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Biomedical subjects

C Viville

Publications and source records attributed to C Viville.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Stenosis and reflux after surgery of the ureterovesical junction in children. Indications and results of reoperation. Apropos of 460 ureterovesical reimplantations].

Implantation of 460 ureters into bladder was performed in 278 children (68 boys, 210 girls) age range 3 months to 15 years. The operative technique used was generally that of Cohen (335 cases), more rarely that of Leadbetter-Politano (118 cases) and very exceptionally that of Lich-Gregoir (7 cases). Indications for surgery included: so-called "essential" reflux: 373 cases, reflux with Hutch's diverticulum: 20 cases, ureterocele: 14 cases, megaureter: 25 cases (including 14 "modelled" as described by Hendren), neurologic bladder: 10 cases, urethral valves: 7 cases, ectopic openings: 6 cases and multiple malformations: 3 cases. Results in antireflux ureterovesical implantations of 427 ureters were good but complications included 18 cases of stenosis and 9 with persistent reflux. Etiology of these unsuccessful cases, as described by H. Hendren, is discussed and indications and operative techniques for recovery surgery analyzed. Treatment in unsuccessful cases included nephrectomy for stenosis, skin shunt operation for neurologic bladder, a repeat Cohen operation and 8 repeat L.P. operations, with 8 successful results and one failure. Recurrence of reflux was treated in one case by interpyelic anastomosis on duplication, in 2 cases by Cohen's operation and twice by L.P.'s operation, with success in 4 cases. Five patients with stenosis and one with reflux were stabilized and recovery operation was not performed. Finally three patients with unsuccessful initial operation were lost to view.

Adolescent↗
PubMed1985

[Retrograde ejaculation, a little known complication of ectopic ureterocele with ureteral duplication].

A 9 year old boy with an ectopic ureterocele on a left ureteral duplication was treated by radical surgery: nephro-uretero-ureterocelectomy. At 22 years of age he presented with total absence of ejaculation, shown to be due to retrograde ejaculation from permanent gaping of bladder neck. Urinary affections were absent and urologic results of operation were good. The prevention of this disturbing genital complication, and the manner to treat it if it does develop, are discussed.

Child↗
PubMed1984

[Intravesical explosion during endoscopic resection. Apropos of a case].

Intravesical explosion during endoscopic resection are rare but may be devastating in effect, as shown by the case reported. The formation of explosive gas, essentially an air-hydrogen mixture, results from carbonization of tissues (particularly with the coagulation current) and the introduction of air into the bladder during manipulation of the resector. The nature of the bladder infusion liquid does not appear to play an important role. Prevention implies the use of a coagulation current of moderate power, the avoidance of air entering the bladder accidentally, and the continuous or repeated evacuation of the air bubble under the bladder vault.

Cystoscopy↗
PubMed1984

[Diagnosis and emergency treatment of traumatic rupture of the male urethra in pelvic fractures. Apropos of 14 cases].

Fourteen of 400 cases of fractured pelvis had rupture of the urethra and, unfortunately, an exploratory catheter was introduced in nearly all these patients. Routine radiological investigations were not conducted, and true emergency surgical repair was performed in only 3 cases, all of these three patients obtaining good urethral permeability. Analysis of data on recently published cases and from the present series shows that opposing views are still held by those who support immediate, emergency (true or deferred) end-to-end suture of the urethra, and those who advocate simple suprapubic drainage of the bladder or "realignment" of the urethra over an indwelling catheter with or without a direct approach to the site of rupture. However, carefully executed immediate end-to-end suture gives better results than other methods, and also considerably reduces duration of hospital stay and incapacity for work.

Adult↗
PubMed1984

[Treatment of primary vesico-renal reflux in adults. Apropos of 41 cases].

Between October 1970 and March 1983, forty one adults (thirty six women and five men) were treated for vesico-ureteral reflux. Fifteen were treated medically and twenty six surgically. In the latter category, four total nephrectomies were performed, one nephrectomy of the upper pole of a duplicated kidney, and twenty one antireflux ureterovesical reimplantations, involving thirty four ureters. The procedures used were Cohen's (26 cases) and Leadbetter-Politano (7 cases). The procedure used in one case is not recorded. The reflux was eliminated in all the cases, except one, which was a reoperation for ureteral stricture in a patient previously treated for reflux in another hospital. Of the sixteen patients with urinary infections, five remained infected despite the elimination of the reflux. IVP and isotopic exploration of kidney function revealed no postoperative change in the majority of the patients. Two patients, suffering from renal insufficiency preoperatively, required dialysis two and four years, respectively, after the elimination of the reflux.

