[Internal urethrotomy under visual control. Renewal of an old technique].
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Biomedical subjects
Publications and source records attributed to C Chatelain.
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90 case records of renal cysts in adults submitted to surgery are studied. A simple pathological classification is proposed. The accompanying signs were, hematuria in 30 p. 100 of cases, but one should always seek another cause; renal colic is present in 22 p. 100 of cases, a palpable tumour in 50 p. 100, on the other hand, infection of the cyst is rare. 35 p. 100 of the cysts were associated with another disease, usually obstructive uropathy, and there were 3 cases of association with carcinoma of the kidney in this series. Pre-operative diagnosis, eliminating carcinoma of the kidney, was ensured by intravenous urography and echotomography which permitted us to restrict the indications for arteriography and aspiration of the cyst. Surgical treatment permits resection of the salient dome of the cyst in the absence of general contra-indications, in order to suppress symptoms due to the cyst and above all, eliminate carcinoma of the kidney. The post-operative period was uneventful and the mortality nil.
For 16 years we have used segmental urethrectomy with end-to-end urethrorrhaphy for treatment of traumatic urethral lesions, in preference to two-stage urethroplasties. The approach has been transperineal, retropubic, and if necessary transpubic. Good results in 41 cases with long-term follow-up allow us to say that this is a good operation. It provides in two thirds of the patients a correct and stable urethral stream, complete bladder emptying, and does not affect urinary control or sexual function if this was normal following the injury.