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S Conquy

Publications and source records attributed to S Conquy.

At least 19 recordsLinked to original sources

Localized hyperthermia versus the sham procedure in obstructive benign hyperplasia of the prostate: a prospective randomized study.

Hyperthermia was shown to cause improvement in 50 to 60% of the patients with benign prostatic hyperplasia (BPH) without considering placebo effects. We studied 68 patients randomly assigned to a treatment group (38) and a sham group (30) who underwent the same manipulation but without applying radio frequency power. The Biodan Prostathermer was used. Criteria for inclusion were based on objective and subjective symptoms. Treatment was performed 6 times at 43 +/- 0.5C for the treatment group. Followup evaluation was performed at 3 months, and the same objective and subjective symptoms were recorded. We observed a statistically significant subjective improvement in the sham group (33%) that was not accompanied by any significant objective improvement. In the treatment group the subjective response was significantly better regarding number of patients (68%) and response rate, and was substantiated by a significant improvement in all objective symptoms (53% of the patients) except voided volume. Therefore, hyperthermia treatment had a definite therapeutic effect on BPH in excess of placebo.

Aged

[Morbidity of radical prostatectomy for localized cancer of the prostate. Apropos of 100 cases].

Adenocarcinoma of the prostate is the most frequent cancer of male over 60 years of age. Radical prostatectomy is one of the preferred modes of treatment for localized stages. Surgical morbidity decreases with experience and consists mainly in bleeding and rectal injury. Delayed morbidity comprises loss of erection, anastomosis stricture, incontinence. A retrospective study of 100 patients is reported.

Aged

[Localized transrectal hyperthermia in the treatment of obstructive manifestations of prostatic adenoma. Review of the literature and personal experience].

For about the last 10 years, transrectal hyperthermia has been used to treat obstructive manifestations of adenoma of prostate. This procedure induces interstitial edema and acts preferentially on the fibrous elements of the prostate. Several therapeutic regimens have been used successively by different teams, after objective and subjective inclusion screening programmes. Results published up to the present show about 45% of objective responders (against 3% in a placebo group) with improvement sustained in 3 out of 4 cases. Morbidity rate (infection and urinary retention) was 3%. Data from a retrospective study of a series of personally treated patients was w used to determine those with the greatest chance of a successful outcome, even though this is never comparable with that of surgical treatment.

Adenoma

[Treatment of urinary stress incontinence in women by percutaneous cervico-cystopexy. Gitte's operation: contribution of intraoperative ultrasonography. Apropos of 47 patients].

Between March 1988 and February 1991, 47 patients with urinary stress incontinence (USI) were treated by Gittes' operation, suspension thread traction being determined by perioperative ultrasonography in 31 of these cases. All patients were re-examined on February 1992 after a mean follow-up of 26 months (range 12 to 24 mths). The global success rate (recovery and improvement) was assessed as 72% at 3 months and 56% at follow-up. Rated as a function of closure pressure (CP), the success rate at evaluation was 62% with normal CP, 42% with CP low for age, and 33% with CP < 30 cm H20. For the 31 patients with perioperative ultrasonography examination the success rate was 80% at 3 months and 70% at follow up. As a function of CP the rate was 83% at follow up with a normal CP, 50% with a CP low for age, 37.5% with a CP < 30 cm H20. Although Gittes' operation is a simple, fairly non-aggressive intervention, results diverge widely from those obtained with "classical" techniques. Optimization of indications is essential, therefore, only patients with pure USI without hypotonia of the sphincter obtaining maximum benefit from the intervention, carried out preferably under perioperative by control ultrasonography.

Adult

[Treatment of urinary incontinence by feedback in women].

Today's treatment of female urinary incontinence is not merely surgical. Provided the indications are clearly established (stress incontinence due to sphincter hypotonia, bladder instability and overflow urination in some cases, sensitive frequency) and the therapist properly trained, vesicosphincteral physiotherapy represents an alternative or a complement to the other therapies. The various aspects of this rehabilitation (manual techniques, electrostimulation, biofeedback) are reported here.

Adult

[Is dysuria an objective or subjective concept?].

A prospective study was carried out in 100 consecutive male patients coming to consultation in the department. These men, whose average age was 65 years (32-82), and who had come for various reasons, answered a questionnaire on the quality of their urine flow, which was rated on a scale ranging from 1 to 4. The results of flow rate measurements were classified in 4 categories according to the maximum flow rate and to the volume of micturation, which always was greater than 150 ml. The comparison of the subjective appreciation and of the objective value showed frequent discrepancies (over- or under-evaluation). These results were analysed according to various parameters, and in particular to the patients' age. It thus appears that one third of the patients only have an accurate appreciation of the quality of their micturation.

Adult

[Low pressure bladder replacement after total cysto-prostatectomy. Apropos of a series of 40 patients].