Adult↗
PubMed1983

[Contact renal refrigeration with continuous control of the intrarenal temperature in surgery for staghorn calculi].

Surgical treatment of staghorn calculi is a meticulous, difficult, and time-consuming procedure which requires the taking of contact films during operation. Incision of the renal parenchyma is frequently also necessary. To limit blood loss, and mainly in order to have a clear field of view, intrarenal blood circulation has to be interrupted by clamping the renal pedicle. This circulatory arrest can be supported for only 20 minutes, without major risks to the renal parenchyma, under normal temperature conditions. However, at least in the authors' hands, more than 10 minutes are necessary between the taking of the contact film and its return after development to the operation room. In contrast, lowering renal temperature by 10 to 20 degrees C enables ischemia to be maintained for up to 4 hours without adverse consequences. Contact refrigeration of the kidney by surrounding it with crushed ice is used, permanent control of temperature being maintained by a thermocouple linked to a continuous digital display. This simple, easy to install method does not require high investments or sophisticated material. It has enabled continuous clamping to be applied for periods of up to nearly 2 hours, with normal follow-up I.V.P. one week later.

Humans↗
PubMed1983

[Closed traumatic ruptures of the normal upper urinary tract].

In the context of urinary tract trauma, closed rupture of the upper urinary tract is rare, although not exceptional. It usually occurs in the region of the pyelo-ureteric junction and more often on the right side. It is more common in children, especially in boys. The diagnosis is often delayed and only made after the appearance of a urinary pseudocyst. The diagnosis depends on intravenous pyelography, ultrasound and retrograde uretero-pyelography, which should only be performed immediately prior to the operation. In the great majority of cases, the urinary tract can be simply repaired by a uretero-ureteral or ureteropyelic anastomosis, or more rarely, a ureterocalyceal anastomosis. The indications for autotransplantation are exceptional and are essentially based on the associated lesions, especially of the renal vascular pedicle. The results are very encouraging; a review of the literature reveals 64 cases of ruptured upper urinary tract whose outcome was able to be followed: 10 nephrectomies (only 3 followed failure of attempted reparative surgery) and 54 salvaged kidneys. Great progress has been made since Bienayme's report in 1962 of 40 cases in which he found only 4 successful repairs.

Adolescent↗
PubMed1983

[Staghorn calculi in the child. Apropos of 17 cases representing 20 kidneys].

The authors report their experience involving 72 cases of lithiasis in the child, 17 involving staghorn calcuti. Of a total of 79 staghorn calculi, 17 affected children. Such staghorn calculi in the child were almost always infected (proteus), often extensive but not associated with any impairment of renal function for a long period. No metabolic disturbance which could explain the formation of these calculi was found, in particular no cases of hyperparathyroidism. Treatment is surgical. The operation is long, difficult and delicate, always requiring peroperative contact films and often clamping of the renal pedicle in the case of nephrotomy. Such clamping is much better tolerated with the use of contact refrigeration of the kidney. On the basis of the results of quantitative renal scintigraphy, nephrotomy seemed better tolerated by the kidneys of children than by the kidneys of adults. True recurrences were rare (3/20) and small "forgotten" calculi (2/20) were often well tolerated.

Child, Preschool↗
PubMed1982

[Hydronephrosis due to abnormality of the pelvi-ureteric junction (P.U.J.). Based upon 162 cases representing 181 P.U.J. syndromes (author's transl)].

The authors present a retrospective analysis over a period of 15 years with a minimum follow-up of 18 months. 34 patients were under the age of 10. In terms of diagnosis and therapeutic indications, intravenous urography remains the basic examination. Two other investigations are extremely valuable: retrograde cystography, in particular in the child, to seek associated vesico-renal reflux and echography, in particular as a harmless means of regular surveillance, both for hydronephroses which have been operated upon and those which have not. Seventy five patients did not undergo surgery and only 25 could be regularly followed up. In contrast to widely accepted ideas, 4 worsened considerably. Only 13 nephrectomies were performed at the outset, including six partial because of double/bifid kidney/ureter. There were thus only 6.7% of total nephrectomies at the outset. Despite this resolutely conservative attitude, there was only one secondary nephrectomy for lithiasis despite a good result of P.U.J. plasty. Renal biopsies confirmed that the renal parenchyma was usually normal, even in the presence of very marked hydronephrosis, in the absence of infection. The results of conservative surgery were good in 83% of cases, thereby justifying the resolutely conservative attitude of the authors. 92 plasties of the pelvi-ureteric junction revealed the rarity (15.2%) of hydronephrosis due to abnormal polar vessel and the relative prevalence (29.5%) of hypoplasia of the first few millimetres of the lumbar ureter distal to the P.U.J.

