort felt by healthcare professionals in university hospital in managing trans people seems to be related to a lack of knowledge and training in that field and not to a disagreement with the need of transgender healthcare. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- L Freton
- Université de Rennes, urologie, CHU Rennes, Rennes, France.
| | - Z-E Khene
- Université de Rennes, urologie, CHU Rennes, Rennes, France
| | - C Richard
- Université de Rennes, urologie, CHU Rennes, Rennes, France
| | - R Mathieu
- Université de Rennes, urologie, CHU Rennes, Rennes, France
| | - Q Alimi
- Université de Rennes, urologie, CHU Rennes, Rennes, France
| | - E Duval
- Réseau de Santé Trans, Rennes, France
| | - L Vassal
- Réseau de Santé Trans, Rennes, France
| | - N Bertheuil
- Université de Rennes, chirurgie plastique et reconstructrice, CHU Rennes, Rennes, France
| | - S Aillet
- Université de Rennes, chirurgie plastique et reconstructrice, CHU Rennes, Rennes, France
| | - F Bonnet
- Université de Rennes, endocrinologie, CHU Rennes, Rennes, France
| | - C Ravel
- Université de Rennes, laboratoire de biologie de la reproduction-CECOS, CHU Rennes, Rennes, France
| | - A Guenego
- Université de Rennes, endocrinologie, CHU Rennes, Rennes, France
| | - D Travers
- Université de Rennes, psychiatrie, CHU Rennes, Rennes, France
| | - N Morel-Journel
- Université de Lyon, urologie, Hospices Civils de Lyon, Lyon, France
| | - J Hascoet
- Université de Rennes, urologie, CHU Rennes, Rennes, France
| | - B Peyronnet
- Université de Rennes, urologie, CHU Rennes, Rennes, France
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Freton L, Richard C, Hascoet J, Khene ZE, Alimi Q, Graffeille V, Verhoest G, Mathieu R, Manunta A, Zhao L, Bensalah K, Peyronnet B. Robotic YV plasty for bladder neck contracture or vesico-urethral anastomosis stenosis in a French university hospital: Preliminary results. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00749-1] [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]
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Peyronnet B, Hascoet J, Auble A, Pinsard M, Freton L, Alimi Q, Bensalah K, Manunta A. How to successfully manage bladder neck injury during robotic artificial urinary sphincter implantation in women? Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01610-9] [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: 12/01/2022]
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Pinar U, Duquesne I, Lannes F, Bardet F, Kaulanjan K, Michiels C, Seizilles de Mazancourt E, Dominique I, Vallee M, Felber M, Freton L, Gondran-Tellier B, Matillon X, Khene ZE, Pradere B. The Use of Doppler Ultrasound for Suspected Testicular Torsion: Lessons Learned from a 15-Year Multicentre Retrospective Study of 2922 Patients. Eur Urol Focus 2021; 8:105-111. [PMID: 33663983 DOI: 10.1016/j.euf.2021.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/07/2021] [Accepted: 02/18/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Use of Doppler ultrasonography (DUS) for patients with suspected testicular torsion (TT) is highly controversial and remains debated, as it can delay surgery and its performance may vary. OBJECTIVE To assess the role, impact, safety, and performance of DUS in the management of patients with suspected TT before scrotal exploration. DESIGN, SETTING, AND PARTICIPANTS The TORSAFUF cohort retrospectively included patients older than 12 yr who underwent surgery for suspected TT in 14 academic hospitals between 2005 and 2019. Perioperative data and surgical and DUS reports were collected. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Clinical factors influencing DUS utilisation were analysed using multivariate logistic regression. The orchidectomy rate and delay to surgery were compared by group with and without DUS receipt using one-to-one propensity score (PS) matching to assess imaging safety. For the group with preoperative imaging, DUS performance was evaluated using a contingency table. RESULTS AND LIMITATIONS Overall, 2922 patients were included, of whom 956 (32.7%) underwent DUS before surgery. DUS was more likely to be performed in older patients (odds ratio [OR] 1.1, 95% confidence interval [CI] 1.1-1.2), those who experienced progressive onset of pain (OR 1.5, 95% CI 1.1-2), and patients who presented at the emergency department more than 6 h after their first scrotal symptoms (OR 2.3, 95% CI 1.9-2.8). After PS matching, DUS receipt was not significantly associated with orchidectomy but the delay to surgery was 1 h longer. DUS demonstrated strong sensitivity of 85.2% (95% CI 82.1-88.3%) and specificity of 52.7% (95% CI 48.8-56.6%). The performance was better for younger patients and for those with time since onset of pain of >6 h. CONCLUSIONS In this large retrospective study, DUS before surgery was safe, feasible, and useful in selected cases with suspected TT, but it should not delay or replace surgery in cases with a strong clinical suspicion. PATIENT SUMMARY We analysed the performance and safety of an ultrasound scan of the scrotum before surgery for patients with a suspected twisted testicle (TT). This scan before surgery was not associated with a higher risk of negative outcomes but was only moderate in accurately diagnosing TT. Surgery to correct TT should not be delayed.
