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Eric Lechevallier

Publications and source records attributed to Eric Lechevallier.

At least 19 recordsLinked to original sources
PubMed2006

[Flexible ureteroscopy and holmium-Yag laser: material and technique].

Flexible ureteroscopy combined with Holmium-YAG laser is an effective, reproducible and minimally traumatic diagnostic and therapeutic technique perfectly adapted to diseases of the upper urinary tract. This technology must be part of the therapeutic armamentarium of any centre involved in the management of urinary stones. The technical facilities must be complete and adapted. Flexible ureteroscopy is a technique with a rapid learning curve once the operator is familiar with all of the equipment. This article describes the material and technique of flexible ureteroscopy combined with Holmium-YAG laser.

Equipment Design↗
PubMed2006

[Intravesical BCG instillations for the treatment of superficial bladder tumours in renal transplant recipients].

Superficial urothelial tumours of the bladder are more frequent and more often at higher risk of progression and recurrence in renal transplant recipients. When conservative treatment of these tumours is indicated, BCG instillations are recommended. However, immunosuppression of renal transplant recipients constitutes a classical contraindication to BCG therapy. Some authors have nevertheless used BCG instillations in renal transplant recipients. The authors reviewed the use of BCG in renal transplant recipients by studying the effects of immunosuppression on the mechanisms of action of BCG and the various clinical experiences reported in the international literature.

Adjuvants, Immunologic↗
PubMed2005

De novo renal cell carcinoma of native kidney in renal transplant recipients.

BACKGROUND: The 10-year risk of developing a solid malignancy is 20% for kidney transplant recipients. The goal of the current study was to investigate the epidemiology and the diagnostic and prognostic parameters associated with de novo malignancies of the native kidney among transplant recipients at the authors' institution (Department of Urology and Renal Transplantation, Hôpital Salvator, Marseille, France). METHODS: The authors reexamined the follow-up of 933 consecutive transplant recipients at their institution between 1987 and 2003. Immunossupressive therapy was not modified in the event of malignant disease, nor was systematic radiologic monitoring of native kidneys performed. All de novo malignancies of the native kidney were included in the current analysis. RESULTS: Among the 933 patients examined, a combined total of 12 malignancies of the native kidney were diagnosed in 11 individuals. For these 11 individuals, the average ages at transplantation and diagnosis were 42.5 and 49.1 years, respectively. Ten malignancies were discovered fortuitously, whereas two were symptomatic. Among the 10 renal echographies performed, there was 1 false-negative result. Tomodensitometry was performed in 11 cases and yielded no false-negative results. The average tumor size was 37 mm. Nephrectomy was performed in 10 cases, and biopsy was performed in 1. Among the 12 kidney malignancies encountered in the current study, there were 7 conventional cell carcinomas, 3 basophilic papillary carcinomas, and 2 chromophobic renal cell carcinomas. Half of all tumors were Furhman Grade 3 lesions, and pT1aN0M0 tumors (2003 TNM staging system) also accounted for half of all malignancies in the current cohort. Two affected transplant recipients died (one due to disease), and the remaining nine are alive without recurrence and with normal renal functioning (median follow-up, 39 months). CONCLUSIONS: There appears to be an increased risk of malignancy of the native kidney in renal transplant recipients, with high-grade and papillary tumors being particularly common. Consequently, systematic radiologic follow-up of native kidneys must be performed for individuals who undergo kidney transplantation.

Adenoma↗
PubMed2005

Follow-up of renal oncocytoma diagnosed by percutaneous tumor biopsy.

OBJECTIVES: To evaluate the outcome of patients with oncocytoma of the kidney diagnosed in our center by percutaneous biopsy and treated with watchful waiting. METHODS: From January 1998 to April 2004, of 148 solid renal tumors biopsied in our center, 15 were renal oncocytomas. The mean (+/- standard deviation) follow-up was 30 +/- 19.8 months. We report on the outcome of these patients. RESULTS: The mean age at diagnosis was 57.6 +/- 14.4 years, and mean tumor size was 3.49 +/- 2.43 cm, corresponding to a mean tumor volume of 62.3 +/- 135.4 cm3. During follow-up, 6 of 15 patients needed surgery: two partial and four total nephrectomies. Indications for surgery were initial tumor burden, greater than 0.5 cm/yr tumor growth, and patient's preference in 1 case, 4 cases, and 1 case, respectively. The patients who received surgical treatment were significantly younger (45.5 +/- 11.1 years versus 65.6 +/- 10.3 years) and had more bulky tumors at diagnosis (50 +/- 30.1 mm versus 27.3 +/- 10.5 mm). In 1 patient, a chromophobic renal cell carcinoma was associated with the oncocytoma. All 9 patients who did not receive surgical treatment remained asymptomatic. CONCLUSIONS: The evolution of renal oncocytoma seems to be increase of tumor size with variable velocity. Treatment must be conservative. Initial management might be nonsurgical with close follow-up. Monitoring should not miss the time of conservative surgery. Initial tumor volume or fast tumor growth are indications for surgery. Partial nephrectomy, if the tumor size and localization are reasonable, is currently the technique of choice.

