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J Irani

Publications and source records attributed to J Irani.

68 records · Page 4Linked to original sources
PubMed1991

[Prostatic cancer before the age of 50--report of 7 cases].

Based on a retrospective series of 7 cases, the authors study the particular features of prostatic cancer before the age of 50 years. These 7 patients all had an advanced tumour with, in 4 cases, documented metastases. A single patient had a well differentiated tumour, while the others had a moderately or poorly differentiated or undifferentiated tumour. All patients died rapidly, except one who is currently receiving treatment with an LHRH agonist, with a follow-up of 25 months. On the basis of this study, the authors distinguish between prostatic cancers clinically detectable before the age of 50 years, and those which remain occult, leading to a histological discussion between a benign disease and true early cancer. In the light of these findings, systematic screening for prostatic cancer before the age of 50 years does not appear to be justified.

Age Factors↗
PubMed1991

[Burch's procedure. Value of association with fixation to the promontorium and colpoperineorrhaphy].

One hundred and ninety nine patients complaining of genuine stress incontinence not previously treated underwent Burch colposuspension. The operation has been either isolated (42.2%) or associated to a vaginal repair (36.2%) or associated to a vaginal repair and a sacral hysteropexy (21.6%). No serious operative complication occurred. The overall rate of postoperative complications was of 14% without significant difference between the surgical procedures. The overall clinical cure rate for stress incontinence was 90%. The rate of failure was significantly higher when the Burch operation was performed alone. The failures were revealed mostly in the six first months, confirming the stability of the results (20 months average follow-up). The present data confirms that Burch colposuspension is effective in stress urinary incontinence. The authors recommend a systematic association to a vaginal repair and, in case of bladder descent, to a sacral hysteropexy.

Adult↗
PubMed1990

Carcinoma of the penis in lichen sclerosus atrophicus. A case report.

Three cases of glans penis epidermoid carcinoma after lichen sclerosus et atrophicus (LSA) or balanitis xerotica obliterans are discussed. Relationships between both diseases are analyzed but remain unclear. Balanitis xerotica obliterans causes foreskin and urethral meatus stenosis that requires circumcision. Glans penis carcinoma can be observed many years later even after circumcision. The knowledge of LSA is important to do circumcision at the beginning of the disease with a long-term follow-up of these patients to realize a glans penis biopsy if necessary. Most cases of LSA are not recognized, and the frequency is higher than reported.

Balanitis↗
PubMed1990

[Cancers of the prostate and cyproterone acetate. Value of blood testosterone and PSA levels for treatment surveillance].

On the basis of a retrospective series of 74 patients with adenocarcinoma of the prostate, the authors study the survival of these patients according to the clinical stage of the lesion when treated with cyproterone acetate. Biologically speaking, the authors have studied the evolution of the blood testosterone level, as well as of PSA and PAPs. Their conclusion is that the PSA is an excellent indicator of the efficacy of the cyproterone acetate treatment. Its fast decrease proves treatment efficacy, while a new rise indicates the resumption of evolution of the neoplastic process and must lead to change the therapeutic approach.

Adenocarcinoma↗
PubMed1990

[Hepatitis after treatment with cyproterone acetate. Apropos of a case].

Regarding a case of little-differentiated adenocarcinoma of prostate in a 79-year old male patient undergoing antiandrogenic corticosteroid therapy (cyproterone acetate), the authors describe a rare complication related to treatment with the drug. Cytolytic icterus, without cholestasis, occurred eleven weeks after starting the treatment without metastasis of the primary cancerous lesion, and regressed when administration of the antiandrogenic agent was interrupted. This description is compatible with toxic hepatitis. This is a rare complication, which should be differentiated from stasis icterus consecutive to treatment with progestogens. Its diagnosis precludes also primary or drug-induced secondary tumors or degenerative hepatic lesions. A knowledge of this complication by the urologist is important, so the latter might not conclude too hastily to metastatic extension of primary cancer of prostate. Withdrawal of the patient from antiandrogenic therapy is mandatory, and management should incorporate complete biological investigation of liver function, CT scans and, depending upon the case, liver biopsy as the only means of studying this exceptionally rare complication.

Adenocarcinoma↗
PubMed1990

[Cystinic lithiasis. Current aspects of the urologic treatment].

On the basis of a series of 9 patients (12 renal units) gathered over 19 years, the authors analyze the current possibilities of treatment of cystine lithiasis. They first describe the characteristics of this litiasis, which is rare but serious, being naturally prone to recurrence because it is caused by a genetic defect. The development of extracorporeal lithotripsy raised great hopes for the treatment of this lithiasis, but it was soon realized that cystine strones were hard to break. However, even the mere fragmentation of the stones improves the dissolving action of the various drugs proposed to modify the pH of urine. The authors consider that open surgery by means of posterior vertical lumbar section still is indicated for larger stones, and percutaneous nephrolithotomy seems to be a very useful technique, either exclusively or as a complement of extracorporeal lithotrity.

Adult↗
PubMed1990

[Vesicorenal reflux and ureteral duplication. Study of 62 cases].

On the basis of a series of 62 files gathered over 18 years, the authors study vesicorenal reflux in duplication of the ureters. The abnormally was bilateral in 10 cases, and a total of 206 ureters was analyzed. Clinically, fever and a urinary infection are the usual expression. While intravenous pyelography allows assessing the condition of the upper urinary tract, retrograde cystography demonstrates the reflux and indicates its degree. This study confirms that the reflux mainly occurs in the lower pelvis and that it is very marked (stage II + stage III = 62.9%). Three categories of patients should be distinguished: infants younger than age 2; children from age 2 to age 15; and adults. Purely medical treatment was disappointing, and surgery seems to by far the best solution. However, the solution is different according to whether or not another malformation is associated with duplication and reflux. In the latter case, the surgical procedure is simple, while in the former there often is a complex pathology which sometimes raises difficult surgical problems, especially in children.

