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Biomedical subjects

B Mauroy

Publications and source records attributed to B Mauroy.

29 records · Page 2Linked to original sources
PubMed1997

Study of the effects of thermotherapy in benign prostatic hypertrophy.

UNLABELLED: Prostatic transurethral thermotherapy was evaluated clinically using the Prostcare microwave system of the Bruker Company, which uses a microwave radiometer to measure and control intraprostatic temperature. OBJECTIVES: The aim of our study was to evaluate the immediate histological lesions induced in the prostatic tissue depending on the temperatures delivered to the prostate; the histological changes when adenectomy is carried out after thermotherapy, and the endoscopic appearance of the prostatic fossa 48 h, and 1, 2, 3 and 6 months after thermotherapy. METHODS: Our study was divided into three stages: in the first stage, we conducted thermotherapy in 10 patients in whom suprapubic adenectomy was indicated. During thermotherapy, a multipoint fiber-optic receptor and two thermocouples were implanted into the prostage gland at a distance of 5-15 mm from the urethra. Adenectomy was carried out 10 min after thermotherapy; the second stage of our study concerned the changes seen over time. We heated adenomas using the same protocol and carried out adenectomy 24, 48, 72 h, and 1 week, 6 weeks and 3 months after thermotherapy, and lastly, we studied the endoscopic appearance after a single heating-session of 30 min by endoscopic controls at different times after thermotherapy (48 h, 1, 2, 3 and 6 months after thermotherapy). RESULTS: Macroscopic appearance: necrotic lesions measured 30 mm in length on average. Necrosis was roughly circumferential. Immediate histological aspect: in all cases, histological examination showed coagulation necrosis with periurethral thromboses. Histological changes: at 8 days, necrosis intensity was maximal and histological structures were difficult to identify. Endoscopic appearance: 3 months after thermotherapy, the typical endoscopic appearance was a large periurethral cavity. There was a sharp demarcation between untreated areas and cicatricial tissue. CONCLUSION: The efficacy of thermotherapy depends on the radiometric temperature, which should reach 47 degrees C (i.e. a temperature of 55-65 degrees C delivered to the prostate), and a rapid increase in temperature, i.e. in the power applied, which should reach the thermal radiometric level of 47 degrees C in 5 min. As soon as necrosis is obtained, the power is automatically reduced. Using this protocol, heating proves effective in 30 min.

Humans↗
PubMed1997

[Rehabilitation of female urinary incontinence. Techniques and indications].

Female uro-gynaecological retraining was initially confined to prophylactic management during the post-partum period. It has gradually been extended to other diseases, either alone or as a complement to medical or surgical treatment. The results of clinical examination and complementary investigations, especially urodynamic studies, now allow the application of increasingly precise retraining techniques. This progress essentially concerns the three types of technique most frequently used: Manual retraining concerns the bulbospongiosus muscles, as well as the levator ani muscles. Biofeedback is increasingly used to qualitatively improve muscle contraction. Electrostimulation can promote the action of various groups of tonic or phasic muscle fibres. Apart from these endocavitary techniques, retraining is also evolving towards a global management of the abdominopelvic sphere., where it is indicated in the management of the post-partum period and various gynaecological and urinary diseases. However, concomitant diseases such as perineo-abdominodiaphragmatic imbalance, an anorectal problem, a sexual problem or finally painful symptoms, must also be taken into account in some cases. Retraining must be very precisely prescribed, confirming application of all of these techniques and adapting them to the national health refund classification. The number of sessions varies according to the disease, but rarely exceeds 30 sessions in the initial prescription. On the other hand, like any muscle system, the pelvic floor must be maintained by means of several sessions per year. The success of this retraining treatment essentially depends on several factors: the quality of the therapist, his training, his spirit of integration in a multidisciplinary team, but also the patient's motivation.

Adult↗
PubMed1997

[Anatomical mechanisms of continence in man].

According to classical concepts, the role of the bladder sphincteric apparatus is to contain without weakness and to expel without effort. Continence without dysuria is the result of: biomechanical properties of the bladder wall which confer: viscoelasticity accounting for its compliance, contractility allowing expulsion of its contents. The action of bladder neck structures and passive urethral mechanisms which, under normal conditions, are practically sufficient to ensure passive continence. Muscle fibre tone collapses the urethra during the continence phase and closes the bladder neck by creating vesicourethral angulation. The arrangement of these muscle fibres in the bladder neck and urethra accounts for the sphincter function over the entire length of these two structures. The external sphincter composed of striated muscle fibres derived from perineal muscles, which are amenable to retraining. The main role of the sphincter under normal conditions is to oppose an unwanted bladder contraction or to rapidly interrupt ongoing micturition and it only has a relatively limited role in passive continence. It is particularly important after prostatic surgery, either for benign prostatic hyperplasia or for cancer, when the striated sphincter remains the only structure able to oppose the pressure forces which tend to expel urine from the bladder.

Biomechanical Phenomena↗
PubMed1994

[Epididymal leiomyosarcoma. A case report with review of the literature].

The authors report the 14th case of leiomyosarcoma of the epididymis in a 67-year-old man. Treatment consisted of radical left orchidectomy without adjuvant chemotherapy or radiotherapy. The patient is free of local or distant recurrence with a follow-up of 2 years. The other 13 cases reported in the literature are briefly reviewed.

