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C Viville

Publications and source records attributed to C Viville.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Congenital megaureter (MU) in the adult. A series of 55 patients presenting 64 megaureters].

Analysis of series of 64 instances of MU in 55 patients leads the authors to the following conclusions: --MU is fairly rare in adults since it is usually discovered at an earlier age; --adult MU shows little activity, even when it is complicated by lithiasis; --renal involvement frequently bears no strict relationship to the magnitude of the MU and is not always obviously improved by surgery; --surgical treatment of MU (anti-reflux ureterovesical reimplantation, with or without ureteral modelling) gives reliable results (14 successes, 2 failures, and 1 patient lost to follow up), comparable to those obtained in children); --the main operating indications consist of: infection, associated urinary, youth, and the possibility of pregnancy; --the problem of associated lithiasis must be dealt with before or during surgical treatment of MU, never after, because of the risk of postoperative lithic migration. Treatment of associated lithiasis has been appreciably simplified by endoscopic methods, and particularly by extracorporeal litholapaxy.

Adult↗
PubMed1989

[Percutaneous placement of a double-J endoprosthesis using a descending approach in malignant pelvic tumor threatening the permeability of the upper urinary tract. Apropos of 10 patients].

The percutaneous route should be used for ureteral endoprosthesis placement, whenever ascending retrograde passage is not accessible. The authors review the experience gained from attending 10 patients with advance-stage pelvic malignancies and describe the technique used. Emphasis is placed on care needed when selecting the proper route of entry, as well as on advantages presented by J x 2 large gauge probes developed from new biocompatible polymers. This surgical technique may, some times, ensure comfortable survival in selected, premedicated patients under local anesthesia, in whom it is well-tolerated, and yields low complication rates.

Adult↗
PubMed1989

[Transposition of a lower pole kidney pedicle to the anterior side of the pelvis in the treatment of certain types of hydronephrosis].

Reviewing 8 cases, the author describes the technique and gives the results from surgical treatment of certain types of hydronephrosis involving a transposition of the lower pole vascular pedicle into the anterior side of the pelvis, preventing thus the former from compressing the pyeloureteral junction. The author underlines the difficulty residing in the proper selection of the surgical indications. Success depends upon the quality of such indications. This method characteristically combines simplicity and reliability.

Adolescent↗
PubMed1988

[Value of the continuous guide in endoscopic operations on the upper urinary tract].

Endoscopic operations on the upper urinary tract, whether they are performed from below upwards from the bladder or from above downwards from the kidney, are faced by a common difficulty: the risk of a false passage. This has led to the idea of using a flexible metal guide, as in vascular radiology. However, such a non-tense guide is not really a guide, as nothing prevents it from twisting around the end of the instrument which it is intended to guide, resulting in false passages. In contrast, a guide which is brought out through the urethral meatus and at the lumbar fossa can be placed under tension, preventing any deviation of the instrument or its covering catheter. The continuous guide is essentially used in three situations: 1. percutaneous nephrolithotomy: when a second phase is not excluded, the continuous guide will make it much easier; 2. descending ureteroscopy; 3. ascending ureteroscopy.

Endoscopes↗
PubMed1988

[Endoscopic and percutaneous treatment of purulent retention caused by obstructive calculi of the upper urinary tract. Observations apropos of 6 case reports].

On the basis of 6 cases of pyonephrosis due to renal stones successfully treated without surgery over a period of one year, the authors define their current therapeutic approach which consists of 2 phases: --1st phase: salvage of the kidney by ultrasound guided percutaneous nephrostomy under local anaesthesia. No hasty endoscopic procedures in an attempt to insert a ureteric catheter into the kidney; --2nd phase: elimination of the obstructing stone (on average, 8 days after the 1st phase), by percutaneous nephrolithotomy, descending ureteroscopy or ascending ureteroscopy.

Adult↗
PubMed1988

[Antegrade endoscopic treatment of calculi of the ureter].

The author has treated 29 ureteric stones, situated in the lumbar ureter in 27 cases, via an antegrade endoscopic approach. On only one occasion, at the beginning of the series, the attempt failed due to loss of the nephrostomy tract. Another attempt failed in a case of an unusually hard stone in the pelvic segment of a congenital megaureter. In 18 out of 29 cases (62%), the stone was pushed back into the renal cavities and was extracted by percutaneous nephrotomy, in the absence of extracorporeal lithotripsy. The other 11 cases were treated by in situ lithotripsy (10 cases) or by Dormia basket extraction (1 case). Apart from the complete failures indicated above, there was also on partial failure following electric in situ lithotripsy in the iliac ureter. 26/29 cases were treated with complete success. There were no immediate complications and no cases of secondary stenosis. After a comparative analysis of the published series, the author concludes on the superiority of antegrade endoscopic treatment of lumbar ureteric stones over retrograde treatment by ascending ureteroscopy.

