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Jacques Petit

Publications and source records attributed to Jacques Petit.

12 recordsLinked to original sources
PubMed2006

[Urodynamic changes after transobturator suburethral tape].

INTRODUCTION: Prospective study of urodynamic changes induced by transobturator insertion of suburethral tape a dip-stick under-urethral. MATERIALS AND METHODS: 25 women with pure (12) or mixed (13) stress urinary incontinence were operated by this technique, allowing urodynamic assessment and completion of the MHU urinary disability questionnaire. Three operators performed these 25 tape insertions in 2 centres (Amiens and St Quentin hospitals) according to a standardized technique. Six months after the operation, patients were reviewed by clinical examination, MHU questionnaire and urodynamic assessment. RESULTS: The cure rate at 6 months was 80% (20 patients) and the improvement rate was 20% (5 patients). The maximum flow rate decreased from 23.6 ml/s to 18.9 ml/s (p = 0.02) and the post-voiding residual volume increased from 26.8 ml to 66.8 ml (p = 0.01). Urethral resistance increased from 0.16 to. 0.25 (p = 0.03) and maximum closure pressure increased from 43.8 to 47.5 cm H2O (p = 0.02). These results demonstrate the obstructive nature of this suburethral tape. The results of the MHU questionnaire showed accentuation of dysuria (p = 0.04) and improvement of stress urinary incontinence (p < 0.001). CONCLUSION: This prospective study confirms the efficacy of this technique, but analysis of the urodynamic studies and the MHU questionnaire demonstrates obstruction. Long-term surveillance of these patients by uroflowmetry and residual urine appears to be useful to detect possible progression to chronic urinary retention.

Adult↗
PubMed2006

[Study of urothelial bladder tumours in renal transplant recipients].

OBJECTIVE: To study the prevalence, treatment and outcome of urothelial bladder tumours (UBT) in renal transplant recipients. PATIENTS AND METHODS: Multicentre retrospective study performed in 2004 by questionnaire sent to members of the AFU Transplantation Committee. RESULT: Seven centres returned the questionnaire with a total of 32 UBTs in 21 males and 3 females with a mean age of 63.2 +/- 10.1 years, with no history of UBT. The incidence was 255 per 100,000. The median interval between transplantation and UBT was 60 months (range: 5 to 259 months). 72% of UBTs were stage pT > or = 1 and 63% were grade 3. CIS was present in 20% of cases. 25% of patients were N+. In addition to resection of the UBT, 3 patients were also treated with mitomycin C and 1 was treated with BCG. 7 patients underwent cystectomy, with a palliative objective in 42% of cases, associated with radiotherapy-chemotherapy (2/3) or chemotherapy alone (1/3). Immunosuppressive therapy was decreased in 50% of cases. Six patients (25%) died from bladder cancer, 25% relapsed with a tumour progression rate of 50%. 46% of patients were in remission of their UBT 4% died from an intercurrent cause. 76% of survivors have a Junctional graft with no alteration of serum creatinine. CONCLUSION: Renal transplant recipients have an increased incidence of UBT, which are more aggressive and associated with a higher mortality compared to the general population. Increased surveillance and aggressive treatment therefore appear to be justified.

Female↗
PubMed2005

Cholesterol crystal embolization diagnosed on bladder transurethral resection.

Cholesterol crystal embolization (CCE) is a severe systemic disorder caused by vascular migration of cholesterol crystals originating from ulcerative atherosclerotic plaques located in large arteries. We report 2 cases of CCE diagnosed on bladder transurethral resection in 2 men aged 94 and 72 years. Both patients had atherosclerosis disease. One patient had been treated by heparin 1 month before for pulmonary embolism and the other had had a coronary angiography and bypass graft surgery 5 months before for silent myocardial infarction. One patient presented with hematuria and the other with acute renal failure. Cystoscopy showed multiple papillary tumors of the bladder wall. Bladder transurethral resections showed transitional cell carcinoma with cholesterol crystals occluding the lumen of small arterioles in the submucosa. Eight cases of CCE in the bladder wall have been reported in the literature in 3 women and 5 men aged 56 to 79 years. Cholesterol crystal embolization is often discovered in the bladder wall on necropsy specimens. Only 2 cases have been fortuitously discovered on bladder transurethral resection performed for transitional cell carcinoma. Cholesterol crystal embolization in the bladder wall is often a marker of severe disease although the evolution is quite favorable in our patients, still alive 1 and 2 years after diagnosis.