Adenoma, Oxyphilic↗
PubMed2005

[Urological problems encountered during pregnancy].

The many anatomical and physiological changes occurring during pregnancy affect the entire urinary tract. These changes can induce various urological diseases, alter renalfunction and can be life-threatening to the foetus and the mother Some changes can persist post partum. Asymptomatic bacteriuria must be investigated and treated to prevent about 40% of pyelonephritis and a twofold higher premature delivery rate. Duplex ultrasound is the reference examination to diagnose renal colic due to stones and a low-dose IVU can be proposed whenever there is a doubt about the diagnosis. Treatment is conservative. Lower urinary tract symptoms are very frequent and some disorders, such as stress incontinence, can persist after delivery. This review article describes the anatomical and physiological changes observed during pregnancy and their pathological consequences on the urinary tract in order to detect, prevent and treat these disorders.

Female↗
PubMed2005

[Prostate cancer at high risk of recurrence: results of 12 months of radiotherapy-hormone therapy].

OBJECTIVE: To evaluate the risk of progression after conformal radiotherapy combined with 12 months of adjuvant hormone therapy in a series of patients with prostate cancer considered to be at high risk of progression. MATERIAL AND METHODS: Between January 1997 and December 2001, 63 consecutive patients classified at high-risk according to Amico's classification were treated by combined radiotherapy-hormone therapy. All patients presented at least one factor of the high-risk group of Amico's classification: TNM 92 stage T2c, T3 or T4, or Gleason score > or = 8 or baseline PSA > 20 ng/ml. All patients were treated by combined radiotherapy-hormone therapy with concomitant hormone therapy for 2 months and adjuvant hormone therapy for 10 months. Biochemical progression was defined according to the ASTRO criteria. The median follow-up was 36 months. RESULTS: The 3-year and 5-year biochemical recurrence-free survival was 78%. No local recurrence was observed in 94% of cases and no metastases were observed in 93% of patients. On univariate analysis, only a baseline PSA greater than 22 ng/ml was identified as a predictive factor of early biochemical recurrence. The 3-year biochemical recurrence-free survival was 96% for patients with baseline PSA < 22 ng/ml and 56% for patients with baseline PSA > or = 22 ng/ml (p=0.0017). CONCLUSION: The early results of 12 months of radiotherapy-hormone therapy in high-risk patients in our series were comparable to those reported in the literature. Only a high baseline PSA was predictive of early biochemical recurrence. Adjuvant hormone therapy (long-term, intermittent hormone therapy) could therefore be modulated as a function of the baseline PSA.

Adenocarcinoma↗
PubMed2005

[Renal oncocytoma associated with renal cell carcinoma].

Renal oncocytoma is a benign tumour that can be associated with renal cell carcinoma in rare genetic syndromes. The authors report the case of a 62-year-old patient with no medical history, in whom assessment of low back pain in 1999 demonstrated a 40 mm tumour of the lower pole of the left kidney. Percutaneous needle biopsy of the tumour demonstrated oncocytoma confirmed by Hale's stain. Follow-up ultrasound demonstrated an increase in size (88 mm) and a nine-fold increase in volume over four years (210 cm3 in April 2003). Surgery was indicated in view of the rapid increase of the tumour volume. Histological examination of the operative specimen demonstrated a combination of oncocytoma and Fuhrman grade III renal cell carcinoma.

Adenoma, Oxyphilic↗
PubMed2005

[Current place of chemotherapy in the treatment of hormone-refractory metastatic prostate cancer].