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Affiliation(s)
- Ugo Pinar
- Department of Urology, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, AP-HP, Sorbonne Université, Paris, France.
| | - Igor Duquesne
- Department of Urology, Hôpital Cochin, AP-HP, Université de Paris, Paris France
| | - François Lannes
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - Florian Bardet
- Department of Urology, Dijon University Hospital, Dijon, France
| | - Kevin Kaulanjan
- Department of Urology, CHU Pointe à Pitre, Guadeloupe, France
| | - Clément Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | | | - Ines Dominique
- Department of Urology, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Maxime Vallee
- Department of Urology, Poitiers University Hospital, Poitiers, France
| | - Margaux Felber
- Department of Urology, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, AP-HP, Sorbonne Université, Paris, France
| | - Lucas Freton
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - Bastien Gondran-Tellier
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - Xavier Matillon
- Department of Urology and Transplantation, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Zine-Edine Khene
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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Mauger de Varennes A, Khene Z, Pradere B, Lannes F, Freton L, Dang V, Berchiche W, Ortier E, Michiels C, Margue G, Gaillard C, Ali Benali N, Bardet F, Hulin M, Gaillard V, Manuguerra A, Pinar U, Duquesne I, Felber M, Plassais C. Marqueurs biologiques préopératoires prédictifs de la viabilité testiculaire suite à une torsion du cordon spermatique. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Freton L, Alimi Q, Zhao L, Haudebert C, Bourre T, Mermier M, Laine-Caroff P, Hascoet J, Mathieu R, Manunta A, Bensalah K, Peyronnet B. Plastie yv robotique et lambeau peritonéal pour sténose d’anastomose vésico-urétrale après prostatectomie radicale et radiothérapie. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.030] [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]
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Richard C, Hascoet J, Mazouin C, Freton L, Tondut L, Dosin G, Manunta A, Khene Z, Mathieu R, Verhoest G, Bensalah K, Peyronnet B. Explantation d’une prothèse de promontofixation par voie transvésicale et exérèse des bras d’une bandelette tvt laparoscopique robot-assistée. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.041] [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]
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Freton L, Hascoet J, Khene Z, Alimi Q, Mazouin C, Graffeille V, Verhoest G, Mathieu R, Manunta A, Zhao L, Bensalah K, Peyronnet B. Plastie yv et plastie postérieur robotique pour sclérose de col vésical post-pvp. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.029] [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]
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Freton L, Khene Z, Hascoet J, Alimi Q, Verhoest G, Mathieu R, Manunta A, Duval E, Vassal L, Berteuil N, Ravel C, Guénégo A, Bensalah K, Peyronnet B. Auto-évaluation de professionnels de santé concernant la prise en charge des patient.e.s transgenres. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Richard C, Hascoet J, Mazouin C, Freton L, Dosin G, Buisset J, Graffeille V, Manunta A, Khene Z, Mathieu R, Verhoest G, Bensalah K, Peyronnet B. Cure de fistule vésico-vaginale par voie vaginale avec interposition d’un lambeau de martius en position du jockey. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.018] [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]
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Dosin G, Mazouin C, Manunta A, Hascoet J, Bensalah K, Verhoest G, Freton L, Mathieu R, Graffeille V, Khene Z, Voiry C, Samson E, Haudebert C, Pradere B, Peyronnet B. Cystectomie et dérivation cutanée non continente par conduit iléal robotique intracorporelle pour vessie neurologique. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.022] [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]
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Peyronnet B, Manunta A, Buisser J, Richard C, Dosin G, Alimi Q, Freton L, Mathieu R, Verhoest G, Bensalah K, Hascoet J. Implantation robot-assistée d’un sphincter artificiel urinaire ams 800 chez les patientes neurologique après entérocystoplastie d’agrandissement et cystostomie continente. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dosin G, Hascoet J, Mazouin C, Freton L, Zineddine K, Voiry C, Samson E, Richard C, Haudebert C, Bensalah K, Verhoest G, Mathieu R, Courboin E, Manunta A, Peyronnet B. Réfection chirurgicale robot assistée des anastomoses urétéro-iléale pour sténose urétérale distale après chirurgie de cystectomie bricker chez le patient neurologique. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Richard C, Voiry C, Freton L, Kerdraon J, Hascoet J, Brochard C, Bonan I, Jezequel M, Siproudhis L, Manunta A, Peyronnet B. Sexual dysfunction in adult women with spina bifida. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33673-9] [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: 11/30/2022] Open
