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F Pontonnier

Publications and source records attributed to F Pontonnier.

At least 37 records · Page 2Linked to original sources
PubMed1998

[The use of MRI with a pelvic phased array antenna in the evaluation of the gland and tumor volume of clinically localized prostatic adenocarcinoma].

UNLABELLED: Prostate cancer is clinically understaged in 50% of cases. It was improved with the use of random biopsies, PSA analysis (balanced and unbalanced) and Gleason grade on biopsies. Traditional imaging techniques such as endorectal ultrasonography and CT Scan are known to be of no interest. MRI is a non-evasive technique which allows the three dimensional study of an organ with a high quality of tissue contrast. Moreover, the positioning of surface antennae or "phased array" allowed improvement in spatial resolution. OBJECTIVE: To determine whether MRI allows an accurate staging of clinically localised adenocarcinoma by the direct estimation of capsular effraction, measure of glandular and tumor volumes and finally by obtaining reliable PSAd. MATERIAL AND METHODS: A prospective study was done from March 1995 to November 1996 on 55 patients with a clinically localised adenocarcinoma. MRI 1 Tesla Imager (SIEMENS), pelvic phased array antennae. FSE sequences (T1 and T2), axial and frontal. Evaluation of volumes by on-screen. Standford protocol for histo-pathologic reading on the axial cuts. Direct planimetry on a millimetre paper. RESULTS: Reliable estimation of glandular volume (average difference 0.7 cc). Sub-evaluation of tumoral volume (average difference 1.04 cc) with a 30% margin of error, accuracy 87%. Tumoral stage exact in almost 90% of the cases with a PPV of 94%. CONCLUSION: Prostatic MRI, using surface antennae, allows to complete the conventional stage by stage development by correctly diagnosing 75% of locally evolved stages. Its limits are linked to the nature of the signal of the tumorous tissue as to the localisation of neoplasic lesions.

Adenocarcinoma↗
PubMed1997

Inconstant ascending testis as a potential risk factor for spermatogenesis in infertile men with no history of cryptorchism.

The usual testicular location, either low or high in the scrotum, as well as testis ascent into suprascrotal position at least once a week from a usually scrotal position reported by the patient to occur spontaneously and regularly, were recorded in 85 fertile and 1014 infertile men, including 95 with a history of cryptorchism. The frequency of at least one testis being in a high scrotal location was similar in fertile (16.5%) and non-cryptorchid infertile (17%) men but higher in previously cryptorchid infertile men (27.2%), a difference probably due to cryptorchism. Testicular ascent was more frequent when scrotal location was high rather than low. An ascending testis was encountered more frequently in previously cryptorchid (30.4%) than in non-cryptorchid infertile men without any history of cryptorchism (18.3%) or in fertile men (11.8%). Moreover, in infertile men, spermatogenesis was more depressed in cases of testicular ascent than when both testes were never ascending, independently of a varicocele. Testis ascent could be a risk factor for spermatogenesis in infertile men without any history of maldescended testicle.

Adult↗
PubMed1997

[Prevention of sterility in spinal cord injured men].

The reproductive function of spinal cord injured males is not the primary concern of health professionals responsible for the management of these young adults. However, the fertility of these patients is threatened right from the first days after trauma, as indicated by abnormalities of the sperm count, reflecting the histological alterations observed on testicular biopsy. The factors predisposing to asthenoteratospermia, responsible for impaired fertility, are analysed and discussed. Urinary tract infection is the leading factor. This acute situation must be managed early, by preventing urinary tract infection and by obtaining a semen donation as soon as possible, after improvement of the general status.

Adult↗
PubMed1997

[Renal oncocytoma. Report of 13 cases].

We report 13 cases of renal oncocytoma. Urinary symptoms occurred in only 3 cases. The patient's age ranged from 41 to 74 years with an average of 62.3 years. The mean tumor diameter was 5.6 cm (range: 1.5-14). Diagnostic features of ultrasonography, CT scan and, in some instances, angiography were suggestive of renal oncocytoma in 2 patients, but never affirmative, 4 patients were treated by partial nephrectomy. No local or metastatic recurrence was observed with a mean follow-up of 30.8 months, ranging from 6 to 96 months. We assume that the term renal oncocytoma should be restricted to tumors exclusively composed of regular oncocytic cells with an eosinophilic granular mitochondria-rich cytoplasm and an absence of malignant potential. Diagnostic imaging characteristics may sometimes suggest the diagnosis of renal oncocytoma, but cannot eliminate the main differential diagnosis, i.e. granular renal cell adenocarcinoma. When the tumor is small and unifocal, nephron sparing surgery may be considered. Whether or not the diagnosis has been confirmed by fine needle aspiration, conservative surgery must be controlled by intraoperative frozen sections of the tumor and surgical margins.

