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Biomedical subjects

P Colombeau

Publications and source records attributed to P Colombeau.

At least 19 recordsLinked to original sources
PubMed2004

Efficacy and tolerability of radiotherapy as treatment for bicalutamide-induced gynaecomastia and breast pain in prostate cancer.

OBJECTIVE: To assess the efficacy and tolerability of localised radiotherapy for the treatment of bicalutamide ('Casodex''Casodex' is a trademark of the AstraZeneca group of companies.)-induced gynaecomastia and/or breast pain. METHODS: This open-label, non-comparative, multicentre study included 51 patients receiving bicalutamide 150 mg for the treatment of non-metastatic prostate cancer (T1b-T4, Nx, M0). Patients who developed symptomatic gynaecomastia and/or breast pain received two 6-Gy fractions of external-beam radiation to the breasts and were then assessed at two 3-monthly follow-up visits. RESULTS: 37/51 (72.5%) patients experienced gynaecomastia and 41/51 (80.4%) experienced breast pain, typically within the first 6 months. Twenty seven and 38 patients, respectively, went on to receive breast irradiation. Following radiotherapy, gynaecomastia improved or resolved in 7/27 (25.9%) and 2/27 (7.4%) cases, respectively, and breast pain improved or resolved in 12/38 (31.6%) and 3/38 (7.9%) cases, respectively. No change was observed in 7 patients (25.9%) with gynaecomastia and 12 patients (31.6%) with breast pain, while 9 patients (33.3%) and 8 patients (21.1%), respectively, worsened. Radiotherapy-related adverse events, reported by 18/41 (43.9%) patients, were generally mild and short lived (median duration approximately 5 weeks). CONCLUSIONS: Therapeutic radiotherapy, using two fractions of 6 Gy external-beam radiation to the male breast, improves the intensity of bicalutamide-induced gynaecomastia and/or breast pain in approximately one-third of patients. Adverse events were often mild and short lived.

Adenocarcinoma↗
PubMed2003

Anterior urethral valves and diverticula.

Obstructive lesions of the anterior urethra (valves, diverticula) are rare and can be difficult to diagnose. One recent case led us to review existing international reports; there are case histories for 260 patients over a 20-year period. The anatomical interpretation of these lesions is far from being unequivocal but many authors clearly distinguish between valves and diverticula, the basic difference being in the contiguity between the anomaly and the corpus spongiosum. Where the clinical presentation depends on age, the diagnosis depends essentially on voiding cysto-urethrography, which must image the whole urethra. Generally, the treatment for valves is simple, consisting of endoscopic resection. For diverticula it is not always necessary or desirable to remove the diverticulum; if there is a well-formed distal obstructing lip, removing it may be enough to cure the obstruction.

Child↗
PubMed2000

[Splenic lobulation and pseudo-cancer of the left kidney].

Discovery of a mass in the spleno-reno-pancreatic region requires complementary investigations to exclude a false diagnosis of renal tumour. While resembling a renal tumour, such masses can actually correspond to splenic lobulation, a cyst of the tail of the pancreas or a splenic entity (accessory spleen or splenosis).

Aged↗
PubMed1999

Adenocarcinoma in the exstrophic bladder.

We report 2 cases of cancerous transformation in an exstrophic bladder. The histology of these tumors, methods of surveillance, and treatment are discussed in conjunction with a review of published reports. These rare tumors are almost entirely adenocarcinomas. Their treatment is surgical (radical cystectomy) with or without associated radiation therapy. Surveillance for patients with bladder exstrophy, whether surgically corrected or not, is indispensable and rests on cystoscopy and urine cytology.

Adenocarcinoma↗
PubMed1998

Renal lesions in Von Hippel-Lindau disease: the benign, the malignant, the unknown.

OBJECTIVES: To describe the features and treatment of renal lesions in von Hippel-Lindau disease (VHL) from a series of patients, to highlight important issues in the management of these lesions. MATERIALS AND METHODS: We performed a retrospective study in 7 patients with VHL who underwent surgery for renal lesions between January 1990 and July 1996. The initial evaluation consisted of an abdominal CT scan and renal arteriography. RESULTS: The mean age of patients at the time of discovery was 38 (+/- 12.01 years). All cases were of type 1. Radiology assessment underestimated the gravity of the lesions in 5 patients. In all patients, unilateral surgery was performed with the kidney being conserved in 4 cases. Of the 44 lesions removed, 23 had signs of progressiveness (atypical or malignant cyst, renal cell carcinoma), most of the cancers were of low grade. 84% of the lesions did not exceed 3 cm and 48% were </=1 cm. During follow-up (42 months), 2 patients relapsed. CONCLUSION: The clinical and pathological features of renal lesions in VHL require strict and early follow-up (from the age of 15). Only under these circumstances should primary conservative surgery be performed, however, recurrences are frequent. This conservative approach remains to be validated by multicentric prospective studies.