The current management of hormone-refractory metastatic prostate cancer is purely palliative. The use of chemotherapy in this indication was revised in 1996, based on the results of studies with a combination of mitoxantrone and prednisone. This combination demonstrated a significant improvement of quality of life (+48%) and pain (+30%), but without any overall survival benefit. Two studies using taxols, TAX_327 and SWOG_9916, were published in the New England Journal of Medicine on 7 October 2004, with, for the first time, a median overall survival benefit of 2 months. However, the encouraging results of these 2 studies, which will probably modify the management of hormone-refractory prostate cancer, need to be interpreted cautiously. First of all, they were conducted in selected study populations (mean age less than 70 years, Kamofsky index greater than 80% in more than 85% of cases, local disease control in more than 70% of cases). They also comprise many methodological imprecisions and biases with especially, in the TAX 327 study, a change of treatment arm in 1/3 of patients without exclusion of these patients from the final analysis. The results obtained are also at the limit of statistical significance. The target improvement of overall survival, +25% and +33%, respectively, was not achieved at the end of these studies. Finally, from a palliative point of view, only one of these 2 studies (TAX_327) demonstrated a palliative benefit compared to mitoxantrone: 9% for pain, for a sixfold higher cost. Adverse effects were significantly more frequent than with mitoxantrone. Patient selection and details about the indications are necessary. Taxols should not be used systematically in this indication. Furthermore, although several studies are underway, the benefit of taxols at earlier stages of the disease are unknown. Urologists must be aware of the place of chemotherapy in the treatment of prostate cancer in order to remain at the centre of the treatment decision.

Adrenal Cortex Hormones↗
PubMed2005

[Reduction of the renal transplantation cold ischaemia time by the use of a timesheet].

OBJECTIVE: Reduction of the cold ischaemia time is one of the major objectives designed to improve the quality and cost of renal transplantation. Based on the experience of other centres, we report the impact of using a renal transplantation timesheet on the cold ischaemia time in our centre. MATERIAL AND METHOD: Since March 2004, we have used a renal transplantation timesheet with the collaboration of all personnel involved in transplantation (coordination, nephrologists, clinical pathologists). For each kidney harvested, the name of the personnel and the start and end times of their interventions were recorded. The authors report the results for the first 7 months. Cold ischaemia times and the incidence of delayed graft function were studied. RESULTS: 47 kidneys were harvested between 01/03/2004 and 30/9/2004 in our centre and 46 transplantations were performed. The mean cold ischaemia time was 14 h 51 min, i.e. a reduction of 8 hours 58 minutes compared to that observed in 2003 (23 h 50 min) (p < 0.01). Delayed graft function (DGF) was observed in 10/46 (21.74%) recipients. This DGF rate was significantly lower than that observed in 2003 (DGF 2003 = 30%), while the mean donor serum creatinine was higher (155 +/- 177 micromol/l vs 98 +/- 71 micromol/l in 2003, p < 0.05). The longest delays were those related to availability of an operating room (n=2: 10 h and 14 h). CONCLUSION: The use of a renal transplantation timesheet allowed a significant reduction of the cold ischaemia time and DGF rate. It requires the collaboration of all renal transplantation personnel and is an indicator of motivation. This timesheet allowed the correction of certain habits that can still be improved. These results should lead to an improvement of the results and cost of renal transplantation.

Creatinine↗
PubMed2005

[Tubulopapillary tumours of the kidney: prognostic value and therapeutic implications of the distinction between type 1 and type 2 based on a series of 58 cases].

OBJECTIVE: The purpose of this study was to demonstrate the prognostic value of subdivision of tubulopapillary tumours into 2 histological subtypes and to discuss the therapeutic implications. MATERIALS AND METHODS: This was a single-centre retrospective study of 58 cases from a series of 414 patients operated for renal cancer between 1988 and 2001 based on review of histology slides (biopsies and operative specimens). The radiological assessment was based on ultrasound reports and review of CT scans. Karyotypes were described by cytogenetic analysis. RESULTS AND DISCUSSION: Tubulopapillary tumours represented 14% of all kidney tumours with a male prevalence of 77% and a mean age of 56.5 years. The overall mean follow-up was 62.6 months. Treatment consisted of 25 right radical nephrectomies, 29 left radical nephrectomies and 4 partial nephrectomies. 84% of tumours were low-grade and 80% were low stage T1 or T2. Multifocal lesions were observed in 31% of cases. Synchronous bilateral lesions were observed in 12% of cases. The 5-year survival was 95% and the 10-year survival was 87%, correlated with stage, grade, tumour diameter, presence of necrosis and low enhancement. According to the data reported by Delahunt, 2 subtypes can be distinguished: Type I tumours (75%) with low grade and low stage were correlated with a high rate of multifocal lesions (30%) with a genetic predisposition. Type 2 tumours (25%), usually unifocal, were correlated with a higher grade and stage, confirmed by their poorer prognosis. Biopsy allows a distinction of the type and grade of the tumour. CONCLUSIONS: In our series, for equivalent mean tumour diameters (55 mm), tubulopapillary tumours treated by radical nephrectomy had a good prognosis regardless of their subtype. Classification of the tumour by biopsy prior to surgery could have implications for therapeutic management. For type 1 tubulopapillary tumours identified on preoperative biopsy, we propose radical nephrectomy due to the high risk of multifocal lesions (30%). Although partial nephrectomy may be indicated for type 1 tubulopapillary tumours less than 4 cm, the patient must be informed about the risk of recurrence and the importance of long-term follow-up. Studies including a larger number of patients must be conducted to compare the survival associated with type 2 tumours compared to that of the classical histological subtype.

