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R O Fourcade

Publications and source records attributed to R O Fourcade.

At least 19 recordsLinked to original sources
PubMed2006

[How to operate kidney puncture in percutaneous nephrolithotomy?].

Obtaining a precise percutaneous calyceal puncture gave way to the development of percutaneous nephrolithotomy, one of the first micro-invasive techniques described in urology. Both radiologist and urologist can perform puncture, sometimes in a collaborative effort. However, being followed by a true surgical procedure, it should be done in the O.R; perfect knowledge of the procedure is mandatory for every urologist. Standard guidance uses a fluoroscopic C-arm device, only able to guide the needle precisely towards the apex of the chosen calyx. Moving the C-arm with cephalad tilting will provide 3-D imaging. Ultrasound guidance is an alternative, but might be difficult with non dilated upper tract. CT guidance and retrograde puncture are rarely used. The access is to be adapted according to the patient (adult or child), type of stone (single or multiple access), or kidney position (eutopic or ectopic). Direct ad stable puncture entering the apex of the chosen calyx is a pre-requisite for easy and efficient subsequent nephrolithotomy.

Humans↗
PubMed2005

[The UrEpik study: a descriptive epidemiological approach to lower urinary tract symptoms, sexual disorders and urinary continence in four countries].

UrEpik is a cross-sectional, epidemiological study undertaken in four cities (Auxerre, Birmingham, Nijmegen and Seoul) to determine the prevalence of lower urinary tract symptoms, urinary incontinence and erectile dysfunction in men aged from 40 to 80 years and their female partners, if applicable. Numerous evaluation questionnaires were collected by post, telephone or direct contact from 4876 men and 3657 women. The prevalence of lower urinary tract disorders was significantly different from one country to another, but increased constantly with age in particular in men with an I-PSS between 8 and 19 for whom it increased by approximately 10% per decade. Incontinence in men seems to be an important problem both in terms of discomfort score and wearing of protection and it increases with age. Analysis of erectile dysfunction (ED) gave different results depending on the method of investigation used. The SFI (sexual functional index) showed a positive correlation between ED and age, which was not found by direct questioning. The psychological impact of ED varied according to culture and age of the subject.

Adult↗
PubMed2004

[The PCPT study: the viewpoint of an urologist involved].

The PCPT study investigating the possibility of decreasing the incidence of prostate cancer by daily administration of 5 mg of finasteride for 7 years appears to be a major clinical study in the management of this disease. Recently published in the New England Journal of Medicine, it makes difficult reading. The current article aims to demonstrate the main methodological characteristics of this study, to describe the most significant results and to discuss its clinical applications in daily urological practice.

Cholestenone 5 alpha-Reductase↗
PubMed2002

[Prevalence of lower urinary tract disorders and incontinence in Auxerre. French segment of the UrEpik study].

OBJECTIVES: To estimate the prevalence of low urinary tract symptoms (LUTS) and urinary incontinence among men and women aged 40 to 79 years. METHODS: A postal survey was carried out in a community-dwelling random sample, in Auxerre, France. LUTS were assessed using the International Prostate Symptom Score (IPSS). Urinary incontinence (UI) was assessed using a score based upon four questions. RESULTS: 1216 men and 591 women participated in the survey. 19.2% of men and 13.7% of women reported moderate to severe LUTS (IPSS > 7). 73% of men and 29% of women suffered from UI. Among men and women reporting severe symptoms of UI (0.4 and 5.4% respectively), one third had been prescribed medications for urinary disorders within the previous six months. CONCLUSION: This survey confirms the high prevalence of LUTS and urinary incontinence among a community-dwelling sample of men and women, and highlights the need for management of these disorders.

Adult↗
PubMed2002

The management of localized prostate cancer.