Adolescent↗
PubMed1990

[Vesicorenal reflux in children under 2 years of age. Indications and results of surgical treatment].

On the basis of 133 cases, the authors analyse the clinical features and the modalities of the treatment of vesicorenal reflux in children under age 2. The number of girls is higher than that of boys. The diagnosis is most often established between 0 and 6 months of age, with a very marked peak between 0 and 1 month. The usual warning sign is a urinary infection with fever. Pyerography is normal in every second case, and retrograde cystography is the key examination, which confirms the reflux and establishes its side and degree (bilateral reflux in 53% of cases, stage II in 48% of cases). 33 children were operated at once. Another 100 first had a medical treatment, ie. urinary antibiotics, on the basis of strict criteria that are listed here. This medical treatment has been very disappointing: 20 children were lost to follow-up and 47 had secondary surgery. When surgery is necessary, advancing plasty according to Cohen's procedure yields excellent results: 98.6% of 76 operations were successful. The authors therefore think that Cohen's procedure is widely indicated, even in children under age 2.

Anti-Bacterial Agents↗
PubMed1989

[Atrophicus sclerosis lichen and cancer of the glans].

Two cases of glans penis epidermoid carcinoma after lichen sclerosus and atrophicus or balanitis xerotica obliterans are discussed. Relationship between both diseases are analysed but remain not clear. Balanitis xerotica obliterans gives foreskin and urethral meatus stenosis that required circumcision. Glans carcinoma can be observed many years later even after circumcision. The knowledge of lichen sclerosus and atrophicus is important to do circumcision at the beginning of the disease with a long term follow-up of these patients to realize a glans penis biopsy if necessary. Most of lichen sclerosus and atrophicus are not recognized and the frequency would be higher than reported.

Balanitis↗
PubMedDate not supplied

[Correlation between chemical composition, density, and results of extracorporal lithotripsy in renal and ureteral lumbar calculi].

Based on a series of 388 patients with a total of 466 renal and lumbar ureteric stones (414 kidneys) treated between 1987 and 1990 by extracorporeal shock wave lithotripsy (ESWL) using the SONOLITH 3000* apparatus, the authors analyse the indications and results criteria for ESWL. The success criteria adopted excluded any residual fragment and considered patients lost to follow-up as failures. The success rate varied between 48.3% and 73.8% when residual fragments less than 5 mm were included and when drop-outs were excluded. A correlation was established between the radiographic appearance of the stone (dense, smooth, spiculated), its predominant spectrophometric nature and the results of ESWL: low density, spiculated Weddellite (WD) stones gave good results and very dense, smooth Whewellite (WW) stones gave less favourable results. The authors propose a refinement of the indications for ESWL in order to improve the results. Predominantly WW stones may be suitable for primary percutaneous nephrolithotomy.

Adolescent↗
PubMedDate not supplied

[Impotence in pelvic fractures. Report of 16 cases].

The authors study impotence secondary to a pelvic fracture on the basis of a retrospective series of 16 cases. All these patients had a lesion of the membranous urethra and seven of them underwent a deferred emergency urethral repair. Although the constancy of the urethral lesion is probably related to the fact that this series was recruited from a urology department, impotence is classically considered to be more frequent in the presence of a urethral lesion than in the absence of such a lesion. Two patients presented with incomplete impotence and fourteen with complete impotence. Ten of these sixteen patients spontaneously regained satisfactory erections. When erections were not obtained, the authors analysed the various therapeutic possibilities available, stressing the arterial factor which is usually insufficiently investigated.

Adolescent↗
PubMedDate not supplied

[Calcified renal cancers. 7 case reports].

The authors report a series of 7 patients with calcified renal cancer (5 men and 2 women with a mean age of 51 years). The calcifications had a variable appearance:arcuate (1 patient), disseminated throughout the mass (5 patients), mixed (1 patient). The distribution according to stage was as follows: T1: 1 patient, T2: 3 patients, T4: 3 patients. Five patients were treated by radical nephrectomy, but surgery was impossible in 2 patients due to the local extension of the tumour. Two patients are alive with no signs of recurrence (follow-up: +7 years and +7 months), 1 died 10 years after his nephrectomy, from myocardial infarction, 1 was lost to follow-up and 3 died within several months. These 3 patients had a spindle cell renal cancer. In the light of this series, the authors situate calcified renal cancers in relation to other calcified renal masses (of various origins) and in relation to adult renal cancers. They demonstrate that any calcified renal mass must raise the suspicion of cancer and they describe the diagnostic approach to such a hypothesis.

Adult↗
PubMedDate not supplied

[Sarcomatoid cancer of the kidney in the adult. 7 case reports].

Based on a retrospective series of 7 patients (6 men and 1 woman) with a mean age of 56.5 years, the authors describe the clinical, radiological and pathological features and the clinical course of sarcomatoid renal cancers in adults. They stress the severity of this type of tumour, due to the fact that the lesion is usually very advanced at the time of diagnosis (3 cases of Robson's stage III tumours and 4 stage IV tumours). Radiological assessment frequently reveals calcifications within the mass (4 out of 7 patients). Surgical excision is sometimes impossible and, when it can be performed, it has little influence on the prognosis or the survival.

Adenocarcinoma↗