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F Staerman

Publications and source records attributed to F Staerman.

35 records · Page 2Linked to original sources
PubMed1994

Erythrocyte polyamines and prognosis in stage D2 prostatic carcinoma patients.

We studied 43 patients with newly diagnosed, untreated, stage D2 prostatic carcinoma, and correlated the initial performance status, hemoglobin, prostate specific antigen levels, tumor Gleason grade, extent of disease on the bone scan, and erythrocyte spermidine and spermine levels with progression. Three patients died of unrelated causes and were excluded from the study, 16 remained in remission with a mean 28 +/- 11 months of followup and 24 had progression (18, or 75%, of whom died of the cancer) with a mean 12 +/- 9 months of followup (p < 0.05 for followup) after initiation of hormonal therapy. Pretreatment performance status, hemoglobin, and erythrocyte spermidine and spermine levels were correlated with progression, hemoglobin and spermine being the most significant independent variables (p = 0.006 and p = 0.001, respectively). Concerning cause-specific survival, only hemoglobin and spermine erythrocyte levels were significant independent variables (p = 0.02 and p = 0.0025, respectively). If confirmed, polyamine erythrocyte levels obtained by a simple blood sample could discriminate at diagnosis patients with a high risk of rapid hormonal relapse who may benefit from a more aggressive primary management.

Aged↗
PubMed1994

[Synchronous bladder metastasis of a clear-cell adenocarcinoma of the kidney].

Urinary bladder synchronous metastases from renal cell carcinoma are rare, three cases were reported in the literature and we present the fourth. In these four published cases, the bladder metastases followed a left kidney tumor and in three, a brain metastases was also found. A possible retrograde metastatic dissemination through the left genital and vertebral veins has to be taken in consideration. The short survival after the extirpation of the tumor and the bladder metastases implies a less aggressive approach in the presence of a bladder metastases.

Adenocarcinoma, Clear Cell↗
PubMed1994

[Extracorporeal lithotripsy for urinary calculi: a non invasive technique? Report of 150 patients treated with the Nova lithotriptor].

The NOVA apparatus is an electrohydraulic lithotriptor not yet available in France. The authors present an evaluation of the first 150 patients treated with this machine. 92.2% of the 185 stones treated were fragmented. 141 patients were reviewed at 1 month and, if necessary, 3 months after the first session; 4/24 patients and 1/3 patients were not reviewed after their second and third treatment session, respectively. Evaluation of the 177 sessions performed (16% of second sessions and 2% of third sessions), 69.11% of patients did not have any residual stones. The success rate was 52% for renal stones; 96% for stones of the lumbar ureter and 50% for pelvic stones. The morbidity was low (10% of renal colic, 5% of obstructive stone) but in combination with second treatment sessions, it generated a risk of being rehospitalised after the first session of 26%. When the procedures performed under anaesthesia before and after ECL (apart from repeated sessions) are added, the risk of this supplementary anaesthetic for a given patient is 18.66%. Lastly, the risk of undergoing another anaesthetic after the 1st ECL was 33%. These data indicate the limits of the "noninvasive" nature of a modern and effective lithotriptor.

Adolescent↗
PubMed1994

[Acquired experience in anesthesia and perioperative intensive care in percutaneous nephrolithotomy. Current approach in the endoscopic treatment of lithiasis and pyelo-ureteral junction anomalies].

Percutaneous endoscopic treatment of the kidney retains a place in the treatment of renal stones (percutaneous nephrolithotomy--PCNL) and ureteropelvic junction abnormalities (endopyeloplasty). It requires anaesthesia ensuring surgical comfort and safety for the patients despite changes in position and the prolonged ventral supine position. The operation carries certain iatrogenic risks related to caliceal irrigation in patients with more or less documented episodes of infection and carries risks of haemorrhage and effraction of adjacent organs. 282 patients treated by PCNL between 1984 and 1991 were reviewed in order to define the respective indications for general anaesthesia and peridural anaesthesia and to determine the modalities, to evaluate the risk and severity of absorption of irrigation fluid and to assess the risk of infection by defining the indications for prophylactic antibiotics. General anaesthesia, using etomidate and propofol via an infusion pump, ensures surgical comfort, anaesthetic safety and better control of intraoperative complications. The renewed interest in this technique must be counterbalanced by the growing incidence of anaphylactic reactions related to anaesthetic drugs. Operations lasting more than 2 hours, raised intracaliceal pressure, the initially exclusive use of glycine for irrigation induce haemodilution complications, possibly aggravated by glycine intoxication. Repeated surgery is preferable with the use of an Amplatz tube as often as possible and physiological saline, except when required by the operation. Patients with a history of urinary tract infection or infected stones should receive prolonged and effective antibiotics before, during and after the operation. Prophylactic antibiotics are reserved for those patients with no history of infection. These principles equally apply to percutaneous nephrolithotomy and endopyeloplasty.