At this point in time, the only possibility of curing prostate cancer is through the early detection and treatment of localized disease. The large number of treatment options available for localized prostate cancer, including radical prostatectomy, radiotherapy (either external beam or interstitial), hormone therapy and watchful waiting, can be confusing for the patient. These treatments are associated with different adverse effects, further complicating the treatment decision. As there will inevitably be a trade-off between expected cure and acceptable adverse effects, it is important to discuss all options with the patient. The doctor and patient must together decide the appropriate treatment for him and his tumor.

Aged↗
PubMed2002

The value of patient-doctor dialog in the treatment of early prostate cancer.

A lack of information about the characteristics of prostate cancer, the treatment options available, and the negative effects associated with each treatment option leaves many newly diagnosed patients feeling anxious, depressed and confused, and can ultimately lead to feelings of distrust towards the treating physician. Improving patient-doctor dialog increases the chances of successfully achieving the patient's goals in managing their disease. Factors considered important for improving patient-doctor dialog include an individualized approach to care, providing the patient with complete, comprehensive and unbiased information on treatment options, and allowing the patient sufficient time to come to a treatment decision.

Humans↗
PubMed2001

[Prevalence of nocturia among people in Auxerre: the French part of the UrEpik study].

OBJECTIVES: To estimate the prevalence of nocturia among men and women aged 40 to 79 years old. MATERIAL AND METHODS: A postal survey was carried out in a community-dwelling random sample in Auxerre, France. Nocturia was assessed using the item 7 of the International Prostate Symptom Score (IPSS). RESULTS: 1216 men and 591 women participated in the survey. Average nocturnal urinary frequency was 0.98 and 0.95 among men and women, respectively. Between the age ranges 40-49 years and 70-79 years, the frequency increased from 0.70 to 1.61 among men, and from 0.72 to 1.31 among women. In the age range 70-79 years, 48.1% of men and 31% of women awakened from sleep to urinate at least twice per night. CONCLUSION: Patients and primary care physicians should be more informed about screening and management options, and impact of nocturia on quality of life and related morbidity.

Adult↗
PubMed2000

[Morbidity of endoscopic prostatic resection: 3-month prospective study. Practical Urology Club].

OBJECTIVES: To quantify the complications of TUR of prostate occurring during the first three post-operative months. PATIENTS AND METHODS: Multicentric cooperative study where skilled urologists, aged between 45 and 55 years old, with various practice settings, compile complications in their consecutive patients undergoing TURP between March and June 1996. 410 patients have been assessed by 17 urologists. RESULTS: Rate of intraoperative complications is low with 10 patients being transfused and 3 TUR syndromes being observed. Two deaths occurred in patients aged 84 and 92 years-old at post-op day 27 and 30 respectively. Twenty four percent of patients experienced at least one complication during the observation period, the most frequent of which was asymptomatic bacteriuria in 8.5%. Urethral--mainly meatal--stenosis was the main cause for the readmission/reintervention rate (6.5%). CONCLUSION: Early morbidity/mortality of TURP for BPH albeit real, occurs in a small percentage of patients, with a general mild intensity. Alongside with excellent objective and subjective outcome, these rates allow TUR of prostate to remain the gold-standard treatment for BPH.

Aged↗
PubMed2000

[Efficiency and tolerance of terazosine in ambulatory patients with benign prostatic hypertrophy: comparative randomized and double-blind trial versus alfuzosin. The MG Terazosine Group].