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Peyronnet B, Hascoet J, Freton L, Khene Z, Graffeille V, Alimi Q, El-Akri M, Richard C, Kerdraon J, Voiry C, Bensalah K, Verhoest G, Manunta A. Cystectomy and ileal conduit for neurogenic bladder: Comparison of the open, laparoscopic and robot-assisted approaches. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33038-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: 11/25/2022] Open
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Chebbi A, Peyronnet B, Giwerc A, Freton L, Hutin M, Olivier J, Langouet Q, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayatopoulos P, Betari R, Matillon X, Caes T, Patard PM, Szabla N, Brichart N, Boehm A, Sabourin L, Guleryuz K, Dariane C, Lebacle C, Rizk J, Gryn A, Madec FX, Rod X, Fiard G, Pradere B, Pfister C, Nouhaud FX. Observation vs. early drainage for grade IV blunt renal trauma: a multicenter study. World J Urol 2020; 39:963-969. [PMID: 32447442 DOI: 10.1007/s00345-020-03255-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 03/22/2020] [Accepted: 05/11/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The aim of this study was to compare observation and early drainage by ureteral stenting in patients with blunt renal trauma and urinary extravasation. MATERIALS AND METHODS A retrospective national multicenter study was performed including all patients admitted for renal trauma at 17 hospitals between 2005 and 2015. Patients presenting with a urinary extravasation on initial imaging were considered for inclusion. Patients were divided in two groups according to the initial approach: observation vs. early drainage by ureteral stent (within 48 h after admission). The primary endpoint was the persistence of urinary extravasation on follow-up imaging. RESULTS Out of 1799 patients with renal trauma, 238 were included in the analysis (57 in the early drainage and 181 in the observation group). In the early drainage group, 29 patients had persistent urinary extravasation vs. 77 in the observation group (50.9% vs. 42.5%; p value = 0.27). The rates of secondary upper urinary tract drainage did not differ significantly between the early drainage group (26.4%) and the observation group (16%) (p = 0.14). There were no statistically significant differences between the two groups in terms of secondary nephrectomy (0% vs. 2.8%; p = 0.34), and death from trauma (0% vs. 1.8%; p = 0.99). In multivariate analysis, early drainage remained not statistically associated with persistence of urinary extravasation on follow-up imaging (OR = 1.35; p = 0.36) CONCLUSION: In this multicenter cohort, observation was not different from early drainage in terms of persistent urinary extravasation after grade IV blunt renal trauma. Further randomized controlled prospective trials are needed to confirm these findings.
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Affiliation(s)
- Ala Chebbi
- Urology, University of Rouen, Rouen, France.
- Service d'urologie, Hopital Charles Nicolle, 37 boulevard Gambetta, 76000, Rouen, France.
| | | | | | | | - Marine Hutin
- Urology, University of Montpellier, Montpellier, France
| | | | | | - Marina Ruggiero
- Urology, University of Paris Sud, CHU Bicetre, Paris, France
| | | | | | | | | | - Reem Betari
- Urology, University of Amiens, Amiens, France
| | | | | | | | | | | | | | - Laura Sabourin
- Urology, University of Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | - Cédric Lebacle
- Urology, University of Paris Sud, CHU Bicetre, Paris, France
| | | | | | | | - Xavier Rod
- Urology, University of Nantes, Nantes, France
| | - Gaelle Fiard
- Urology, University of Grenoble, Grenoble, France
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Freton L, Peyronnet B, Greenwell T, Morel-Journel N, Brucker BM, Zhao LC. Urethral stricture management in male candidates to artificial urinary sphincter: Is the best always the enemy of the good? Prog Urol 2020; 30:301-303. [PMID: 32376212 DOI: 10.1016/j.purol.2020.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Affiliation(s)
- L Freton
- Department of urology, university of Rennes, Rennes, France.
