Prog Urol
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Microscopic abscesses of the prostate (< 1 cm) are usually treated by antibiotics with good prostatic diffusion, such as fluoroquinolones, for a minimum of 4 to 6 weeks. Complementary surgical drainage is generally required for larger abscesses or in case of an unfavourable course. The main points of discussion in the literature are the type of drainage and the incision that should be performed. ⋯ CT-guided percutaneous drainage (perineal or transrectal), or more frequently transrectal ultrasound-guided drainage, now allows rapid and effective evacuation of the abscess, without the need for general anaesthesia. The perineal route allows a simple J stent to be left in place for several days to ensure complete drainage, but it is not universally accepted. Transurethral exposure is indicated for periurethral prostatic abscesses.
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Comparative Study
[Renal adenocarcinoma with retrohepatic vena cava thrombus: role of extracorporeal circulation in a retrospective series of 10 cases].
Renal cell carcinoma is accompanied by tumour thrombus in the inferior vena cava (IVC) in 4 to 10% of cases. Since the use of cardiopulmonary bypass (CPB), surgery for extensive thrombus has been improved by reduction of blood loss, facilitating complete resection of the kidney and thrombus and possible repair of the inferior vena cava. ⋯ The level of the thrombus in the inferior vena cava determines the mode of vascular management. The presence of invasion of the inferior vena cava wall is difficult to predict because of the poor sensitivity of radiological examinations. CPB did not induce any excess morbidity in this series. The use of CPB in renal cancers with retrohepatic thrombus facilitates the resection procedure and allows inferior vena cava reconstruction in a bloodless environment.
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The authors report three cases of traumatic dislocation of the testis. Each case concerned a young patient, victim of a motorbike accident with direct trauma to the perineum and scrotum on the reservoir. Preoperative radiological assessment consisted of ultrasound, computed tomography, or even magnetic resonance imaging, depending on the case. ⋯ The authors define the place of radiological assessment, which can guide the diagnosis and therapeutic strategy. Surgical exploration, allowing assessment of the lesions, is required in every case. Repositioning of the testis in the scrotum ensures cure when the testis is still viable.
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The medical device vigilance system was set up in France in line with European directives. It consists of reporting of incidents or risks of incidents related to medical devices, evaluation of information, follow-up of files and conduct of device safety studies. Health establishments must appoint a local medical device vigilance correspondent responsible for sending declarations to the ministry. ⋯ The national medical device vigilance commission and the eight technical subcommittees consequently play an advisory role to the Minister of Health. When decided by the Minister, manufacturers of medical devices for which a declaration has been submitted may be required to modify them or withdraw them from the market. Medical device vigilance is therefore now an integral part of clinical practice.
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To determine the diagnostic value of transrectal magnetic resonance imaging (MRI) in the local staging of prostatic cancer. ⋯ In this study, transrectal MRI appeared to be satisfactory to improve the staging of localized prostate cancer, especially in terms of seminal vesicle lesion and apical invasion, but, most importantly, appeared to be very useful to predict negative resection margins.