Aged↗
PubMed2004

Assessment of Chlamydia trachomatis infection in asymptomatic male partners of infertile couples.

Three specimens from 111 asymptomatic male partners of infertile couples attending the Department of Urology in Amiens, France, were examined by the PCR COBAS AMPLICOR test (Roche Molecular Diagnostics) for the presence of Chlamydia trachomatis. The specimens analysed were: first void urine (FVU), urine obtained after prostatic massage (UPM) and semen specimens. Serum from each patient was also obtained and analysed for the presence of IgG and IgA chlamydial antibodies by in-house microimmunofluorescence (MIF) and pELISA. C. trachomatis was detected by PCR in 5.4% of FVU samples, 2.7% of semen specimens and in 0.9% of UPM samples. Two treatments for processing the samples (storage at -70 degrees C and heating to 95 degrees C) were routinely used before initial testing to reduce the effects of inhibitors of PCR. Despite these precautions, the PCR method revealed the presence of inhibitors in 7.3% of semen specimens and 3.6% of FVU samples. C. trachomatis was detected by PCR COBAS AMPLICOR in seven of 111 patients (6.3%) and by serology in five of 111 patients (4.5%). The detection of C. trachomatis in FVU, UPM and semen specimens can serve as a marker for the presence of this organism in the genital tract, and can be used as a reliable way of detecting asymptomatic carriers of infection.

Adult↗
PubMed2004

[Emphysematous cystitis complicated by bladder perforation: diagnosis and treatment of a rare case].

Emphysematous cystitis is a rare disease mainly encountered in poorly controlled diabetics, immunodepressed patients or patients with infravesical obstruction. The pathophysiology of this disease is characterized by the formation of carbon dioxide (CO2) present in the lumen and/or bladder wall, derived from bacterial fermentation of carbohydrates. The bacteria most frequently responsible are facultative aerobes-anaerobes (Escherichia coli) and more rarely strict anaerobes (Clostridium perfringens). The authors report a case of emphysematous cystitis in a context of pelvic trauma and fracture of the pelvis, complicated by secondary bladder rupture. The diagnostic and therapeutic aspects are discussed.

Aged↗
PubMed2004

[Natural history of a suspicious renal mass in a patient with gastric cancer: how to evaluate the risk of multiple primary tumours (MPT)?].

The coexistence of several tumours in the same patient is a rare phenomenon and corresponds to the multiple primary tumour (MPT) syndrome. The most frequently diagnosed MPT include gastrointestinal tumours associated with urological tumours. Overexpression of the STAG1 gene could explain the development of several solid tumours and could be the origin of the multiple primary tumour syndrome. A suspicious renal mass discovered at the same time as a documented cancer is usually a malignant lesion and may justify combined radical surgical treatment. The authors report the natural history of a suspicious renal mass in a patient with primary gastric tumour corresponding to a MPT syndrome. They recall and discuss the epidemiology, pathophysiology, diagnosis and treatment of MPT.

Adenocarcinoma↗
PubMed2003

Diagnosis and treatment of prostate cancers in renal-transplant recipients.

BACKGROUND: There is no consensus regarding prostate cancer in renal-transplant recipients (RTR). A questionnaire evaluating prostate cancer screening after transplantation and assessing the number, diagnostic modalities, treatment, and outcome of prostate cancer cases was mailed to 22 French renal-transplant centers. RESULTS: Among 1,680 RTR in 1998, 11 (0.65%) cases of prostate cancer were diagnosed, and among the 2,338 recipients followed up, 28 (1%) cases of prostate cancer have been diagnosed and treated. Median ages at diagnosis and at transplantation were 63 and 58, respectively. Clinical stages were T1 50% and T2 25%. Eighteen patients had a Gleason score under 7. At 18 months of mean follow-up, 2 men had died from prostate cancer, and in the curative treatment group, 16 of 17 men were alive with no evidence of disease. CONCLUSIONS: The incidence of prostate cancer in RTR appeared to be higher than expected. Prostate specific antigen (PSA) testing should be performed routinely each year in renal transplantation centers.