Adult↗
PubMed1988

[Treatment of staghorn calculi by percutaneous nephrolithotomy. Apropos of 18 cases].

This series involves 19 kidneys treated by the same operator. The predominance of women (14/18) and of proteus urinary infection (11) was identical to other published series. 13/19 calculi with complete staghorn calculi occupying the renal pelvis and the 3 calyceal groups. 7 patients had a past history of 15 lombotomies for staghorn calculus. PCLN was carried out under fluoroscopic visualisation only, in 13 cases with one single channel, in 4 cases with two channels and in 3 cases with three channels. One operative phase was sufficient in 9 kidneys, two in another 9, whilst one kidney required 3. The mean duration of irradiation was 20 minutes (as against 12 minutes for the entire series of 135 CNL of the same operator). The post-operative course was uneventful apart from late hematuria which required no particular surgical management. 14/19 kidneys (73.6%) were totally cleared of their calculi. For the other 5 kidneys, two were treated by extracorporeal lithotripsy, with one success, two were lost to follow-up, including one after refusal of a third PCNL, and one will shortly be retreated by PCNL. After analysis of the literature compared with his own experience, the author considers that approximately 90% of staghorn calculi (large portion in pelvis, small calyceal portions, wide calyceal branches) can be treated by PCNL alone or completed by ECL and that some 10% of staghorn calculi (small pelvis portion, large extensively branched calyceal portions, narrow calyceal branches) still require traditional surgery.

Adult↗
PubMed1987

[Extension to the upper urinary tract of excreto-urinary carcinoma of the bladder. Apropos of 6 cases].

Of a total of 261 patients with carcinoma of bladder, 6 (2.3%) presented secondary lesions in upper urinary tract 3 to 13 years after initial diagnosis, including one only after total cysto-prostatectomy. These 6 patients represent 12 renal units, including 5 with iatrogenic reflux, and all had secondary urethral localizations. Urine cytology was particularly reliable since results were positive after treatment of bladder lesion and before detection of upper urinary tract foci. The latter developed whatever the stage or grade of the bladder tumor, from carcinoma in situ, through grade I stage O (3 cases), to undifferentiated and infiltrating tumor. Treatment included surgical excision, endoscopic resection including upper urinary tract (2 cases) and radio-chemo and immuno-therapy (BCG). Results were only fair with 2 deaths and 4 survivors, all with recurrence, although one has not had surgery and is in comfort without dialysis after 18 years. Two hypotheses have been invoked for the origin of these secondary upper tract tumoral localizations: grafting of tumoral cells propulsed upwards by vesicorenal reflux, almost always iatrogenic and a mysterious carcinogenic factor in urine responsible for the multicentric origin of lesions. Both are probable in part, the former appearing well established statistically. These widespread lesions require the application of all urologic resources but treatment is deceiving: since no test exists to determine evolutive potential with accuracy, treatment of bladder cancer lies between the risk of doing too much or too little.

Adult↗
PubMed1987

[Treatment of a vesicorectal fistula associated with a neurogenic bladder].

In the case reported a large vesicorectal fistula associated with a neurogenic bladder was closed using an original surgical approach, involving the use of Kraske's approach which allows the rectum to be opened posteriorly while avoiding sphincter structures. This is the fundamental difference that distinguishes it from York-Masson's approach which cuts the anal sphincter. Even though it is indicated only exceptionally, this new approach is therefore one that should be known.

Adult↗
PubMed1987

[Continent transureteral vesicostomy].

The method consists of sectioning pelvic ureter as it crosses the iliac vessels. The proximal ureteric segment is anastomosed to the contralateral ureter. The distal segment is brought out onto the skin in the supra-pubic region. The patient catheterises himself via this stoma. The second phase of the operation consists of suppressing the urine flow by section-suture of the bladder neck proximally and of the urethra distally. Augmentation enterocystoplasty is almost always essential. Provided the patient is cooperative, this technique can ensure: perfect continence without the need for any form of appliance, complete bladder emptying and decompression of the upper urinary tract.

Adolescent↗
PubMed1987

[Intrinsic endometriosis of the ureter].

