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Biomedical subjects

C Coulange

Publications and source records attributed to C Coulange.

At least 73 records · Page 4Linked to original sources
PubMed1992

[New uretero-cystoneostomy in cystocecoplasties. Technique and results].

Ureteric reimplantations into an intestinal segment are frequently followed by early, secondary or late stenoses. In UCN, it is essential to perform atraumatic ureteric dissection followed by reimplantation of a short ureter well vascularized by a single superior pedicle, i.e. the simplest UCN, putting the least strain on the ureter both during creation of the diversion and during subsequent healing. The ileal segment of an ileocaecocystoplasty must extend above the right iliac vessels. It is open on the antimesenteric border and its distal border is stripped of a 3 mm band of mucosa. To reach its homologue, the left ureter passes underneath the common root of the sigmoid mesocolon. Each optimally shortened ureter is placed in and fixed to the start and the end of a longitudinal mucosal tunnel, about 3 cm long. The ileum is sutured as a cuff around the orifice of each ureter. A ureteric stent is left in place for a fortnight. The ileum is sutured to the right laterocaval retroperitoneal tissue. This UCN is simple and rapid to perform.

Cecum↗
PubMed1991

Pericavernous prosthetic band for erectile dysfunction in venogenic impotence. A new surgical technique.

A series of 35 patients who were treated surgically by pericavernoplasty using a prosthetic band is presented. At the 1-year follow-up visit, 57% still had improved erectile capability. At the present time, it is difficult to determine whether or not surgical treatment will result in failure. However, according to recent histological studies, prognostic insight in the future might be provided through the analysis of erectile tissue, but for the present moderation must be used in deciding upon surgical treatment since there is a lack of precise physiopathologic understanding of erectile dysfunction.

Erectile Dysfunction↗
PubMed1991

European experience with the urethral Wallstent for urethral strictures.

We describe the use of the urethral Wallstent in 71 patients with urethral strictures. The stainless steel stent is self expanding when released from its endoscopic introducer. The results over a 3-year period have been good with only mild discomfort and slight urethral leakage for up to 3 months. Migration, infection and encrustation have not been a problem and serial endoscopic review shows healing to be variable but complete in up to 12 months. It is considered that this simple endoscopic technique offers a simple, safe and effective alternative to multiple dilatations, urethrotomies and urethroplasty procedures in patients with bulbar urethral strictures.

Equipment Design↗
PubMed1991

[Ureteral replacement using an ileal graft of reduced diameter. A preliminary report].

Extensive or even complete loss of the ureter of a functioning kidney makes it impossible to restore the normal continuity of the urinary tract by any available surgical technique. An ileal loop of appropriate length, anastomosed to the bladder with its entire lumen, is the only tissue suitable for replacing this missing ureter; this results in the formation of a megaureter or a vesical diverticulum which, although contractile, presents dimensions and conditions of anastomosis which predispose to the development of vesico-ileal reflux and a risk of torpid infection and dangerous reabsorption of the urine. We consider that it would be useful to use the ileum to create a contractile, reduced calibre tube with properties similar to those of the ureter. This technique, which has rare indications, is feasible as illustrated by the 5 cases reported here, corresponding to 7 uretero-ileoplasties modelled according to this technique. Results were satisfactory with a follow up of 6-24 months.

Adult↗
PubMed1990

Total androgen blockade with Zoladex plus flutamide vs. Zoladex alone in advanced prostatic carcinoma: interim report of a multicenter, double-blind, placebo-controlled study.

A double-blind, placebo-controlled, randomized, multicenter study was undertaken to investigate the effects of Zoladex plus flutamide vs. Zoladex plus placebo in patients with advanced prostatic cancer. Interim analysis has revealed no differences between the 2 groups in objective or subjective responses at 6 months' follow-up or in overall survival and time to disease progression at 15 months' follow-up.

Aged↗
PubMed1990

[Quantitative renal DMSA scintigraphy after extracorporeal lithotripsy].