OBJECTIVE: To compare, in general practice, the efficacy and safety of terazosin (5 mg per day in single dose) versus alfuzosin (7.5 mg per day in 3 doses) in patients with symptomatic benign prostatic hyperplasia (BPH) treated for 16 weeks. MATERIAL AND METHODS: Thirteen investigators included patients over the age of 50 years presenting with BPH with an International Prostate Symptom Score (IPSS) greater than 12 and a post-voiding residual volume less than 300 ml. After a one-week observation period, these patients were randomized to receive either terazosin or alfuzosin for 16 weeks (112 days) under double-blind conditions. The primary endpoint was the percentage reduction of the IPSS score at 3 weeks and 16 weeks; the secondary endpoint was the IPSS quality of life score. Safety was evaluated by recording adverse events and monitoring blood pressure. RESULTS: Seventy four patients were included: 39 in the terazosin group, 35 in the alfuzosin group. The 2 groups were not significantly different before treatment. Improvement of the IPSS score was similar in the 2 treatment groups (p = 0.97 at 3 weeks, and p = 0.29 at 16 weeks), as was the improvement of the quality of life score (p = 0.47 at 3 weeks and p = 0.71 at 16 weeks). Treatment was considered to be "effective or very effective" in 31 patients (86%) in the terazosin group, and in 28 patients (82%) in the alfuzosin group. The IPSS score was greater than or equal to 12 before treatment for all patients included in the study. Twenty-five patients had a score < 12 at 3 weeks versus 56 at 16 weeks (p = 0.0001). Seven patients had a quality of life score less than 2 before treatment, versus 38 at 3 weeks, and 56 at 16 weeks (p = 0.0001). No significant difference was observed between the 2 groups in terms of the number of adverse events reported, or the course of blood pressure and prostate specific antigen. No patient dropped out of the study because of treatment-related adverse events. Two deaths were observed in the terazosin group (2 patients aged 86 and 93 years), but any relation to treatment was excluded. CONCLUSION: During this study, terazosin appeared to be as effective and as well tolerated as alfuzosin.

Adrenergic alpha-Antagonists↗
PubMed1998

Androgen deprivation for prostatic carcinoma: a rationale for choosing components.

Ever since prostatic carcinoma was discovered to be dependent on the hormone androgen for its proliferation, androgen deprivation has been the treatment of choice for advanced cases of prostate cancer. Originally, treatment was limited to surgical castration or estrogen therapy. However, the introduction of luteinizing hormone-releasing hormone analogues, antiandrogens, and newer treatment modalities, such as combined androgen blockade, has made choosing a treatment strategy more complex. Assuming that each modality is equally effective, emphasis should be placed on increasing patient tolerance and compliance by the use of long-acting, nontoxic treatments with simple dosing regimens and minimal side effects. This review focuses on the factors influencing the final choice of treatment strategy.

Androgen Antagonists↗
PubMed1997

Adjuvant treatment for failure of local radical therapy.

Adjuvant treatment is suitable where localised tumour recurrence justifies further treatment following failed radical prostatectomy. External beam radiotherapy is effective and may be enhanced by concomitant androgen deprivation therapy. Early adjuvant androgen deprivation therapy compared with 'deferred' therapy may drastically reduce morbidity and possibly increase survival in prostate cancer. A large clinical study is underway.

Chemotherapy, Adjuvant↗
PubMed1996

Estrogen reduction by aromatase inhibition for benign prostatic hyperplasia: results of a double-blind, placebo-controlled, randomized clinical trial using two doses of the aromatase-inhibitor atamestane. Atamestane Study Group.

BACKGROUND: The concept of estrogen withdrawal by an aromatase inhibitor in the treatment of benign prostatic hyperplasia (BPH) was assessed in a prospective, randomized, double-blind, placebo-controlled multicenter trial. METHODS: Two hundred and ninety-two patients with clinical symptoms of BPH were randomly allocated to one of the following treatments for 48 weeks: placebo or the selective aromatase inhibitor, atamestane, at a daily dose of 100 mg or 300 mg. Both doses of atamestane significantly reduced serum concentrations of estradiol and estrone, and produced a slight, dose-dependent, counter-regulatory increase in peripheral androgen concentration. RESULTS: Clinical symptoms improved during treatment in all three groups. Even after 48 weeks, the effect of active treatment did not exceed the effect seen with placebo. Overall tolerance of 100 mg atamestane was excellent, but 300 mg showed a slightly increased incidence of side effects compared with placebo. CONCLUSIONS: The conclusion from this study is that the reduction in estrogen concentration using the selective aromatase inhibitor atamestane has no effect on clinically established BPH.

Aged↗