Adolescent↗
PubMed1993

Accuracy of ultrasound diagnosis after blunt testicular trauma.

The aim of this study is to determine the value of ultrasound evaluation for the diagnosis of testis rupture due to blunt scrotal trauma. We reviewed 16 operated cases of blunt scrotal trauma with hematocele, which were evaluated by ultrasound preoperatively. In 2 cases a tunica albuginea rupture was correctly diagnosed by ultrasonography but there were 2 false-positive and 5 false-negative diagnoses of rupture. Systematic exploration of the 16 cases revealed testicular rupture in 7, simple hematocele in 7 and hematocele associated with spermatic cord injury in 2. In 2 cases orchiectomy was necessary. From our experience the accuracy rate of ultrasound evaluation of blunt scrotal trauma was 56%, with a 58% negative predictive value. Considering these results, ultrasound examination of blunt scrotal trauma with hematocele is not sufficiently accurate to eliminate surgical exploration and, therefore, we recommended early surgical exploration as primary therapy in these cases.

Adult↗
PubMed1993

Polyamines and prostatic carcinoma: clinical and therapeutic implications.

The erythrocyte polyamines, spermidine and spermine, are known proliferation markers. The authors present their experience with polyamines and prostatic carcinoma. 229 patients with prostatic carcinoma had polyamine erythrocyte determination at diagnosis. Previous results confirmed a tendency to spermidine increase with tumor stage and a significant increase in spermine in metastatic and hormonal escape patients. No correlation was found between polyamine erythrocyte levels and hemoglobin, prostate-specific antigen or tumor grade. 148 prostatic carcinoma patients were followed up. Their pretreatment erythrocyte polyamine levels were correlated to progression. Patients (whatever stage) with rapid progression present significantly enhanced pretreatment erythrocyte spermine levels compared to patients with a favorable outcome. Polyamines are not only proliferation markers but are also necessary for cell division. The authors present their results on polyamine deprivation, combining a polyamine-free diet, polyamine synthesis inhibitors and intestinal tract decontamination, on in vivo tumor growth inhibition of the murine prostatic carcinoma Dunning Mat LyLu tumor model.

Adult↗
PubMed1993

Treatment of primary vesicoureteric reflux by polytetrafluoroethylene injection: a middle-term follow-up study.

We have selected 38 patients (55 ureters) with primary vesicoureteric reflux successfully treated by endoscopic subureteric injection of Teflon. The success rate after 1 injection was 83.6%. Nine ureters required a 2nd or even a 3rd injection of Teflon to achieve success. The follow-up time for these successfully treated patients was 2-5 years, and results remained stable in 94.5% of cases. Endoscopic injection of Teflon seems to be a reliable alternative to open surgery in the treatment of primary vesicoureteric reflux.

Adolescent↗
PubMed1993

[Can we do better than surgery in the treatment of benign prostatic hypertrophy? Results after 10 years in endoscopic resection and adenomectomy in urination and sexual disorders].

Surgery is considered to be the reference treatment for obstructive benign prostatic hypertrophy (NPH). Transurethral resection of the prostate (TURP) and suprapubic prostatectomy are the operations most frequently performed by urologists. However, little information is available concerning the long-term results of this surgery. In order to assess the long-term efficacy, we recalled 618 consecutive patients operated for benign prostatic hypertrophy between 1979 and 1982 (390 by TURP and 228 by suprapubic prostatectomy (SP). 167 patients were reviewed and investigated, 150 had died and 301 were lost to follow-up. Ten years after the operation, 85% of the patients reviewed had good or satisfactory micturition and 72% of them were satisfied, regardless of the technique used. In 80% of patients, no complementary procedure was required to ensure urinary comfort. However, the effects of this surgery on sexual function were considerable, as one half of patients reporting sexual intercourse before the operation reported a deterioration of sexual function after the operation. Lastly, long-term morbidity affected 10 to 41% of patients and 9 to 12% of them were reoperated. Although, overall, surgery gave excellent results at 10 years, 15% of patients did not derive any benefit from the procedure. It is therefore important, in the future, to more clearly define the indications for surgery and the place of noninvasive treatments. At the present time, young subjects wishing to preserve their sex life may benefit from noninvasive first-line treatments, provided their quality of life is sufficiently altered by the severity of the urinary symptoms.

