Search PubMed⌕ Search

Biomedical subjects

J L'Hermite

Publications and source records attributed to J L'Hermite.

At least 19 recordsLinked to original sources
PubMed1992

[Urinary tract infections during the 1st month after kidney transplantation].

The incidence and the predisposal factors of urinary tract infections (UTI) in the first month post-transplant were studied in 255 kidney transplantations (252 patients). UTI episodes were demonstrated in 73.7% of the grafts. The most common organisms were: Escherichia coli (35.8%), Staphylococcus (33.6%), Streptococcus D (11.2%), Klebsiella (5.3%). The infectious episodes were recurrent in 39% of the cases. The majority of the UTIs were asymptomatic but 7% of the infections led to septicaemia. Etiology of end-stage renal disease, pre-graft binephrectomy, asymptomatic vesicoureteral reflux into the patient's own kidneys, type of immunosuppressive treatment, acute tubular necrosis, rejection episodes, urological complications, coexistent other infections were not predisposal factors. Bacteriuria was more frequent in female than in male patients. The incidence of UTI was found to be statistically increased with history of UTI preoperatively (p = 0.039) and the use of ureteral catheter (p = 0.018). Occurrence of UTI was less common when the donor was treated by antibiotics before brain death (p-0.025). These results provide additional support for regular monitoring of urine cultures in the first month post-transplant. They should help to identify means of reduction of this infectious risk.

Adult↗
PubMed1990

[The value of mobilization of the prostatic region via perineal approach in the treatment of ruptures and stenoses of the posterior urethra].

UNLABELLED: 11 cases of end to end anastomosis associated with the mobilization of the prostate is reported. The authors use only the perineal access. The operation is utilised in two circumstances: injuries or traumatic strictures to the membranous urethra. 4 ruptured prostato-membranous urethras with 4 good results. 7 stenosis with 5 good results. 2 recurrences which one of them had a good result with a simple urethrotomy. Complication: no incontinence. 2 cases of impotence are noted. One of them had recovered, the other is secondary of the pelvic fracture. Follow up: mean 3 years (6 months-5 years). CONCLUSION: our experience suggest that the mobilization of the prostate is an excellent aid to end to end anastomosis. This technique permits the only perineal access.

Adult↗
PubMed1990

[The Devine urethroplasty. Our experiences apropos of 18 cases].

Our experience with a 1-stage procedure using free patch graft for correction or urethral stricture is reported. Eighteen cases of urethral stricture have been treated. Fourteen of the 18 cases (77%) had a good result. The follow up is more than 5 years. This procedure is recommended with considerable enthusiasm.

Adolescent↗
PubMed1990

[Value of arterioscopy in the prevention of renal artery stenosis after transplantation].

Renal artery stenosis is frequent after transplantation. The systematic pre-operative search for arterial injuries by angioscopy allows a reduction in their incidence. The authors report a series of 60 transplantations with pre-operative angioscopy, which revealed benign injuries and two major injuries which were successfully treated surgically. This prevention allows a reduction in the incidence of stenosis from 12 to 6.6% according to a previous series of 210 transplantations without angioscopy.

Endoscopy↗
PubMed1990

[Revascularization of the penis in arteriogenic impotence. 10 years' experience].

From 1978 to 1987, various techniques have been used by the authors ECA (epigastrico-cavernous anastomosis) and its variants saphene ECA (prolonged by a vein), ECA + DDVL (used with ligature of the deep dorsal vein of the penis), finally FCA (femoro-cavernous anastomosis). According to the method of selection mode, "traditional" using arteriography and nocturnal erectometer; or "dynamic", completed with a flow-rate measurement, used with or without the papaverine test. Three groups of patients emerge corresponding to three periods: empirical surgery then functional surgery (+ flow-rate measurement), then improved (+ flow-rate measurement coupled with the papaverine test). The surgical sequelae are evaluated according to the level of success (G) total erections with normal relations improved (QG) reappearance of erections allowing relations; failure (B) relations impossible. The study concerns 91 patients with 83 experiencing long term success (92%) after more than one year. According to the techniques used the overall results (in improved patients) are: for FCA, 77% after three months (7/9 = 7 G) and 42 long term (3/7 = 3 G) for ECA 82% after three months (68/82 = 54 G + 14 QG) and 74% long term (49/76 = 40 G + 9 QG). According to the type of surgery, the results in improved patients are, all techniques combined: for empirical surgery (36 patients of which, 32 ACA, 2 saphene ECA and 2 FCA) 70% at three months and 48% long term, for improved functional surgery (22 patients with 12 ECA, 2 saphene ECA, 6 ECA + DDVL and 2 arteriolisations of the deep dorsal vein) 100% after three months and 72% long term.(ABSTRACT TRUNCATED AT 250 WORDS)

