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J Tostain

Publications and source records attributed to J Tostain.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Conservative treatment of urogenital fistula following gynecological surgery: the value of fibrin glue].

Ureteric and bladder vaginal fistulas are recognized complications of gynaecologic surgery. We report on 4 cases of fistulas (2 uretero-vaginal and 2 vesico-vaginal) successfully treated by urinary drainage associated with plugging of fistula with fibrin sealant. Efficiency of conservative treatments is directly related to early application. Mechanical and biological properties of fibrin sealant explain its possible role in recovery, without increasing risk of viral transmission.

Adult↗
PubMed1992

[Youssef syndrome].

Youssef's syndrome is a vesico-uterine fistula through the uterine isthmus, with periodic hematuria, or menouria, and an absence of vaginal bleeding or urinary leaks. The sphincteric mechanism of the uterine isthmus could explain this symptoms, quite unusual for a urogenital fistula. Diagnosis can be achieved by cystography and hysterography. Surgical closure of the fistula is the usual treatment, but uterus can be preserved if patient wishes further pregnancy.

Adult↗
PubMed1991

[Major urological cancer excisions after the age of 75].

32 patients more than 75 years old had major surgical procedures for urologic neoplasms: radical nephrectomy for renal cell cancer (9 cases), nephroureterectomy for upper urinary tract tumor (3 cases), radical cystectomy for invasive bladder cancer (20 cases). Postoperative mortality was 12.5%. In the nephrectomy group, 3 palliative procedures gave a mean survival time of 7 months. On 9 curative procedures, 7 patients are alive and free of disease with a mean follow-up of 45.6 months. In the cystectomy group, 5 palliative procedures gave a mean survival time of 7 months. On 15 curative procedures, 6 patients are alive and free of disease with a mean follow-up of 18.6 months. Our data confirm that curative procedures can be performed in the elderly. Mean survival time and quality of life after palliative procedures suggest that only true comfort procedures have to be performed.

Age Factors↗
PubMed1991

[Resection of pyelo-ureteral junction without external urinary drainage for primary ureteral stenosis].

During a 3-year period 30 consecutive patients (20 women and 10 men) with primary ureteropelvic junction obstruction underwent open dismembered pyeloplasty associated with the placement of an indwelling double pigtail stent via antegrade approach. Renal stones were removed in 8 cases, multiple nephrotomies being necessary in 2 patients. 2 men had temporary urinary leakage. Mean hospitalization time after surgical procedure was 9,8 days, but last 18 patients were discharged after only 7,3 days, Stents were removed 4 to 5 weeks after operation. With 1 to 4 years post-operative follow-up, successful treatment with relief of obstruction was achieved in all 38 patients without secondary stricture. Open pyeloplasty with double pigtail stenting appears to be a safe and successful procedure for the treatment of primary ureteropelvic junction obstruction in adults. Comparison with percutaneous endopyelotomy in terms of morbidity, duration of hospitalization and success rate appears to be in favor of open procedure, although secondary stricture may require endourological procedure.

Adult↗
PubMed1990

[Ureteral stenosis in kidney transplantation].

The authors report 13 cases of ureteral or periureteral sclerosis in a series of 330 cases of renal transplantation (3.9%): they occurred early, were asymptomatic (except for anuria); the renal cavities were always dilated, the renal function always deteriorated; the treatment was essentially surgical without mortality and with a low complication rate but 23% of the transplants were lost because of urological complications at 18 months. The authors compare their series with the literature.

Adult↗
PubMed1986

[Renal transplantation and pregnancy. Apropos of a case].

A cystic disease of the medulla is found in a young women at the 5th month of her first pregnancy and entails the death of the foetus in utero. The chronic renal insufficiency rapidly worsens and necessitates periodic hemodialysis. Renal transplantation is carried out from a brother with identical HLA. Two years later the graft is functioning well enough to permit another pregnancy. It proceeds without accompanying nephropathy. A caesarean operation carried out 36 weeks after amenorrhea gives birth to a girl who presents normal psychomotor development at two years of age. The authors consider the influence of pregnancy on the functioning of the kidney graft and the criteria permitting pregnancy after a renal transplant. They discuss the consequences of a renal transplant on the progress of the pregnancy and delivery. Finally, they study the effects of immunosuppressive treatment on the child in the short and long term.