Adult↗
PubMed2003

Early experience with sildenafil for the treatment of erectile dysfunction in renal transplant recipients.

BACKGROUND: Erectile dysfunction (ED) is common in men with renal failure, but is not always alleviated following kidney transplant. The objective of the present study was to assess the feasibility in renal transplant patients of sildenafil citrate treatment, an agent with proven efficacy in the management of ED. METHODS: This was a phase IV, open, multicentre, 3 month, dose-escalation study. All patients meeting the inclusion criteria were prescribed a dose of 50 mg sildenafil at the first visit. Thereafter the dose could be increased to 100 mg or reduced to 25 mg based on efficacy or tolerability. The primary efficacy parameter assessed the ability of patients to achieve erections sufficient for intercourse and to maintain erections after penetration. Secondary endpoints assessed patient satisfaction with sildenafil and the effect of sildenafil on their quality of life. Patients were carefully monitored throughout the study for adverse events, interactions with immunosuppressive therapy and effect on graft function. RESULTS: The study included 50 patients in the intent-to-treat population. Sildenafil significantly improved patient's erection ability and the frequency of their erection maintenance. Analysis of the secondary efficacy parameters revealed that 66% of patients believed treatment had improved their erections. Patients reported improvements in their sexual life and partner relationships and a high level of satisfaction with treatment. There were no interactions between sildenafil and the immunosuppressive drugs and there was no significant adverse effect of sildenafil on graft function. CONCLUSIONS: Sildenafil is an effective and well-tolerated agent for the treatment of ED in renal transplant recipients.

Dose-Response Relationship, Drug↗
PubMed2003

[Bladder nephrogenic metaplasia: circumstances of discovery, predisposing factors, and clinical course in 7 cases diagnosed between 1988 and 2000].

INTRODUCTION: Nephrogenic adenoma (NA) or nephrogenic metaplasia is a rare, benign urothelial tumour. MATERIAL AND METHODS: This retrospective study evaluated the circumstances of discovery, predisposing factors, and clinical course of seven patients with nephrogenic adenoma diagnosed between 1988 and 2000. The mean age of these patients was 55.7 years (range: 16 to 88 years). The mean follow-up was 24 months (range: 4 to 108 months). RESULTS: There are no specific endoscopic findings and the lesion was sometimes flat or papillary with an appearance that can be identical to that of bladder tumour. The diagnosis was always based on histological findings. Suggestive clinical signs were nonspecific and comprised: haematuria, dysuria, or urgency. Treatment was surgical with transurethral resection or electrocoagulation of the lesion, combined with elimination of the factors irritating the urothelial mucosa. In our experience, recurrences were observed in 28.5% of patients and occurred during the year following the initial treatment. CONCLUSION: Nephrogenic adenoma is a rare, benign urothelial tumour most frequently situated in the bladder. The presenting clinical signs are completely nonspecific and usually related to predisposing factors (infections, inflammation, bladder tumour). Only histological examination can provide the essential proof of the benign nature of this lesion. Endoscopic resection therefore has two objectives: diagnostic and therapeutic. The clinical course is characterized by recurrences.

Adolescent↗
PubMed2002

[Lympho-epithelioma of the bladder. Discussion of pathogenesis].

Lympoepithelioma, originally described within the nasopharynx is an undifferenciated malignant epithelial tumor with a prominent lymphoid stroma. We report a case of lymphoepithelioma of the bladder after intravesical BCG treatment for carcinoma in situ.

BCG Vaccine↗
PubMed2002

[Multifocal urothelial tumors and renal autotransplantation].

The authors report the case of a patient with multiple urothelial tumours only sparing the superior left ureter and the urethra. The complex treatment consisted of a combination of resection of the entire urinary tract, except for the left kidney and its proximal ureter that was transplanted into the right iliac fossa, after ex vivo partial pyelectomy. This complex treatment regimen avoided the need for dialysis with a good functional and oncological result, three years later.

Carcinoma, Renal Cell↗