Adult↗
PubMed1998

[Benign prostatic hypertrophy: mini-invasive treatments (interstitial laser-transurethral needle ablation-thermotherapy)].

Endoscopic resection is the "gold standard" to treat benign prostatic hyperplasia refractory to medical treatments, because it is effective and only relatively aggressive. In young patients or debilitated elderly patients, there is a place for so-called minimally invasive surgical treatments, consisting of three possibilities: interstitial laser, TUNA (transurethral needle ablation), and thermotherapy. The results of these last two techniques are very similar o those obtained by endoscopic resection, with virtually no complications. These treatments are performed on an outpatient basis and have no consequences for sexuality. Thermotherapy has also been approved by the FDA in the USA. In France, these treatments can only be used in the context of a clinical trial.

Ambulatory Surgical Procedures↗
PubMed1997

[The Indiana pouch: a technic for simple continent urinary diversion].

OBJECTIVE: Description of the Indiana pouch, a continent urinary diversion after cystectomy for urogenital tumours, and for the sequelae of neurogenic and traumatic bladders. MATERIAL AND METHOD: This was a retrospective study of 16 patients undergoing, between June 1991 and March 1995, cutaneous urinary diversion by ileocaecal graft, detubularized in the colonic segment, with continence ensured by the ileocaecal valve. The postoperative follow-up (4 to 36 months) was performed at 3, 6 and 12 months (abdominal ultrasonography alternating with abdominopelvic CT scan), then annually (CT scan). Finally, a urodynamic assessment was performed in 7 patients. RESULTS: No early complications related to the reservoir were observed. Late complications of the diversion were related to the uretero-colonic anastomosis with 3 dilated renal subunits. Continence was achieved in 12 out of 15 patients, while one patient finally refused self-catheterization. In the patients in whom a urodynamic assessment was performed, the mean capacity of the reservoir was 671.4 +/- 273.9 mL for a filling pressure of between 3.7 +/- 1.6 and 11 +/- 2.5 cm H2O and an ileocaecal valve closure pressure of 97.9 +/- 117.1 cm H2O (full reservoir). CONCLUSION: The Indiana pouch is a useful urinary diversion as it is simple to perform and is associated with a low revision rate, while ensuring low-pressure continence.

Abdomen↗
PubMed1994

[Diagnostic and therapeutic approach in organic impotence].

The incidence of impotence increases with age. Its etiology is always complex and often multifactorial. The hidden organic causes of impotence are as follows in decreasing order of frequency: arterial, venous, neurological and endocrine. Paraclinical investigation of erection dysfunction plays an important role: hormone levels, arterial Doppler, digitalised rigidimetry, the intracavernous test, cavernometry-cavernography and internal iliac angiography, are used to define the diagnosis and determine appropriate management. It is stressed that supportive sex therapy is often indispensable and that penile prostheses are the final recourse, when treatment based upon etiology has failed.

Endocrine System Diseases↗
PubMed1994

[The role of ultrasound-guided trans-rectal puncture in the treatment of prostatic abscess].

Prostatic abscess is a rare complication of urinary tract infection, whose symptoms and signs are not often specific. Prostatic abscess can now be easily diagnosed by transrectal ultrasonography. The authors report six cases of prostatic abscess diagnosed by ultrasonography. These abscess were successfully drained by ultrasound-guided transrectal aspiration, which may constitute a useful solution, as the classical treatments to date consist of transurethral resection or rectotomy.

Abscess↗
PubMed1989

[Meatal polyp in women].

The authors analyse the pathophysiology of pseudo-tumours of the female urethra and present the clinical signs and diagnostic traps associated with these lesions. Treatment is essentially medical by means of a combination of anti-infectious and anti-inflammatory agents and local oestrogens.

Diagnosis, Differential↗