Two cases of ureteral endometriosis are reported and the literature is reviewed with special emphasis on symptoms and therapy. New diagnostic methods such as computer assisted tomography, ultra-sonography and urinary cytology are discussed and evaluated. Intrinsic ureteral endometriosis should be treated with local resection, and reimplantation with the psoas-hitch technique. The need for post-operative hormonal management must be adapted to each case.

Adult↗
PubMed1987

[Percutaneous nephrolithotomy. Personal experience in 100 cases].

100 reno-ureteric calculi have been treated by the same operator between April 1984 and November 1986 by means of PCNL. 78 of them were greater than 1 cm in diameter, 15 were ureteric and 13 were staghorn calculi. 31 patients had already undergone at least one lumbotomy on the same side. The operation was always performed under general anaesthesia and fluoroscopic control and in 2 stages for the first 20 patients. The mean duration of irradiation was 13 minutes. Total success was obtained in 71 cases (including 10 of the 13 staghorn calculi). 18 cases presented with residual stone debris, equal to or less than 3 mm in diameter in 8 cases. Complete failure was observed in 11 cases and the stone had to be removed surgically (4 cases) or by repeat PCNL (2 cases) or by ECL (5 cases). 9 complications were inconsequential in 8 cases and never required a surgical operation, but 1 severe infection was almost fatal. There were no cases of nephrectomy or loss of renal function. The mean duration of hospital stay was 7 days. 31 patients were lost to follow-up, including 26 without stones. The other 69 patients have been followed for 3 months to 2 years. 5 of the 45 patients discharged from hospital without stones returned with a recurrence. Of the 24 patients with a residual stone fragment (less than 3 mm in diameter in 8 cases), only 2 have eliminated it spontaneously and in 2 other patients the residual fragment has increased in size.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Value of urinary cytology in the detection and surveillance of tumors of the urinary tract].

Analysis of 600 case-reports of urine cytology (micturitional samples in 597 cases and pyelo-ureteral brushings in 3) was in relation to 137 patients with carcinoma of urinary excretory pathways and 463 with various lesions representing the full range of urinary tract disease. Two conclusions can be drawn. First, urine cytology is a very effective means of surveillance of patients treated for carcinoma of urinary tract excretory pathways: until results are regularly negative the prognosis must be reserved whatever is found on cystoscopy or even in frozen biopsy specimens. Second, cytology is not valid for routine screening of these tumors: no case was detected on its results alone and false positives were numerous. The principal use for urine cytology is still the regular, prolonged surveillance of patients treated for bladder tumor.

Adolescent↗
PubMed1986

[Persistent urinary infection in children after antireflux ureterovesical reimplantation in primary vesicorenal reflux].

This study is the outcome of the analysis of 200 cases and concentrates solely on successful antireflux operations (i.e. with neither stenosis nor persistent reflux) performed on primary refluxes, 54 children, all of them being females, have retained refractory postoperative urinary infections. Of these cases, 24 cases (12%) have not been cured yet. In these postoperative infections, some factors play probably no part: the magnitude of the preoperative reflux, the existence of pyelonephritic lesions, the type of germ. However the fact of being female, the age (over 6), the duration of the preoperative infection and, above all, the existence of predominantly vesical symptomatology (frequency, voiding pain, and continence problems such as imperiousness, diurnal incontinence, enuresis) are basic factors. This makes it possible to compose the model of the child that will come up with a rebellious postoperative urinary infection. For these children, suppressing the reflux is only part of the treatment. It will have to be curried on by treating the vesical instability by drugs, vesical reeducation and even psychotherapy. On hand of these observations, one may question the classification of refluxes: do all of them really come under the name of "primary" refluxes?

Child↗
PubMed1985

[Transvesical prostatic adenomectomy without a urethral catheter. Apropos of a continuous series of 200 cases].

200 transvesical prostatic adenomectomies were performed without urethral catheters between 1977 and 1984. Le Guillou's technique was employed. The catheter was removed after one week. 90% of the patients passed water immediately. The use of Le Guillou's technique was directly responsible for 1 death (iatrogenic mechanical anuria). 19 patients (9.5%) had to be trans urethrally catheterized of 2 to 8 days after the removal of the cystostomy tube. Long-term follow-up available in 148 of the patients showed 1 failure and 10 successfully treated complications. The advantages of Le Guillou's technique are: Reduced bleeding. Reduced postoperative infection. Virtual disappearance of urethral iatrogenic stenosis. Improved post-operative comfort. Simplification of post-operative nursing.

Aged↗