Adenoma, Oxyphilic↗
PubMed1996

Time series analysis of sperm concentration in fertile men in Toulouse, France between 1977 and 1992.

OBJECTIVES: To investigate whether sperm production has changed during the past 16 years in the Toulouse area of France. DESIGN: Time series analysis of sperm donors' specimens between 1977 and 1992. SETTING: Sperm bank of university hospital in Toulouse, France. SUBJECTS: 302 healthy fertile men candidate sperm donors more than 20 and up to 45 years old and without any infertile brothers. MAIN OUTCOME MEASURE: Spermatozoa concentration. RESULTS: Donors' mean age at time of donation was 34.05 (SD 5.13), but this increased significantly (P<0.001) during the study, from 32.4 in 1977 to 36 in 1992. Mean sperm count of samples was 83.12x10(6)/ml (SD 68.42x10(6)/ml). Sperm concentration was positively linked to the year of donation (Pearson's coefficient r=0.12, P<0.05), but this correlaton disappeared after adjustment for age of donors (r=0.09,P>0.05). CONCLUSION: Sperm concentration has not changed with time in the Toulouse area.

Adult↗
PubMed1996

Micrometastatic adrenal invasion by renal carcinoma in patients undergoing nephrectomy.

OBJECTIVE: To examine adrenal invasion by renal cell carcinoma (RCC), particularly by adrenal micrometastasis, to determine whether adrenalectomy should be performed during radical nephrectomy. PATIENTS AND METHODS: From 1987 to 1994, 129 patients with RCC (90 men and 39 women, mean age 61.4 years, range 22-81) underwent radical nephrectomy with associated adrenalectomy because they had risk factors for adrenal invasion (tumour size > 5 cm. or tumour of the superior pole). Pathological examinations were carried out systematically and records of these examinations reviewed. The tumour size was recorded and the frequency of invasion calculated. RESULTS: There were 10 cases where the gland was invaded: one was a synchronous contralateral metastasis and nine (7%) were ipsilateral invasions of which two were tumours in the superior pole that invaded the gland by direct extension and the other seven invaded the gland by distant metastasis, six being micrometastatic (4.7%). A single micrometastasis was found in two cases (1.5%). There was no adrenal invasion by tumours of < 5 cm in diameter from the superior pole. When only tumours > 5 cm in diameter were considered, the ipsilateral invasion rate was 11% (9/80) and the micrometastatic rate was 7.5% (6/80). CONCLUSION: Adrenalectomy need not be performed routinely in small tumours which are detected early, but the possibility of adrenal micrometastasis from larger tumours (> 5 cm) should be considered.

Adrenal Gland Neoplasms↗
PubMed1996

[Excretory azoospermia: contribution of exploratory and curative surgery. Apropos of a follow-up of 33 patients].

Thirty-three patients with azoospermia of apparently excretory origin underwent surgery for epididymis-deferens anastomosis and/or epididymal sperm puncture. Pathology examinations of the epididymal fluid and biopsies of the testicles or epididymis were performed at surgery. Based on the clinical presentation, sperm results and per-operative findings, patients were divided into six groups by etiology: idiopathic azoospermia (n = 5), post-infectious azoospermia (n = 15), agenesia of the excretory (n = 6) or secretory (n = 3) ducts, vasectomy (n = 2), and obstruction of the ejaculatory ducts (n = 2). Peroperative identification of spermatozoa at epididymal puncture or biopsy was statistically more frequent in patients with agenesis of the excretory ducts than in patients with post-infectious or idiopathic azoospermia. Biopsies of the testicle led to the diagnosis of secretory azoospermia in 3 cases and revealed a functional parenchyma in all the other groups of patients. Epididymis-deferens anastomosis was performed in 45% of the cases and was successful in 13%. Rate of fertility with the intracytoplasmic sperm injection was 33%; there was no difficulty in using fresh or frozen sperm. Clinical pregnancy was continued to term with frozen sperm. This study confirms that testicular function is preserved in excretory azoospermia. With or without epididymis-deferens anastomosis, epididymal spermatozoa can generally be preserved for later use. Couples should however be counselled on the delays to contraception which may vary from months to years.

Adult↗
PubMed1995

Clinical and biological characteristics of infertile men with a history of cryptorchidism.