This study reports the results of renal DMSA isotope scan before and after EDAP extracorporeal lithotripsy in 106 patients. An isotope scan was performed before lithotripsy and on the fourth day after lithotripsy and again on the 90th day when alterations were observed on the first post-lithotripsy scan. The assessment of any sequelae was based on the scale of colours of the spectrum, which revealed three types of modifications. The analysis of the results is divided into three periods according to the development in our lithotripsy technique: high firing rates had a success rate of only 40%, with renal scars on isotope scans in 2/3 of cases; low frequency firing rates had a 55% success rate and induced minor changes which were virtually always reversible; in contrast, low frequency firing rates during the 3rd period had a 60% success rate with scars on isotope scans in 1/3 of cases. These isotope scan modifications also depended on the site of the stone. In conclusion, lithotripsy definitely induces renal modifications. The renal parenchyma cannot remain indifferent to lithotripsy beyond a certain threshold. A homogeneous multicentre study with a common protocol is necessary to compare the various lithotriptors and to define cautious and coherent indications for each lithotriptor in the treatment of renal stones.

Humans↗
PubMed1990

["Wallstent" endoprosthesis in recurrent urethral stricture in men].

Many patients are condemned to repeated urethral dilatations because of the poor efficacy of treatment for male urethral stricture. The authors have recently used a new urethral prosthesis: a metal-reinforced, meshed tube which opens in the urethra and maintains a it open allowing the urothelium to grow over. The prosthesis therefore becomes incorporated in the wall of the urethra. they have implanted this prosthesis in 21 patients with a mean age of 61 years, essentially in the bulbar urethra, for longstanding strictures measuring 5 to 35 mm and unresponsive to currently available treatments. The endoscopic insertion of the prosthesis is performed after dilatation. The mean follow-up is 9 months. The stricture was correctly treated in all patients (three patients required two sessions). The follow-up of these patients is short and the stability of these favourable results needs to be confirmed by a longer follow-up.

Adult↗
PubMed1990

[Long-term results of male urethral stenosis].

Long-term outcome in 142 patients after endoscopic or surgical treatment or urethral stenosis were evaluated. Results seem disappointing. Development of new therapeutic methods is desirable: the principle of use of an endoprosthetic material for stenoses of the bulbar urethra is described, and the operative technique and preliminary results are reported.

Endoscopy↗
PubMed1989

Aortoiliac reconstruction and renal transplantation: staged or simultaneous.

Aortoiliac atherosclerosis can jeopardize the outcome of renal transplantation. During a five-year period, 176 renal transplants were performed. Of these, four patients underwent prior or simultaneous arterial reconstruction. In two, transplantation was successfully performed three and ten months after abdominal aortic aneurysm repair. In the two others with aortoiliac occlusive lesions, simultaneous arterial reconstruction and transplantation were successfully performed. We conclude that the discovery of aortoiliac lesions in a candidate for renal transplantation warrants consideration for staged or simultaneous arterial reconstruction to widen the indications for transplantation in such individuals and provide satisfactory long-term transplant durability.

Adult↗
PubMed1989

[Is intravenous urography indispensable in evaluating a bladder emptying disorder?].

Two patients with disorders of bladder emptying (dysuria, pollakiuria) were treated by endourethral resection after being investigated by ultrasonography without intravenous pyelography. Intravenous pyelography performed subsequently due to persistence and even deterioration of the bladder emptying disorders revealed the diagnosis and allowed treatment of renal tuberculosis. Intravenous pyelography is therefore an essential part of the assessment of patients with prostatic symptoms.

Aged↗
PubMed1989

[Functional and urodynamic study of cecocystoplasties with or without detubation].

The authors analyse and compare the clinical and urodynamic results of 16 tubed caecocystoplasties and 5 detubed ileocaecocystoplasties. The urodynamic assessments were performed between 2 months and up to 4 years after the operation. After a period of about 6 months, there was a functional difference between these two types of reservoir. The loss of pressure peaks in detubed reservoirs is not sufficient to ensure complete nocturnal continence. Neovesico-sphincteric synergy is responsible for real sphincteric self-re-education. Rationally, a detubing procedure in bladder replacement is only desirable in the case of a "deficient" sphincter.

Cecum↗
PubMed1989

[Extra-corporeal lithotripsy (EDAP LT 01) in urinary lithiasis].

Five hundred and twenty six extracorporeal lithotripsies have been performed for renal and ureteric stones. Using low frequencies (1.25 to 2.5 cycles per second), extracorporeal lithotripsy was performed without anaesthesia and without premedication in 85% of cases. 91.9% of patients treated were followed and reviewed after one and three months: 292 (55%) were successes, 124 (22.5%) obtained partial results, 122 (22.5%) were failures. The best results were obtained in stones less than 20 mm in diameter. The results could only be improved by a second session of extracorporeal lithotripsy. Scintigraphic scars observed after high frequency lithotripsy and not observed after low frequency lithotripsy were again seen after renewal of the firing head.

Evaluation Studies as Topic↗