Adult↗
PubMed1984

[Is the improvement of survival in advanced bladder cancer possible?].

A retrospective study included 41 cases of bladder cancer, with deep invasion of the muscles (C) or perivesicular cellular tissue (D), but without detectable metastases, treated curatively by total cystectomy. Comparison was made between a first group of 19 patients not treated by cellulolymphadenectomy and another group of 22 patients in whom curettage was performed to remove cells and nodes and who also received 2 concentrated radiations of 7-5 Gy of telecobalt to the bladder during the immediate pre-operative period. Only 10 patients in the latter group were given routine postoperative chemotherapy. Postoperative mortality was unaltered (10,5% in the first group and 9% in the second), but postoperative survival was markedly affected: 10,5% after 5 years in the first group as against 41% in the second. Five-year life expectancy was therefore increased by a factor of 4 in spite of 9 N+ cancers. In the 2nd group of 19 patients operated upon and regularly followed up 3 years and more 7 are alive. True 5 year survival rate in the 2nd group was therefore 35% as against 10% in the first group. Note that 2 of the 9 N+ patients are alive after 3 years. Aggressive therapy in the 2nd group also drastically reduced pelvic recurrence rate, which dropped from 8 (42,1%) in the first group to 1 (4,5%) in the second. In contrast, the major cause of death (7 cases = 31,8%) in the 2nd series was the development of metastases, without evidence of any pelvic recurrence. The effect of routine chemotherapy is being investigated.

Cobalt Radioisotopes↗
PubMed1983

[Value of surgery in metastatic cancer of the kidney].

The authors analyse a series of 186 patients with renal cell carcinoma in which 33 patients of Stage IV, with metastases, underwent Nephrectomy and 3 had also operative removal of metastases appearing in early post nephrectomy follow up. The survival periods have been disappointing (none at 5 years). With a review of literature they discuss about the extent of nephrectomy, whether done with purely palliative aim, or along with attempted curative excision simultaneously of the associated metastases. Even if the spontaneous regressions are exceptional and the improvement of survival duration less frequent, metastases are not always a reason not to remove Renal Cell Carcinoma.

Adenocarcinoma↗
PubMed1983

[Can the long-term survival in cancer of the kidney in adults be improved by cellulo-lymphadenectomy?].

Updating their homogeneous series of 172 Renal Cell Carcinomas treated by Nephrectomy with or without Regional Lymphadenectomy, the authors analyse the results from 3 criteria: lymphatic spread, regional spread, and (to account for inaccuracies of exact staging) the overall results. The addition of Regional Lymphadenectomy has improved the anticipated 5 years survival, thus justifying its addition to Radical Nephrectomy when done for curative aims.

Humans↗
PubMed1982

[Cytology in the detection and followup of urothelial tumors. Critical review of 500 cytologic investigations (authors transl)].

500 cytologic studies were performed in patients who underwent urological explorations. Sensitivity is defined as the ability to identify correctly those patients who have tumoral disease of urothelium: urine cytology is ineffective in detecting benign papilloma, but sensitivity is more than 66% in low grade carcinoma and 80% in high grade carcinoma; cytology was able to detect 4/6 transitional cell carcinomas of the upper urinary tract. Specificity, which is defined as the ability to identify correctly those patients who do not have tumoral disease, is extremely high; thus, careful urological examination must be completed when cytology is positive. Urinary cytology is needed in every urological exploration concerned with urinary tract.

Carcinoma, Papillary↗
PubMed1981

[Distal complications of therapeutic arteriovenous fistulae (author's transl)].

Having observed 4 personal cases, the authors review the distal complications of therapeutic arteriovenous fistulaes. Ischaemic complications are of arterial origin and may be severe: strong pain increasing during dialysis, soft tissue trophic disorders and ulcerations, and functional sequelae. Venous stasis disappear without permanent damage. The carpal tunnel syndrome is of uncertain and probably mixed aetiology and can easily be cured by surgical decompression. The use of small calibre, termino-terminal or latero-terminal distal anastomoses should help to prevent these complications.

Aged↗