Adolescent↗
PubMed1982

[Well differentiated adenocarcinoma ("yellow cancer") of the prostate. Problems of diagnosis and prognosis (author's transl)].

This paper reports the case of a very large hyperdifferentiated prostatic adenocarcinoma, characterized by a very high lipid content; there is little information in the literature about diagnosis and prognosis of this rare type of cancer. Relevant characteristics of this tumor were its middle prostatic location, its soft consistency and its homogeneous yellow appearance (the so called "yellow cancer") - In spite of its large size, the growth remained confined to the prostate. The histological aspect of this cancer is close to intense glandular hyperplasia, so the differential diagnosis is quite difficult on scanty biopsy samples without lipid stains.

Adenocarcinoma↗
PubMed1982

[Spontaneous regression of a dolichomegaureter in a 4-month-old child].

The authors report a relatively rare case of dolichomegaureter followed up over a period of almost 8 years and which regressed spontaneously and almost completely. They envisage the various pathogenic hypotheses. The interest of this particular case lies on the one hand in the photographic documentation and secondly because of the regression of the dolichomegaureter slowly over the years, long after the disappearance of urinary infection and all treatment had been stopped. This course tended to confirm that the hypothesis of infectious megaureter due to a reversible acute inflammatory obstruction is not the sole explanation for the regression of certain large ureters in the infant.

Follow-Up Studies↗
PubMed1982

[Urothelial bladder carcinoma in situ involving the whole urinary tract. One case (author's transl)].

We report a case of urothelial carcinoma in situ extended to the whole excreto-urinary tract and involving the prostatic gland and the papillary ducts of the kidney. The patient was followed up for almost five years. The evolution was unfavorable, as multifocal invasion appeared. We emphasize the difficulties of the pathological diagnosis on biopsy samples and relate the usual behaviour of this type of cancer who may often simulate an interstitial cystitis. Because of uncertain prognosis and difficulties in the evaluation of the disease, the optimal management for such patients remains imprecise in spite of the benefit of cytologic surveillance. Thus, in the absence of obvious invasion the choice of treatment depends at time on morphological data as well as on topographic and functional criteria.

Adult↗
PubMed1981

[Vesico-renal reflux and compensatory renal hypertrophy (author's transl)].

The effects of vesico-renal reflux on the proximal kidney vary widely from one child to another and there remains considerable disagreement concerning the harmful consequences of reflux. Even more curious is the fact that in the same child, bilateral, symmetrical and infected reflux with distension of the urinary tract may be accompanied by severe involvement of one kidney whilst the contralateral kidney is not only free of any problem but sometimes even in a state of compensatory hypertrophy. Eight examples (out of a series of 310 cases of reflux in the child) are reported, renal function being assessed by quantitative renal scintigraphy. It would seem that the manner of reaction of a kidney subjected to reflux varies according to whether it is previously healthy or already damaged. But what are the nature and pathogenesis of such pre-existent lesions? Why do they affect some kidneys but not others?

Adolescent↗
PubMed1981

[Iatrogenic stenosis of the male urethra. 50 cases (author's transl)].

The iatrogenic aetiology of urethral stenosis now plays a considerable role : 40.6% of stenoses seen between 1966 and 1980. It would appear to be increasing in frequency : 10 new cases per year during the past 4 years. The role of the indwelling urethral catheter is particularly troublesome despite the constant improvement in the material used. With the exception improvement in the material used. With the exception of 11 meatal stenosis after circumcision, 2 apparently post-radiotherapy stenosis and 3 strictures after cytoscopy, a urethral catheter was alone responsible in 14 cases and apparently the principal factor in 20 others (i.e. 34/50). The treatment of iatrogenic stenosis of the urethra involves all methods, with a marked preference for internal urethrotomy. Finally, prevention is based essentially upon more caution in the use of indwelling urethral catheters.

Adolescent↗