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Biomedical subjects

M Avérous

Publications and source records attributed to M Avérous.

11 recordsLinked to original sources
PubMed1995

The management of upper urinary tract calculi by piezoelectric extracorporeal shock wave lithotripsy in spinal cord injury patients.

From May 1988 to September 1994, 15 spinal cord injury patients were treated by piezoelectric extracorporeal shock wave lithotripsy. Aged from 23 to 71 years (mean = 39), they presented with a total of 23 stones, of which 18 were located in the calyces, three in the renal pelvis and two in the proximal ureter. The maximum dimensions of calculi varied from 5 to 35 mm (mean = 11). Patients were placed in a dorsal decubitus position during the sessions, three being sedated with diazepam, while the other 12 remained unsedated. All were treated routinely with systemic antibiotics. Auxiliary procedures consisted of two pyelocalyceal flushings, three double J ureteral stenting and three ureteroscopies with fragment removal with a Dormia basket. No episode of autonomic dysreflexia was observed. Short term side effects were limited to a few cases of gross haematuria which regressed spontaneously. Overall, eight successes (53%), and seven failures (47%), were registered. Of the failures, one was the result of a partial fragmentation, while six were related to intrarenal retention of residual fragments resulting in four cases in rapid recurrences. Extracorporeal shock wave lithotripsy can be easily applied to spinal cord injury patients. Its usefulness and limitations need to be well understood and a global consideration must be applied to the prevention and early detection of the upper urinary calculi in this exposed population of patients.

Adult↗
PubMed1994

Treatment of 150 ureteric calculi with the Lithoclast.

From May 1992 to October 1993, 150 ureteral stones, impervious to piezoelectric extracorporeal shock wave lithotripsy (ESWL) with ultrasound localization (EDAP LT.01), were treated with the Lithoclast. The maximum dimensions varied from 5 to 25 mm with a mean of 11 mm. 46 calculi were situated in the pelvic ureter, 82 in the abdominal ureter, and 22 were stuck in the ureteropelvic junction. There was no complete failure of fragmentation, but 39 abdominal calculi (48%) required additional treatment by ESWL due to migration of the fragments into the calyces. Apart from a few needle-sized perforations, ureteral tissue was not damaged by the Lithoclast. The use of this endoscopic lithotripter, which is highly efficient and painless, is, however, limited by the significant effect of retrograde propulsion of very mobile stones or fragments in the urinary tract.

Adolescent↗
PubMed1994

[Urological treatment of urolithiasis in children].

Endo-urological techniques and extracorporeal shock waves lithotripsy (ESWL) have dramatically improved the management of urolithiasis in children. ESWL has been shown to be safe and effective, achieving a stone clearance rate up to 85% with minimal short-term morbidity, and this non-invasive method has become the first-line treatment for most upper urinary tract calculi in children. However, it long-term effects on kidney function and growth remain unknown, and its repeated use should therefore be restricted. Endo-urological techniques, mainly percutaneous procedures and ureteroscopy, and surgical procedures, are only indicated for large multiple stones, or secondary stones needing simultaneous treatment of an underlying uropathy.

Child↗
PubMed1994

[Early postoperative complications of rigid uretero-renoscopy: screening for iatrogenic vesico-ureteral reflux. 30 cases].

From April to September 1992, systematic screening for iatrogenic vesicoureteric reflux was performed in a series of 30 patients treated by rigid ureterorenoscopy. Most of these endoscopies were performed for renal stones using a Wolff Multiscope (7.5/12 F) without prior dilatation of the urinary tract. The study protocol was essentially based on pre- and postoperative retrograde and voiding cystography. The site and tone of the ureteric orifice and the compliance of the intramural ureter were also evaluated and the operating time was determined. Out of 33 ureteric endoscopies, only one case of type I pelvic vesicoureteric reflux was demonstrated following an operation with no particular technical problems. This rare and benign deferred complication draws attention to the potential consequences of rigid ureterorenoscopy on the vesicoureteric antireflux device.

Adult↗
PubMed1994

[Piezo-electric extracorporeal lithotripsy of non-coralliform kidney calculi with a maximal measurement of greater than or equal to 25 mm. Apropos of 25 cases].