Out of 85 fertile and 1014 infertile men, two (2.4%) and 95 (9.4%) respectively had a history of cryptorchidism. Thus cryptorchidism appears to be a risk factor for fertility since this difference was significant. Further comparisons showed that the volume of a former cryptorchid testis was smaller than the contralateral normally descended one and that sperm output/concentration was more impaired in bilateral than in unilateral cryptorchidism. A retractile testis, defined as a testis reported by the patient to be spontaneously and regularly, i.e. at least once a week, ascending up into a supra-scrotal position, was more frequent in infertile men with a history of cryptorchidism than in fertile men. Retractility was more frequent on the cryptorchid side, and was found more frequently after hormonal than after surgical treatment. Independently of all epidemiological and clinical parameters studied, retractility was associated with a lower sperm output. Among the infertile men with a history of cryptorchidism, 45% had an abnormally high scrotal temperature. This abnormal temperature represented a pejorative risk factor for fertility in this group, since it was associated with a more severely impaired spermatogenesis and a higher incidence of primary infertility than in infertile men with a history of cryptorchidism but normal scrotal temperatures.

Adult↗
PubMed1995

[Ureteral involvement in an inflammatory aneurysm of the abdominal aorta. (Apropos of a case. Review of the literature)].

Diagnosis and treatment of ureteral obstruction secondary to perianeurysmal retroperitoneal fibrosis are controversial. Diagnosis includes the use of computed tomography and abdominal ultrasound, surgical treatment combines prosthetic graft with preoperative ureteral stenting. Ureterolysis is not always necessary, because aneurysm repair promotes resolution of the inflammatory process and relieves the ureteric obstruction. However radiologic survey is essential as in the case report.

Acute Kidney Injury↗
PubMed1994

[Percutaneous endopyelotomies. Preliminary results (a series of 16 patients)].

Percutaneous endopyelotomy was performed in 16 patients with ureteropelvic junction obstruction. The procedure was always completed with no intra-operative complication. After a mean follow-up of 18 months (6-30 mos), we report 12 good results (75%), 2 patients with no clinical symptoms but remaining partial radiological obstruction, and 2 failures (12.5%) which required early open surgery. Much care must be given to the ureteral stenting: one of our failures was due to extra-pelvic migration of the stent. Endopyelotomy may be considered as an efficient procedure, but long-term evaluation is still required.

Adolescent↗
PubMed1993

[How to recognize and classify male infertility].

Infertility of the couple affects 19% of the general population, 4% of which are infertile. Almost 50% of infertilities are ascribable to the male partner. Male infertility is determined by a preliminary clinical and biological evaluation which consists of full examination of the semen, with sperm and spermocyte counts and cultures. Further examinations depend on the data provided by this evaluation. The causes of human infertility can be classified as follows: 1. Abnormalities of the spermatozoa which may be of testicular origin (defect of gonadal maturation, genetic of genic congenital anomalies, varicocele) or of post-testicular origin (acquired or congenital excretory obstacle to be located by surgery and treated whenever possible. 2. Abnormalities of seminal plasma (seminal infections, autoimmunization, isoimmunization). 3. Abnormalities of ejaculation (pathogenic or iatrogenic retrograde ejaculation, organic or psychic anejaculation). 4. Unknown cause requiring more sophisticated sperm examinations, such as microvideography of the flagellum, exploration of the acrosome and of nuclear maturation.

Ejaculation↗
PubMed1992

[Role and contribution of karyotyping in male infertility].

In the context of the aetiological investigation of male infertility, the authors stress the place and the contribution of blood karyotype testing in the light of their personal experience based on 1,612 subjects. This examination has an important place, as about 15% of azoospermic subjects and 6 to 7% of subjects with oligospermia less than 10 million spermatozoa per ml, either alone or in combination with other abnormalities of the semen examination, present a congenital chromosomal abnormality. A remarkable constancy of the results was observed according to identical recruitment criteria. The contribution of this examination is also important: the medical and psychological value of detecting the cause of azoospermia, genetic counselling and antenatal chromosomal diagnosis for non-azoospermic subjects with an equilibrated structural abnormality, in whom treatment allows a chance of procreation, genetic counselling for the family of these subjects in order to prevent the appearance of a chromosomally abnormal infant. In conclusion, the authors argue in favour of the routine use of this test in all infertile subjects with at least isolated oligospermia less than 10 million spermatozoa per ml.

Chromosome Aberrations↗
PubMed1992

[Evolution and treatment of 8 patients with Fournier's perineal-scrotal gangrene].

The authors present eight cases of Fournier's gangrene treated from 1987 to 1989 (3 years). There was no discernable cause for 5 patients (62.5%). Immediate aggressive surgical debridement of all necrotic tissue was performed. Intravenous antibiotics and resuscitation fluid and hyperbaric oxygenation were also administered to all patients. Skin grafting was performed for 4 patients (40%), 3 weeks after surgical debridement. One patient died (12.5%) and 2 subsequently developed an urethral stricture. Etiology, treatment and outcome of Fournier's gangrene are discussed and the results of the study are compared to other studies. This disease is still serious, its pathogenesis is not completely elucidated, but when immediate adequate treatment is performed, the outcome is generally favourable.

Acute Disease↗