Carcinoma, Papillary↗
PubMed2005

[Treatment of inferior caliceal stones by flexible ureteroscopy].

OBJECTIVE: Evaluation of the treatment of inferior caliceal stones by flexible ureterorenoscopy and Holinium-YAG laser on a series of 69 operations. MATERIAL AND METHOD: Between April 1998 and December 2003, 69 flexible ureteroscopies were performed for 55 stones in 49 patients. The mean age of the patients was 51.6 years (range: 18-78). The mean stone diameter was 12.8 mm (range: 5-3 1). 46% of stones had been pretreated by ESWL, PCNL or surgery. Endocorporeal lithotripsy was performed by Holmium-YAG laser in 45 cases, Lithoclast in 5 cases and en bloc extraction in 3 cases. Technical features, efficacy and morbidity were studied. The results were classified into fragment-free (FS), residual fragments (RF) < or = 4 mm, RF > 4 mm and failures. The results were evaluated on D0-D1 and at 3 months on a plain abdominal x-ray and ultrasound. RESULTS: The mean operating time was 61 minutes (range: 25-120). Nine stones required several procedures. 20% of stones were cystine stones. A ureteric stent was placed in 67 cases. The mean length of stay was 2.5 days (D0-D8). At 3 months, after one or several ureteroscopies, the results were: 22% FS, 40% RF < or = 4 mm, 13% RF > 4 mm and 25% failures. One half of failures occurred during the first 14 ureteroscopy procedures. There were 13 minor complications and no major complications. CONCLUSIONS: The results of flexible ureteroscopy in the treatment of inferior caliceal stones are encouraging, especially with standardization of the technique. It appears to be a good compromise between ESWL and PCNL, particularly for stones between 10 and 20 mm, cystine stones and after failure of reference techniques.

Adolescent↗
PubMed2004

Accuracy and clinical role of fine needle percutaneous biopsy with computerized tomography guidance of small (less than 4.0 cm) renal masses.

PURPOSE: We evaluated the accuracy and clinical role of fine needle percutaneous biopsy of solid renal masses 4.0 cm or smaller with helical computerized tomography (CT) guidance. MATERIALS AND METHODS: In 88 consecutive patients (mean age 61 years) 88 biopsies were performed. Median tumor size was 2.8 cm. Tumor biopsy was performed with an 18 gauge needle using helical CT guidance in an outpatient setting. At least 2 whole cores per tumor were obtained. RESULTS: Biopsy material was insufficient for analysis in 3 (3.4%) procedures. Median tumor size of failed biopsies was 3.0 cm. There were 5 (5.6%) biopsies which revealed fibrosis and were considered inconclusive. A benign lesion was found in 14 (15.9%) biopsies. In the 66 biopsies positive for malignancy there were 65 cases of renal cell carcinoma and 1 lymphoma. A total of 62 patients underwent surgery. Biopsy changed tumor management in 42 (47.8%) patients who avoided radical nephrectomy, 13 of whom had a lesion which did not require surgery, 1 with a lymphoma and 28 who were treated with partial nephrectomy. Biopsy accuracy for histopathological tumor type and Fuhrman nuclear grade was 92% and 69.8%, respectively. No substantial morbidity occurred. CONCLUSIONS: Fine needle biopsy of small renal masses could select benign lesions for which observation might be an alternative to surgery. The accuracy of fine needle biopsy in identifying histological tumor type was high. However, biopsy was less accurate in evaluating Furhman grade. Biopsy with helical CT guidance could be a key point in tailored management of small solid renal masses and provide important information to those patients harboring renal masses.

Aged↗
PubMed2004

[Limited prognostic value of surgical biopsy before transplantation of good quality renal transplants].

