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Jean-Paul Boiteux

Publications and source records attributed to Jean-Paul Boiteux.

5 recordsLinked to original sources
PubMed2006

Should bladder biopsies be performed routinely after bacillus Calmette-Guérin treatment for high-risk superficial transitional cell cancer of the bladder?

OBJECTIVE: After endoscopic resection of high-grade superficial urothelial neoplasms (Ta, T1 or Tis), adjuvant bacillus Calmette-Guérin (BCG) therapy is performed routinely to avoid recurrence and/or progression. Vesical biopsies often are performed to assess the efficacy of treatment. The aim of our study was to evaluate the usefulness of these biopsies. MATERIALS AND METHODS: During this retrospective bi-centre study, 130 patients who had undergone vesical high-grade tumour resection were included. There were 40 Ta associated with Tis in three cases, 87 T1 associated with Tis in 13 cases, and three isolated Tis. After BCG treatment, the following parameters were studied: cytoscopic findings, urine cytology and the histologic results of systematised biopsies. RESULTS: Urine cytology was positive (high-grade) for 26 patients and negative (normal or low-grade) for 104 patients. For the 26 patients with positive cytology, vesical flexible cystoscopy findings were considered suspicious in 18 patients and normal in eight patients. As for the 104 patients who presented negative cytology, cystoscopic findings were considered negative in 76 patients and suspicious in 28 patients. In the present study, the sensitivity of cytology and cystoscopy in the detection of recurrence after BCG treatment was 56% and 87.5%, respectively; specificity was 56% and 81.6%, respectively. When the two examinations were combined, sensitivity was 100%, and specificity was 76%. CONCLUSIONS: After BCG therapy, the association of negative flexible cystoscopy findings and normal urine cytology made it possible to avoid routine biopsies. Patients could therefore avoid the morbidity of this procedure.

BCG Vaccine↗
PubMed2004

[Pyelo-ureteric amyloidosis].

The authors report a case of urinary tract amyloidosis in a 55-year-old woman with no particular medical history. In the light of this original case, the authors present a review of the pathophysiology, diagnosis, histology and treatment of this disease. A review of the literature confirms the rarity of this entity and its variable clinical expression. An aetiological work-up must always be performed, as amyloidosis can be the complication of numerous diseases.

Amyloidosis↗
PubMed2004

[Compression of the bulbar urethra by transobturator suburethral tape: anatomical study].

INTRODUCTION: The management of female stress urinary incontinence has been markedly improved by the suprapubic tension-free vaginal tape (TVT) and transobturator tape techniques. The objective of our study was to assess the feasibility of this type of technique in males based on cadavre dissection. MATERIAL AND METHOD: A 300 mm x 15 mm polypropylene tape was inserted via a transobturator approach on a cadavre stored in the refrigerator at 4 degrees C and on three cadavres stored in formalin. The technique was almost identical to that used in females. It requires a midline perineal incision in the raphe and two small lateral incisions. The deep transverse muscle of the perineum was opened with scissors. The needle was introduced via the lateral incisions and its progression was guided by a finger introduced into the perineal orifice. The cadavre was then sectioned sagittally to verify the course of the tape and its relations to adjacent structures. RESULTS: The operative technique did not raise any particular problems. Dissection revealed that the tape crossed the deep transverse muscle of the perineum and the levator ani muscle, before travelling towards the obturator foramen. The tape avoided the bladder, prostate, corpora cavernosa, and pudendal pedicle. CONCLUSION: The transobturator tape technique therefore appears to be feasible in males. It does not appear to comprise any particular risks for adjacent organs. This anatomical study appeared to be essential before considering an in vivo application.

Cadaver↗
PubMed2002

[Post-traumatic secondary arteriovenous fistulae of the kidney and their embolization. Report of 3 cases].

INTRODUCTION: Non-iatrogenic post-traumatic arteriovenous fistulas of the kidney raise a diagnostic and especially therapeutic problems. The authors report their experience based on 3 cases of arteriovenous fistulas treated by selective embolization during diagnostic arteriography. MATERIALS AND METHOD: In a series of 18 patients urgently admitted to hospital for kidney trauma during 2000, 3 patients presented a secondary arteriovenous fistula diagnosed on arteriography. All patients were initially treated by surveillance in the surgical ward. The diagnosis of arteriovenous fistula was subsequently suspected following recurrence of haematuria with a moderate fall in haemoglobin in two cases, and secondary appearance of lumbar pain without anaemia in the third case. For the two patients with secondary haematuria, arteriography demonstrated an arteriovenous fistula associated with an arterio-caliceal fistula. For the last patient, Doppler ultrasound suggested the diagnosis of arteriovenous fistula, which was confirmed by the arteriography. RESULTS: Selective embolization by "coils" and particle was performed during arteriography and ensured closure of the fistulas in every case. The postoperative course was uneventful for all three patients. With a mean follow-up of 7 months, no recurrence of the fistula has been observed. The remaining renal parenchyma is functional with preservation of renal function. CONCLUSION: The risk of arteriovenous fistula must be kept in mind in any case of lumbar trauma. Arteriography with selective embolization allows good control of these secondary fistulas while preserving a maximum of functional renal parenchyma, and therefore appears to be the treatment of choice of this complication.

Adult↗