| | - B Peyronnet
- Department of urology, university of Rennes, Rennes, France
| | - T Greenwell
- Department of urology, university College London hospital, London, UK
| | | | - B M Brucker
- Department of urology, New York university, New York, USA
| | - L C Zhao
- Department of urology, New York university, New York, USA
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Abdessater M, Rouprêt M, Misrai V, Matillon X, Gondran-Tellier B, Freton L, Vallée M, Dominique I, Felber M, Khene ZE, Fortier E, Lannes F, Michiels C, Grevez T, Szabla N, Boustany J, Bardet F, Kaulanjan K, Seizilles de Mazancourt E, Ploussard G, Pinar U, Pradere B. COVID19 pandemic impacts on anxiety of French urologist in training: Outcomes from a national survey. Prog Urol 2020; 30:448-455. [PMID: 32376208 PMCID: PMC7177119 DOI: 10.1016/j.purol.2020.04.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The COVID-19 outbreak in France is disturbing our health system. Urologists in training who are already known to have burnout, are in the front line to face this disease. The aim of our study was to assess the psychological impact of COVID-19 pandemic on young French urologists in training. MATERIAL AND METHODS A self-administered anonymous questionnaire evaluating the pandemic added stress, and its negative impact on work and training quality, was e-mailed to the members of the French Association of Urologists in Training (AFUF). The association includes all French junior and senior residents. The survey lasted 3 days. Multivariable analyses using logistic regression was performed to identify the predictive factors. RESULTS Two hundred and seventy-five (55.5%) of the 495 AFUF members responded to the questionnaire. More than 90% of responders felt more stressed by the pandemic. Fellows and senior residents were more likely to feel that the crisis had an important impact on their work quality (OR=1.76, IC95=[1.01-3.13]), even more when COVID 19 patients were present in their department (OR=2.31, IC95=[1.20-4.65]). Past medical history of respiratory disease (OR=2.57, IC95=[1.31-5.98]) and taking in charge COVID19 patients (OR=1.85, IC95=[0.98-3.59]) were additional risk factors. CONCLUSION COVID19 pandemic has a negative impact on young French urologists in training and on their work and training quality. Managing their psychosocial well-being during this time is as important as managing their physical health. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- M Abdessater
- Sorbonne Université, GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, 75013 Paris, France
| | - M Rouprêt
- Sorbonne Université, GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, 75013 Paris, France.
| | - V Misrai
- Clinique Pasteur, 31300 Toulouse, France
| | - X Matillon
- Department of Urology and Transplantation, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - B Gondran-Tellier
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - L Freton
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - M Vallée
- Department of Urology, Poitiers University Hospital, Poitiers, France
| | - I Dominique
- Department of Urology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - M Felber
- Sorbonne Université, GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, 75013 Paris, France
| | - Z-E Khene
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - E Fortier
- Department of Urology, Montpellier University Hospital, Montpellier, France
| | - F Lannes
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - C Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - T Grevez
- Department of Urology, CHRU Tours, Francois Rabelais University, Tours, France
| | - N Szabla
- Department of Urology and Transplantation, Caen University Hospital, Caen, France
| | - J Boustany
- Department of Urology and Renal Transplantation, Henri Mondor University Hospital, Créteil, France
| | - F Bardet
- Department of Urology, Dijon University Hospital, Dijon, France
| | - K Kaulanjan
- Department of Urology, CHU Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe
| | - E Seizilles de Mazancourt
- Department of Urology and Transplantation, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - G Ploussard
- Department of Urology, Ramsay Santé, Clinique La Croix du Sud, Quint Fonsegrives, France
| | - U Pinar
- Sorbonne Université, GRC n(o) 5, Predictive onco-urology, AP-HP, Hôpital Pitié-Salpêtrière, Urology, 75013 Paris, France
| | - B Pradere
