[Retropubic radical prostatectomy].
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Biomedical subjects
Publications and source records attributed to S Gabellon.
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The advent of "minimal invasive surgery" with the development of new endoscopic techniques modified many therapeutical concepts in urology as in other fields. The treatment of the ureteropelvic junction obstruction reserved in the past to open surgery can nowadays be successfully realized with endopelvic or endoureteral techniques under visual or fluoroscopic guidance. The authors present their experience with two new techniques: antegrade endopyelotomy under visual control or retrograde fluoroscopic endopyelotomy. Based on experimental and clinical studies which demonstrated the extraordinary capacity of the incised ureter to regenerate and regain a peristaltic activity, these treatments offer a cure rate nearly as high as open pyeloplasty.
The new techniques of medically assisted procreation allow to approach most of the male infertilities. Their complexity and cost call for a precise diagnosis prior to treatment initiation and a multidisciplinary investigation of the sterile couple is mandatory. We demonstrate the urological side of these investigations.
Oncocytoma is an uncommon benign tumor of the kidney. Its incidence represents 3 to 10% of all solid renal masses. This diagnosis, seldom recognized before the operation, is often revealed by anatomo-histological examination. Surgical treatment of a small tumor, ever the most benign, can be limited to enucleation or partial nephrectomy to spare renal parenchyma. When a small, solid and well-confined renal mass is discovered, the diagnosis of oncocytoma must be considered and the usual investigations (abdominal ultrasound, CT-scan...) must be completed by renal angiography to obtain as much information as possible in support of the diagnosis of oncocytoma, justifying nephron-sparing surgery.
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Erection, a complex physiological phenomenon, is the result of numerous simultaneously interacting mechanisms. A defect of one of these mechanisms can induce erectile dysfunction. In this paper, the authors define the various tests used to investigate the principal pathways governing erection, taking into account their respective value in view of the increasing pressure of budget restrictions on health systems.
Mechanical devices for assisting erection are gaining a wider interest and are of significant importance in the treatment of erectile dysfunction. The authors have assessed their contribution to the treatment of impotence in 36 patients at our outpatient Andrology clinic/CHUV. (31 patients with organic impotence, the remaining five being of psychogenic origin).
In 1986, a prospective study was started in CHUV on the squamous-cell carcinoma of the esophagus treated with a multimodality protocol associating preoperative chemotherapy and surgery. Nineteen patients are currently followed-up. Dysphagia is the main symptom and was found in 16 patients (84%). After chemotherapy, dysphagia disappeared completely in 7 cases (44%), regressed in 7 other cases and worsened in 1 case. Twelve patients were operated on, without operative mortality. Histologically, no tumor was found in one case (5%) after the preoperative treatment. Follow-up is currently too short to draw statistical conclusions. The rationale, advantages and perspectives of the multimodality treatment are presented and compared with different recent series.
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