From June 1991 to April 1993, 25 non-staghorn renal stones with a maximal diameter greater than or equal to 25 mm were treated by piezoelectric extracorporeal lithotripsy (EDAP LT 01). The complete success rate was 56% after 1 (16%), 2 (12%), 3 (16%) or 4 sessions (12%). 14 double J ureteric stents were implanted (56% of cases) and 4 complications were observed (2 cases of acute pyelonephritis and 2 cases of ureteric silting). These results were inferior to those obtained with percutaneous surgery, but help to define the potential indications of extracorporeal shock-wave lithotripsy. This treatment modality can therefore be applied to large friable weddellite or even struvite stones, particularly when the anatomical conditions are unfavourable for percutaneous surgery.

Acute Disease↗
PubMed1993

[Diagnosis of ectopic ureteral openings in the seminal tract. Value of modern imaging].

We recently observed 3 cases of ectopic ureteric orifice in the seminal tract in patients between the ages of 16 and 42 years. The first case was discovered incidentally, but the other two presented with scrotal symptoms. Intravenous urography, ultrasonography and computed tomography contributed to the diagnosis, but magnetic resonance imaging was the most conclusive, avoiding the need for deferentography in one case. These 3 recent cases allow an evaluation of the respective value of these various imaging modalities.

Adolescent↗
PubMed1991

[Urination control during sleep].

The authors present their approach to the sleep factor in children with enuresis, based on a still on-going exploration of manometric changes in bladder activity. Twenty patients have already been examined by cystomanometry in day time and polygraphic sleep recording at night, combined with continuous measurement of bladder pressure. This method derives from the studies of Gastaut and Broughton, in 1963, but takes into account the concept of bladder immaturity. The patients studied fell into two homogeneous groups, depending on whether enuresis was obviously due to bladder immaturity (Group I) or was strictly isolated (Group II). No disorder of sleep organization has been found in none of these two groups, but both had apparently nonspecific irritant factors. The enuresis episode is described. It tends to occur frequently at the beginning of the night, is prepared by an increase in bladder pressure which is always very pronounced in Group I subjects, and is associated with insufficient awakening reaction due to an apparently exceedingly high awakening threshold. The physiopathological and therapeutic implications of these findings are discussed.

Adolescent↗
PubMed1987

[Trans-intestinal cutaneous ureterostomy].

On the basis of a personal series of 243 cases of transintestinal cutaneous ureterostomy, including 216 cases following total cystectomy, the authors initially review the technical factors determining success, stressing in particular the quality of the uretero-intestinal anastomoses and the careful formation of the parietal tract and the cutaneous stoma. They then analyse their results, defining successively the operative mortality attributable to the diversion (reduced by 2% once the technique has been mastered) the early non-fatal complications (14.8% of intestinal obstructions, only requiring re-operation in 4.5% of cases; 11% of urinary fistula, most of which resolved spontaneously; 8% of faecal fistulae, requiring re-operation in 2/3 of cases; 3.7% of ischaemic necroses of the cutaneous stoma) and finally the late complications affecting the uretero-intestinal anastomoses (17% of stenoses, mostly unilateral), the intestinal graft (0.8% of calculi on non-absorbable sutures: 5.3% of stenoses of the cutaneous stoma; 6% of mucosal prolapses) and the equipment, which has made enormous progress in recent years. Renal function is only preserved when renal failure was not present pre-operatively. The authors conclude on the unquestionable value of transintestinal cutaneous ureterostomy as a high urinary diversion procedure, while recognising that it does not constitute either the ideal solution nor the exclusive solution, particularly after total cystectomy.

Colon, Sigmoid↗
PubMed1985

[Adenocarcinoma of the kidney with invasion of the inferior vena cava. Apropos of 32 cases].

The authors present 32 cases of renal cell carcinoma with inferior vena cava involvement. Three sub-groups of patients can be distinguished on the basis of the level of this involvement: A (24 patients) with infra-hepatic involvement, B (6 patients) with retro-hepatic involvement and C (2 patients) with supra-hepatic involvement. The surgical tactics and results are analysed for each of these 3 sub-groups. The prognosis is relatively good in sub-group A, but is increasingly less favourable in groups B and C.

Aged↗
PubMedDate not supplied

[Long-term results of Burch's cervico-cystopexy. Apropos of 40 cases].

Forty patients with stress urinary incontinence, treated between April 1982 and June 1988 according to Burch's technique, were reviewed. 24 (60%) successes, 8 (20%) major improvements and 8 (20%) failures were recorded with a mean follow-up of 85 months. Compared to the early postoperative findings, a marked deterioration in urinary continence was observed in 4 cases (10%). These results are in contrast with earlier papers reporting remarkable stability of the therapeutic performance of this type of cervicocystopexy. Although too brief to allow reliable statistical analysis, this series simply draws attention to the hypothetical long-term efficacy of Burch's operation.

Adult↗