Aged↗
PubMed1992

[Ureteral risk in celioscopic surgery].

In recent years, there has been a significant improvement in laparoscopic surgery which had led to more and more frequent use of this technic in various cases. As a consequence, the ureteral injury which have been a less common iatrogenic pathologic up to know is likely to be more and more frequent in the years to come. The authors present 2 cases of 28 and 36 years old patients. In both cases the laparoscopy was indicated for gynecologic pathology. The healing ureteral occurred in those cases during a revealing postoperative peritonitis. Treatment consisted in healing up the lesion by ureteral stent. Treatment and evolution of this injury are discussed.

Adult↗
PubMed1992

[Partial cystectomy: and alternative to radical cystectomy? Apropos of a series of 75 patients].

From a retrospective series of 75 patients, we try to determine the place of this treatment with respect to bladder urothelial cancer. Of our 75 patients the breakdown of tumours according to their stage is the following: PTA: 16 (21.3%) PT1: 12 (16%) PT2: 21 (28%) PT3 A: 15 (20%) PT3 B: 7 (9.3%) PT4: 4 (5.4%) 47 patients benefited from a complete check up of tumoural spread which is negative in any case. In 28 cases, an uretero-vesical reimplantation was necessary for carcinologic reasons. None of the patients benefited from chemotherapy and/or radiotherapy in pre or post-operative period. Mortality was 4% (3 cases) and morbidity 8% (6 cases)- Sixty two Patients were followed-up at 5 years. The results are expressed according to different carcinologic parameters. The overall rate of recurrence is 61.2% (38/62). The actuarial survival corrected at 5 years, all stages and grades included, is 53.2% (32/62). There was no recurrence in 18 patients (29%) and 29 patients preserved their bladder. The advantages of partial cystectomy are obvious: Its mortality and morbidity are weak. It also preserves the sexual function and mainly avoids resorting to urinary derivations. As a principle these indications apply to a small percentage of invasive tumours T2-T3 A located in the mobile part of the bladder that is unifocal and of small size (< 4 cms).

Actuarial Analysis↗
PubMed1990

The supernumerary muscles of the leg: a report of two cases.

Two cases of supernumerary muscles of the leg reported, which were both inserted on the sides of the calcaneus. The accessory soleus m., adductor of the fore-foot, is a variation of the triceps surae which through hypertrophy on the medial side of the leg can become particularly problematic in athletes. The fourth peroneal m. abductor of the fore-foot, is considered to increase the stability of the ankle and is asymptomatic.

Adult↗
PubMed1986

[Computerized tomography in evaluating the extension of bladder tumors. 215 cases].

CT scan imaging was used to explore 215 cases of bladder tumor (48 A-B1, 55 B2, 85 C, 27 D), and findings compared with those at operation and on histopathology of specimens after total cystectomy (141 cases), partial cystectomy (13 cases) or endoscopic resection (61 cases). The radiologic technique used was that of natural contrast, evaluating the negative contrast of intravesical urine in relation to the normal or pathologic bladder wall. Analysis of scan sections, assisted by a previous pathologic and radiologic study of 14 transverse sections of pelvis, allowed definition of a certain number of semiologic criteria corresponding to the various stages of the disease. Results showed global reliability to be relatively satisfactory for assessment of local and regional extension (85%): it was obviously a more effective investigation for tumors of low invasion (A-B1: 75%, B2: 81%) than for widely infiltrating tumors (C: 94%, D: 93%). Glandular extension was less reliably evaluated, however, since global efficacy was only 65%. Failures observed can be explained by the frequent small size of the metastatic glands, the poorness in cellular and fatty tissues and, particularly, by the fact that the scanner provides data of size of glands only and not on their internal architecture. The place of the scanner among other paraclinical methods of evaluating tumoral extension has still to be determined.

Humans↗
PubMedDate not supplied

[Treatment of bladder instability with interferential current. Report of 20 cases: preliminary results].

20 patients with unstable bladder unresponsive to medical treatment by anticholinergics were treated by interferential current retraining stimulations. This technique combines the advantages of retraining stimulation with external application. Each patient received 6 to 20 stimulation sessions at a rate of one per week in children and two per week in adults. 18 patients were clinically and urodynamically improved with resolution of incontinence and the follow up urodynamic assessment showed return of normal bladder volume and tone. No adverse effects were observed. No recurrences of the symptoms were observed with a mean follow-up of 18 months. The authors believe that this reliable technique constitutes an alternative to other retraining stimulation methods.

Aged↗
PubMedDate not supplied

[Urinary infections in pregnant women].

Urinary tract infection is frequent during pregnancy with a high potential risk for mother and child. Based on a review of the literature and a retrospective survey conducted in 20 representative French university hospitals during 1993, the authors propose a practical review designed to standardize the therapeutic approach to this disease. They define a high-risk group which requires systematic screening and close surveillance during pregnancy. They evaluate the need for complementary investigations in relation to the 3 clinical presentations encountered (asymptomatic bacteriuria, cystitis and acute pyelonephritis) taking into account their respective adverse effects. The therapeutic modalities of the three clinical forms are then described, including drainage of the urinary tract.

Acute Disease↗