Erectile Dysfunction↗
PubMed1990

[Junctional syndrome responsible for prostatic urethral dilatation: a new pathological entity?].

The authors report two observations of monstrous ectasia of the prostatic urethra, in boys age 12, without any previous pathological history; discovered on at the time of major dysuria previous urinary troubles with chronic retention of 500 cl and 1.250 l respectively. In the absence of any organic obstacle, etiology relieves functional troubles. If functional explorations show a normal or hypertensive detrusor, then they discuss the possibility of vesico-sphincter dyssynergia or an obvious hypertension of the striated sphincter. From this moment onwards, purely intrinsic urethral functional trouble is plausible, all the more because the recovery was assured by treatments directed only at the urinary canal. In the first case, after surgical treatment owing to complex lesions (plastic reduction of the urethral ectasia preserving the posterior wall and respecting the striated sphincter) combined with diverticulectomies with urethral reimplantations), the patient recovered complete vesical waste removal at once, with normalisation of the flowmeter in six months. In the second case, a simpler treatment (sub-montanal urethrotomy of the principle) allowed a normalisation period of 10 months with complete vesical waste removal. The functional results are maintained after a period of nine and two years respectively. The integrity of the striated sphincter controlled post-operatively by the operatory gesture on the urinary canal and confronts the authors in the idea of intrinsic urethral pathology, although electronic microscopic examination may not have shown achalasia.

Child↗
PubMed1989

[Internal urethrotomy with endoscopic resection of the callus. 32 cases with a follow-up exceeding 5 years].

Thirty-two patients were operated for urethral stricture by internal urethrotomy with endoscopic resection of the callus. Complications consisted of one urethral perforation, one urethral haemorrhage and one case of acute epididymitis. With a follow-up of 5 to 15 years, the authors obtained 85% of good results for strictures less than 1.5 cm long. The success rate was 66% for strictures between 1.5 and 2 cm. The recurrence rate was high for strictures longer than 2 cm (75%). The indications for this technique therefore depend more on the length of the stricture than on its cause or its site. Lastly, endoscopic resection of the callus improves the results or urethrotomy alone by 15%.

Adult↗
PubMed1989

[Cure of complex post-irradiation uro-genital fistulae].

The authors report two cases of complex radiation induced urogenital fistulae (vesicovaginal and combined rectovaginal), which were closed successfully at the second attempt with complete restitution of bladder function, without any urinary diversion using colpocleisis in one patient. They mention the necessity of bringing a new source of blood supply into the fistula repair area. Then, they review the different extensive procedures used to ensure this result: small bowel graft, omentopexy to reinforce the suture lines, fibroadipose tissue from the labia majora (Martius' operation). Lastly, basedow their experience and a review of the literature, they propose a therapeutic strategy based on a transperitoneovesical approach with the combined used of isolated small bowel and omental pedicle graft.

Female↗
PubMed1984

[Choice of a technic in the treatment of primary vesico-renal reflux in the adult].

This article compares five techniques for the surgical management of primary vesicorenal reflux in adults, with reference thirty six cases. The techniques used were Bischoff (8), Lich-Gregoir (6), Politano-Leadbetter (8), Glenn-Anderson (10) and Cohen (4). Surgery provided good results in 30 cases and poor results in six. The best results were registered with the advancement techniques (Glenn-Anderson and Cohen).

Adult↗