The results of 40 consecutive patients who underwent bladder replacement following cystoprostatectomy for invasive bladder cancer are reported. A 30 cm detubularized ileal segment was used to make the neobladder. Mean follow-up was 19 months (over 2 years in 17 patients). All patients achieved diurnal continence. Nocturnal continence was obtained in 70.5% of patients: 41% had no leakage and nocturia less than 2, while 29.5% had some occasional leakage. Urodynamic evaluation showed the average peak flow to be at 18.3 ml/s and an average neobladder capacity of 410 ml. Six patients had spontaneous contractions of the enteric bladder of greater than 40 cm H20, always associated with elevated urethral pressure. Post-void residue was smaller than 100 cc in all cases. This procedure is simple to do, and led to an excellent diurnal continence, although it cannot assure nocturnal continence in every single patient.

Aged

[Treatment of prostatic obstruction using localized hyperthermia. A preliminary study].

The LDMWH (Promeditech 2000), a hyperthermia apparatus emitting microwaves with a frequency of 915 MHz, has been used since July 1988 in the Urology Department of Hôpital Cochin and the Polyclinic of Montreuil for the treatment of prostatic obstructions. Patients are selected on the basis of objective criteria (flowmetry, post-micturating residue) and subjective criteria (standard clinical history). Only patients with objective obstruction are treated by localized hyperthermia, which constitutes a real alternative to surgery. Treatment is performed as an outpatient procedure without anaesthesia as one one-hour session per week for a period of six weeks. The results are evaluated one and three months after completion of treatment by assessing the same objective and subjective criteria as before treatment. The results of the first 26 patients with sufficient follow-up reveals 45% good objective results and 65% good subjective results.

Aged

[Benign prostatic hypertrophy. Treatment using local hyperthermia].

The authors have used local hyperthermia in the treatment of benign prostatic hypertrophy (BPH). The "Promeditech" device consists of a computer-controlled microwave hyperthermia system which warms up the prostate through a probe inserted into the rectum. Forty-three patients aged from 57 to 81 years were treated. All presented with severe voiding symptoms and were considered for surgery. Treatment was applied once a weeks for 5 weeks without anaesthesia and on an out-patient basis. At each session, hyperthermia was maintained at 42.5 to 43.5 degrees C for 60 minutes. Objective and subjective criteria for treatment were: post-voiding residual volume, voided volume, maximum flow rate and frequency, urgency, dysuria and nocturia respectively. These parameters were determined for all patients before and after treatment. Results were evaluated at 3 months and 6 months. Objective improvement was observed in 45 p. 100 of the patients, and subjective improvement in 58 p. 100. In 4 out of 5 patients fitted with an in-dwelling catheter for more than 3 months, it was possible to remove the catheter. This procedure must be more widely tested, but it seems to be particularly appropriate for two kinds of patients: those who do not accept retrograde ejaculation and those who are considered poor surgical risks.

Aged

[Sexual disorders after an operation for benign prostatic hypertrophy].

A prospective study was conducted on the sexual function of 70 patients undergoing transurethral (48 cases) or transvesical (22 cases) prostatectomy for benign prostatic hypertrophy. 22 patients with no sexual activity before operation, remained sexually inactive after surgery. Frequency of intercourse and penile erection remained generally unchanged after operation. Retrograde ejaculation was observed in 33 patients (69%). Only one patient complained of total loss of potency after operation. Orgasm was maintained in all other patients; however 25 patients considered it to be "different". 4 of the sexually active operated patients (8%) and 7 of their partners complained of lack of sexual satisfaction after operation.

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[Continent replacement enterocystoplasty using a low-pressure detubularized ileal pouch after radical prostatocystectomy].

Tubular ileal-ileo-caecal or colonic replacement enterocystoplasties induce nocturnal incontinence in more than 70% of cases, partly due to the presence of peristaltic waves responsible for pressures greater than 40 cm of water for low filling volumes. The use of debutularised intestinal grafts considerably attenuates these pressure waves, ensuring excellent diurnal continence and a dramatic reduction in nocturnal incontinence together with protection of the upper urinary tract. The detubularised ileal bladder combines the reliability of all low pressure reservoirs with a simple technique: a 30 cm ileal segment is isolated then opened 2 cm from its anti-mesenteric border. The two limbs of the loop are sutured to each other. The ureters are reimplanted at the summit of each limb according to the mucosal groove procedure and the summit of the pouch is anastomosed to the urethra. This procedure has been used in 10 patients following radical cystectomy for cancer. Seven of these patients underwent clinical, radiological and urodynamic examination 5 months after the operation: all 7 patients were continent during the day. Nocturnal continence was obtained at the cost of getting up one or twice during the night, but incontinence persisted in the other 3 patients. Cystometry did not reveal any pressure waves greater than 25 cm of water for a volume of 500 ml. The detubularised ileal bladder is simple to perform and constitutes a reasonable alternative to traditional tubular enterocystoplasties.(ABSTRACT TRUNCATED AT 250 WORDS)

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