Aged↗
PubMed1993

Does detubularization improve continence in bladder replacement?

Camey in the seventies promoted bladder replacement. In 1987, the French Association of Urology gave us the opportunity to review 729 Tubularized Ileocystoplasty (Camey operation) [1]. The day time continence was excellent or acceptable (mild stress incontinence) on 91% of the patients, the night time continence was excellent (no pads, no leakage) or acceptable (one pad or less than 3 wakes at night) for 44% of the patients (56% had to use a device). Since 1985, the detubularization attempted to improve the continence rate. Today, the review of the literature shows that day time continence has not changed and the night time continence improved less than 20% arising from 44% to 60%. Bladder replacement after prostatocystectomy has been proved to be superior to continent urinary diversion in patients whose urethral and external sphincter can be preserved. Day time continence is excellent in tubularized and detubularized bowel reservoirs. Night time continence, in 30 to 50% of patients, remains an unresolved problem also in detubularized low pressure reservoirs, even if they are of great capacity. The literature is therefore too optimistic when describing night time continence in 85% of the patients. These results are stated in spite of the absence of sensitivity in the neobladder, the loss of reflexic increase in sphincteric activity during bladder filling, and the low sphincteric tonus during sleeping. These optimistic results are due to lack of unanimous criteria for evaluating continence after bladder replacement and not taking into consideration as continence failure the abundant although not frequent nighttime incontinence. In order to improve continence, muscle reeducation and artificial sphincter implantation are the most adequate solutions.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1991

[Results of endoscopic treatment of primary vesico-ureteral reflux with a follow-up of 2-5 years].

34 patients treated by endoscopic injection of Teflon for vesico-ureteric reflux were reviewed with a follow-up of 2 to 5 years. 45 of the 48 treated ureters showed no signs of reflux, i.e. 93.7% medium-term success rate. 3 cases of reflux recurred after two years and 2 of them were successfully reinjected. There were no upper urinary tract complications. Endoscopic injection of Teflon appears to be a reliable alternative to open surgery.

Adolescent↗
PubMed1991

[Renal agenesis, bicornuate uterus and cyst of the Gartner's duct].

A cyst of Gartner's duct with a bicornuate, unicervical uterus and ipsilateral renal agenesis were seen in a 13-month-old girl. Left renal agenesis had been suggested by antenatal ultrasound findings. After birth, there were no symptoms but ultrasonography demonstrated a multicystic mass in the pelvis. Diagnosis was confirmed by histological study of the mass which had been completely removed during surgery. This infrequent genitourinary malformation is due to a developmental abnormality of the wolffian duct early in fetal life. This case is the eighth report in the literature. Course can be complicated by abscess formation and malignant transformation but most patients remain symptom-free. Treatment is discussed.

Abnormalities, Multiple↗
PubMed1990

[Anterior hypospadias and chordee: a one-stage cure using a tubulated and reversed flap].

A one stage urethroplasty using a tubulated and reversed flap was carried out by the authors in 74 cases of hypospadias with chordee between 1978 and 1988. The procedure is derived from the technic of Mustarde and the flip flap of Devine and Horton. The experience led to limit its indication to the patients who have a sufficient length of ventral skin of good quality between the hypospadic meatus and the peno scrotal junction to build the urethra up to the apex of the glans after correction of the chordee. This technic is simple and reliable: complications have been encountered in only two of the last forty cases (one fistula and one urethral stenosis) since the design of the flap was simplified.

Adolescent↗
PubMed1989

[Long-term results of isolated aortic valve replacement using a Bjork-Shiley prosthesis. A clinical study of a series of 365 patients with a postoperative follow-up of 8 to 16 years].