OBJECTIVE: The purpose of this study was to assess the correlations between histological examination of surgical biopsies before transplantation of good quality donor kidneys and delayed return of renal function and renal function at 1 year in order to determine whether histology could explain the various, sometimes surprising outcomes observed with these good quality transplants. MATERIAL AND METHOD: From November 1999 to March 2002, 110 consecutive renal transplantations were performed in our centre from 79 different donors, not including any "borderline" donors. During preparation of each transplant, a surgical wedge biopsy of the mid-renal cortex was performed. Biopsies were paraffin-embedded then stained with P.A.S. (Periodic Acid Shiff). Histological examination was performed by a single pathologist and focused on the glomeruli (number, morphology), and the morphology of the interstitial space and vessels. Delayed return of transplant renal function was defined by the need for dialysis during the first week after renal transplantation. Immunosuppression and surveillance protocols were standardized and uniform. Transplant function at 1 year was evaluated by serum creatinine and creatinine clearance calculated according to Cockcroft's formula. RESULTS: The mean number of glomeruli per biopsy was 15.0 +/- 10.8. 42 renal biopsies (39.2%). Histological examination did not reveal any vascular, interstitial or glomerular lesions. Among these 42 transplants with normal biopsies, 30 (71.4%) did not develop delayed return of renal function (vs 69% of the transplants with abnormal biopsies, p > 0.05). Mean serum creatinine at 1 year (168.5 +/- 63 micromol/l vs 166.9 +/- 40.5 micromol/l, p > 0.05) and mean creatinine clearance at 1 year (53.4 +/- 17.4 ml/min. vs 48.3 +/- 14.3 ml/min, p > 0.05) were not significantly different between the normal biopsy group and the abnormal biopsy group. CONCLUSION: Histological abnormalities are frequently observed in renal transplants derived from good quality donors. The biopsy result before renal transplantation from "non-borderline" donors was not significantly correlated with the risk of delayed return of transplant function or the renal function at 1 year Biopsy alone cannot constitute a reliable criterion for the selection of renal transplants from "non-borderline" donors.

Adolescent↗
PubMed2004

[De novo cancer in a kidney transplant].

Development of cancer on a kidney transplant is a rare complication of renal transplantation. In the light of a case of cancer on a kidney transplant, in a series of 729 consecutive renal transplantations performed between January 1987 and December 2000, the authors discuss the epidemiology, pathophysiology, prognosis, treatment and prevention of this disease and emphasize the importance of regular and prolonged periodic ultrasound surveillance of kidney transplants. The reference treatment is transplantectomy with discontinuation of immunosuppression and resumption of haemodialysis. Under certain conditions, partial transplantectomy could appear be an alternative to the reference treatment.

Adenocarcinoma↗
PubMed2004

[Prostate-sparing cystectomy: long-term functional and oncological results in a series of 25 cases].

OBJECTIVE: To decrease the risk of erectile dysfunction and incontinence by performing prostate-sparing cystectomy for bladder cancer; and to evaluate the oncological results by comparing them to those of radical cystectomy. MATERIALS AND METHODS: Since 1994, 141 men have undergone cystectomy for bladder cancer. Twenty five patients with a mean age of 57 years (range: 47-75 years) underwent prostate-sparing cystectomy. The exclusion criteria were: contraindication to bladder replacement, invasion of the prostatic urethra, and associated prostatic adenocarcinoma. TURP was performed preoperatively to evaluate the prostatic urethra. All patients had a PSA < 4 ng/ml or negative prostatic needle biopsies. The Ditrovie and IIEF scores were used to evaluate the quality of voiding and erectile function. RESULTS: The mean follow-up was 53.4 months (median: 46 months). The overall 5-year survival regardless of stage was 66%. Seven patients (28%) died, all from their cancer. Six patients (24%) developed a pelvic recurrence, 2 patients (8%) developed an urethral recurrence (1 had a multifocal lesion, and 1 had CIS) treated by TURP and 6 patients (24%) developed distant metastases. Among the patients with pelvic recurrence, 4 (66%) presented a multifocal tumour. One patient developed prostatic adenocarcinoma after 36 months, which was treated by external beam radiotherapy. At 1 year, 100% of patients reported normal daytime continence and 19 out of 22 patients (86.4%) were continent at night and had to get up 1 to 3 times per night. At 1 year, 10 out of 22 patients (45.4%) had normal erections, 9 (40.9%) reported impaired erectile function but allowing sexual intercourse, and 3 had major erectile dysfunction (13.6%). At 3 years, 93.7% of patients had normal daytime continence; 75% of patients were continent at night, 37.5% of patients reported normal erections, 37.5% of patients reported partial erections and 25% of patients reported major erectile dysfunction. CONCLUSION: Prostate-sparing cystectomy for the treatment of invasive bladder cancer improves continence, sexual function and quality of life of patients, with poorer oncological results to those of radical cystectomy in terms of pelvic recurrence. Rigorous patient selection should improve these results.