- Department of Urology, CHRU Tours, Francois Rabelais University, Tours, France; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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Khene Z, Peyronnet B, Freton L, Graffeille V, Pradere B, Robert C, Kammerer-Jacquet SF, Verhoest G, Rioux-Leclercq N, Shariat S, Mathieu R, Bensalah K. What Is Better for Predicting Morbidity of Robotic Partial Nephrectomy—A Score or Your Clinical Judgement? Eur Urol Focus 2020; 6:313-319. [DOI: 10.1016/j.euf.2018.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/08/2018] [Accepted: 10/31/2018] [Indexed: 01/20/2023]
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Freton L, Pradere B, Fiard G, Chebbi A, Caes T, Hutin M, Olivier J, Ruggiero M, Dominique I, Millet C, Bergerat S, Panayatopoulos P, Betari R, Patard PM, Szabla N, Brichart N, Sabourin L, Guleryuz K, Dariane C, Lebacle C, Rizk J, Gryn A, Madec FX, Rod X, Nouhaud FX, Matillon X, Peyronnet B. [Renal Trauma]. Prog Urol 2019; 29:936-942. [PMID: 31668829 DOI: 10.1016/j.purol.2019.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 09/25/2019] [Accepted: 09/28/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Renal traumas are common, observed in 10% of patients with abdominal trauma. Most renal traumas are blunt, resulting from a direct hit or from an abrupt deceleration. MATERIAL AND METHODS We realized a synthesis of renal trauma management for nurses. RESULTS Clinical presentation often encompasses gross hematuria and lumbar pain. The best diagnostic tool is computed tomography (CT) urogram. Based on CT urogram images, renal traumas are classified according to the American Association for the Surgery of Trauma (AAST) classification in five grades of increasing severity. The management is conservative in the vast majority of cases and has been largely simplified over the past few years, being now mostly based on observation. Radiological interventional and endoscopic procedures are used only in very selected cases and surgical exploration has become extremely rare. CONCLUSION The prognosis has also considerably improved and renal trauma rarely result in death or loss of the kidney nowadays.
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Affiliation(s)
- L Freton
- Service d'urologie, université de Rennes, 35000 Rennes, France.
| | - B Pradere
- Service d'urologie, PRES Centre Val-de-Loire, CHRU de Tours et université François-Rabelais de Tours, 37000 Tours, France
| | - G Fiard
- Service d'urologie, université de Grenoble, 38700 Grenoble, France
| | - A Chebbi
- Service d'urologie, université de Rouen, 76000 Rouen, France
| | - T Caes
- Service d'urologie, université de Lille, 59000 Lille, France
| | - M Hutin
- Service d'urologie, université de Montpellier, 34000 Montpellier, France
| | - J Olivier
- Service d'urologie, université de Lille, 59000 Lille, France
| | - M Ruggiero
- Service d'urologie, université de Paris Sud, CHU de Bicêtre, 94270 Paris, France
| | - I Dominique
- Service d'urologie, université de Lyon, 69002 Lyon, France
| | - C Millet
- Service d'urologie, université de Clermont-Ferrand, 63100 Clermont-Ferrand, France
| | - S Bergerat
- Service d'urologie, université de Strasbourg, 67000 Strasbourg, France
| | | | - R Betari
- Service d'urologie, université de Brest, 29200 Brest, France
| | - P-M Patard
- Service d'urologie, université de Toulouse, 31300 Toulouse, France
| | - N Szabla
- Service d'urologie, université de Caen, 14033 Caen, France
| | - N Brichart
- Service d'urologie, CHR d'Orléans, 45100 Orléans, France
| | - L Sabourin
- Service d'urologie, université de Clermont-Ferrand, 63100 Clermont-Ferrand, France
| | - K Guleryuz
- Service d'urologie, université de Caen, 14033 Caen, France
| | - C Dariane
- Service d'urologie, université de Paris-Descartes, 75006 Paris, France
| | - C Lebacle
- Service d'urologie, université de Paris Sud, CHU de Bicêtre, 94270 Paris, France
| | - J Rizk
- Service d'urologie, université de Lille, 59000 Lille, France
| | - A Gryn
- Service d'urologie, université de Toulouse, 31300 Toulouse, France
| | - F-X Madec
- Service d'urologie, hôpital Saint-Joseph, 75014 Paris, France
| | - X Rod
- Service d'urologie, université de Nantes, 44000 Nantes, France
| | - F-X Nouhaud
- Service d'urologie, université de Rouen, 76000 Rouen, France
| | - X Matillon
- Service d'urologie, université de Lyon, 69002 Lyon, France
| | - B Peyronnet
- Service d'urologie, université de Rennes, 35000 Rennes, France
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