365 patients (mean age: 59 years) surviving isolated aortic valve replacement performed between 1971 and 1978 by means of a standard flat disk Bjork-Shiley prosthesis, underwent regular and complete follow-up (100% survival rate) representing 3,248 patient-years with a maximum follow-up of 15.4 years (mean: 8.9 years). All of these patients received anticoagulant treatment, which was considered to be well-controlled in 90.5% of cases. 121 secondary deaths (33.1%) were observed. Cardiac causes were the most frequent (35/121, i.e., 28.9%). Four deaths were directly related to the prosthesis (2 infections, 1 thrombosis, 1 dysfunction). Twenty deaths (16.5%) were related to cerebral vascular accidents and 2 (1.6%) to haemorrhagic complications. In 24 cases, the cause of death could not be determined (19.8%). Overall, 1 out of 5 deaths (21.4%) was directly or indirectly related to the prosthesis. The actuarial survival rate was 85.5% at 5 years and 67.9% at 10 years. Seventeen thromboembolic complications (7 lethal, 10 non-lethal) were observed and represented a linear incidence of 0.5% per patient-year. Fourty-one haemorrhagic complications were observed in 28 patients, i.e. a linear incidence of 1.26% per patient-year. Nine reoperations were necessary, responsible for 3 deaths. No cases of mechanical failure of the prosthesis were observed. All of the lethal and non lethal complications related to the prosthesis represented a linear incidence of 2.6% per patient-year. AT 5 and 10 years after the operation, 89.2% and 79.6% of the patients were free of any valve-related complications. The functional results was considered to be good or excellent in the very great majority of surviving patients (97.8%).(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1987

[Puigvert's operation in male urinary incontinence].

Puigvert's operation for male urinary incontinence was performed in 9 patients. In 8 cases the incontinence was secondary to prostate surgery. Results on continence were evaluated at follow-up during the immediate postoperative period and after 6 weeks, 3 and 6 months and two years. (Table: see text). Results indicate that this technique is simple and safe but unsatisfactory.

Aged↗
PubMedDate not supplied

[Percutaneous surgery for lithiasis: results and perspectives. Apropos of 390 operations].

Percutaneous nephrolithotomy (PCNL) has radically changed the treatment of renal stones. The indications for this technique have been modified by the development and refinement of extracorporeal lithotripsy (ECL). The authors present their experience of 390 PCNL performed between 1984 and 1991, for solitary stones in 75% of cases. There were only 11 cases of failed puncture (3.8%). The overall morbidity was 18% with only 4.4% of major complications, i.e. life threatening or requiring reoperation. There were two deaths (0.5%). Stones were completely eliminated in 80.25% of patients, after a second operation (PCNL or other technique) in 32 cases (11%). 45 staghorn calculi were treated with 11% of complications and a 51% complete cure rate. The mean hospital stay was 6 days (2 to 30). PCNL is a safe and reliable technique. Its indications have decreased (6.5% of our patients treated for renal stones), but it still retains a place in the therapeutic approach to patients with renal stones.

Adolescent↗
PubMedDate not supplied

[Dose adaptation during training of intracavernous self-injections of prostaglandin E1].

OBJECTIVE: Dose adaptation in self-administered intracavernous PGE1 injections is poorly defined in learning protocols and its degree of difficulty depends on the aetiology of the erectile dysfunction. The authors tried to standardize this phase by studying the results and complications of a protocol using an identical initial dose of PGE1 regardless of the aetiology of erectile dysfunction. MATERIAL AND METHODS: 101 patients consulting for erectile dysfunction participated in a learning protocol of self-administered intracavernous PGE1 injections, consisting of 3 injections systematically starting with 10 micrograms of PGE1, following assessment of the aetiology. RESULTS: For an efficacy of 58.4%, 79.2% and 88.1% after one, two or three injections, respectively, the prolonged erection rate (> or = 6 hours) was 2.7% after the first injection and 0% after the other injections. However, erection durations of 2 to 6 hours have frequently been reported in neurological patients. Discontinuations during the learning phase were only observed in patients presenting with tumescence without rigidity after one injection (5.4%) or two injections (21%). CONCLUSION: In the light of these results and to minimize prolonged erections and discontinuations, while ensuring efficacy, PGE1 dose adaptation can be simply performed by starting with 10 micrograms in all patients except for neurogenic patients (5 micrograms) with an increase to 20 or 30 micrograms in the case of failure.

Adult↗