Aged↗
PubMed2004

[Percutaneous nephrolithotomy (PCNL) in subjects over the age of 70: a multicentre retrospective study of 210 cases].

INTRODUCTION: Percutaneous nephrolithotomy (PCNL) in subjects over the age of 70 is considered to be associated with a higher risk than extracorporeal shock-wave lithotripsy (ESWL). However this technique is sometimes necessary for very large or complex stones in patients with several comorbidities. STUDY OBJECTIVE: To evaluate the predictive factors of success and operative risks likely to influence the results of PCNL in a population of patients over the age of 70. MATERIAL AND METHOD: Retrospective study of 203 patients (110 males, 97 females) over the age of 70, in whom a total of 210 PCNL were performed over a 12-year period in ten referral centres for the treatment of stones. 68.5% of cases presented a comorbidity and the median ASA score was 2. The median stone dimensions were 24 x 15 mm. There were 67 solitary pelvic stones, 7 infrapelvic ureteric stones, 31 solitary inferior caliceal stones, 40 complex stones and 13 staghorn calculi. A standard one-stage operative technique was performed in 92% of cases; the nephrostomy tract was easily performed by the urologists themselves in 71.8% of cases. RESULTS: The overall stone-free (SF) rate was 70.8%. The patient's weight and height (p=0.03 and p=0.01), stone dimensions and their solitary nature were significant factors of success (p<0.00001 and p=0.01) with SF rates of 81.1% for pelvic stones and 90.3%for solitary inferior caliceal stones (p<0.003); the SF rate for complete staghorn calculi was only 30.8%. A history of stones (p=0.04) and diabetes (p=0.03) influenced the stone-free rate, but the other comorbidities, body mass index, and age did not influence the stone-free rate. There were two deaths (0.9% and haemostasis nephrectomy was performed in 2 ASA 3 subjects in renal failure. In the other patients, there was no difference between preoperative and postoperative serum creatinine and haemoglobin levels. The ease of nephrostomy, the rapidity of PCNL, the day of removal of the drainage nephrostomy, the mean hospital stay (median stay: 6 days), sterility of postoperative urine and at the 1-month visit were significantly correlated with the SF rate. CONCLUSIONS: PCNL in subjects over the age of 70 years is a safe and reliable technique that achieved a stone-free rate of 70.8% for all types of stones combined. The best results were obtained for solitary stones larger than 20 mm in the renal pelvis or inferior calyx. Apart from diabetes, which remains a risk factor, well controlled comorbidities do not increase the operative risk. PCNL did not affect haemodynamic parameters or renal function.

Age Factors↗
PubMed2004

[Urinary stones in subjects over the age of sixty].

OBJECTIVE: Urinary stones, affecting 10% of the French population, is a frequent disease. Data of the literature on this disease in subjects over the age of 60 years reveal age-related changes of risk factors, especially affecting urine composition, but very few data have been reported concerning the clinical characteristics of the disease. Due to the absence of recent data on urinary stones in subjects over the age of 60 in France, we decided to study the epidemiology and urological treatment of urinary stones in the elderly in France. MATERIAL AND METHOD: From November 2001 to August 2002, a survey concerning urinary stones in subjects over the age of 60 was performed by the Association Française d'Urologie Stone Committee among urologist members of the AFU. The parameters studied were epidemiological, clinical, metabolic and therapeutic. The results were analysed on the overall patient population and on the subgroup of patients over the age of 70. RESULTS: The study included 176 patients over the age of 60, 110 of whom were over the age of 70. These patients presented their first episode of urinary stones in 41% of cases. Renal colic was the most frequent presenting symptom. Signs of severity were frequently associated, with urinary tract infection in 24% of cases, associated with sepsis in 49% of cases after the age of 70 years. The incidence of uric acid stones was higher than in the general population. CONCLUSION: Urinary stones can often occur for the first time after the age of 60. This disease appears to be more serious than in the general population due to the high incidence of infectious complications. Uric stones also appear to be more frequent. A multidisciplinary study based on a larger population is necessary to confirm these results.

Age Distribution↗