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Biomedical subjects

M Zerbib

Publications and source records attributed to M Zerbib.

At least 109 records · Page 6Linked to original sources
PubMed1991

[Treatment of calculi of the lumbar ureter. Apropos of a series of 118 patients].

118 patients suffering from a calculus in the lumbar ureter were treated from January, 1987 to January, 1990. The treatment of 91 patients combined an initial internal ureteral drainage, followed by extracorporeal lithotrity (ECL): 40 calculi were driven back into the kidney and 51 were treated within the ureter. 69 patients (76%) no longer have any calculus; 17 (19%) retain residual fragments smaller than or equal to 3 mm in the lower calyces. We therefore count 5 failures, including 3 in which a second-intention surgical ureterotomy was performed. The ascent of the probe failed in 9 cases at the beginning of the series (6 ureterotomies and 3 percutaneous nephrostomies + ECL). 11 patients were treated with probeless in situ ECL. The others were treated with ureteroscopy (4), percutaneous nephrostomy + ECL (1) and nephrectomy (2). There is not one single treatment for the calculi of the lumbar ureter, and they require associating several therapeutic procedures.

Drainage↗
PubMed1991

[Low pressure bladder replacement after total cysto-prostatectomy. Apropos of a series of 40 patients].

The results of 40 consecutive patients who underwent bladder replacement following cystoprostatectomy for invasive bladder cancer are reported. A 30 cm detubularized ileal segment was used to make the neobladder. Mean follow-up was 19 months (over 2 years in 17 patients). All patients achieved diurnal continence. Nocturnal continence was obtained in 70.5% of patients: 41% had no leakage and nocturia less than 2, while 29.5% had some occasional leakage. Urodynamic evaluation showed the average peak flow to be at 18.3 ml/s and an average neobladder capacity of 410 ml. Six patients had spontaneous contractions of the enteric bladder of greater than 40 cm H20, always associated with elevated urethral pressure. Post-void residue was smaller than 100 cc in all cases. This procedure is simple to do, and led to an excellent diurnal continence, although it cannot assure nocturnal continence in every single patient.

Aged↗
PubMed1991

[Conservative treatment of a recurring retroperitoneal liposarcoma. Apropos of a case followed over 27 years].

We report about the case of a patient who, over 27 years, presented with seven local recurrences of a retroperitoneal liposarcoma. This evolution seems to characterize differentiated (adult and myxoid) forms of liposarcoma, for which metastatic expansion is less frequent that in the undifferentiated, pleiomorphic or round-cell forms. The treatment of these tumors is mainly surgical. Adjuvant radiation therapy might reduce the frequency of local recurrence.

Combined Modality Therapy↗
PubMed1990

Extracorporeal shock-wave lithotripsy to remove calcified ureteral stents.

A patient was seen with a large calcification of the renal end of a silicone catheter placed to intubate a cutaneous ureterostomy. Because of the stone, withdrawal of the catheter was impossible, and the patient presented with obstruction and dilatation of the renal cavities along with febrile bacteriuria and renal failure. Extracorporeal shock-wave lithotripsy, done under intravenous sedation, was found to be an effective noninvasive method to treat such a complication of long-term urinary drainage.

Catheters, Indwelling↗
PubMed1990

Clinical experience with a new pulsed dye laser for ureteral stone lithotripsy.

We treated 45 patients (46 ureteral stones) with a new pulsed dye laser. A 250 mu. fiber was used through a rigid (40 stones) or flexible (6) ureteroscope. Stones were in the upper (5 cases), middle (5) or lower (36) third of the ureter. Stone composition was calcium oxalate dihydrate (34 patients) or monohydrate (7), struvite (2) or uric acid (2). Of the calculi 36 (78%) were fragmented, including 14 that also required simultaneous basket removal of fragments. Ten stones were not fragmented: 6 because of the pure monohydrate composition and 4 due to malfunction of the laser. No damage to the ureteral wall was noted. Retrograde rigid ureteroscopy with laser lithotripsy was effective for lower and middle third ureteral stones. Flexible ureteroscopy with laser lithotripsy was effective (impacted stones) but difficult for upper third ureteral stones.

Endoscopy↗
PubMed1990

Clinical experience with a new pulsed dye laser for ureteral stone lithotripsy.

Forty-five patients with 46 ureteral stones were treated using a new pulsed dye laser (Pulsolith, TMI). A fiber of 250 micrometers was used through rigid (40 cases) or flexible (6 cases) ureteroscopes. Stones were located in the upper third (5 cases), middle third (5 cases), or lower third (36 cases) of the ureter. Stone composition was calcium oxalate dihydrate or monohydrate, struvite, or uric acid in 34, 7, 2, and 2 patients, respectively. Thirty-six stones (78%) were fragmented, including 14 cases that required basket removal of fragments at the same time. Ten stones were not fragmented, 6 because of the pure monohydrate composition and 4 due to a laser breakdown. No damage to the ureteral wall was noted. Retrograde rigid ureteroscopy with laser lithotripsy was effective for lower and middle third ureteral stones. Flexible ureteroscopy with laser lithotripsy was effective (impacted stones) but difficult for upper third ureteral stones. Laser lithotripsy was not effective for pure calcium oxalate monohydrate stones.

Calcium Oxalate↗
PubMed1990

Genitourinary tumors and HIV1 infection.

4 patients with solid genitourinary tumors and HIV1 infection have been treated in our institution over the last 2 years. Two patients had seminoma, 1 renal adenocarcinoma and 1 renal angiosarcoma. All had deeply impaired immunity with a low CD4 level. 3 had or developed a true AIDS syndrome according to the WHO and CDC criterias of 1988. The remaining patient was seropositive and died less than 3 months following the diagnosis of renal angiosarcoma. He is the first reported case of renal sarcoma in a patient infected with HIV1. 2 patients were homosexuals, and the 2 others were drug addicts. Along with other reported cases, our cases underline the association between the depression of immunity due to HIV and the onset of solid genitourinary tumors.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Laser lithotripsy of ureteral calculi: initial experience with a new pulsed dye laser.

Thirty-two patients with ureteral calculi ranging in size from 5 x 5 to 12 x 18 mm underwent lithotripsy with a new pulsed dye laser (Pulsolith, TMI). In 24 cases, the patients were entirely free of stones following laser lithotripsy alone, or with adjunctive stone basket removal. There were three instances of equipment failure and five calcium oxalate monohydrate stones that did not respond to laser energy.

Calcium Oxalate↗
PubMed1990

[Treatment of prostatic obstruction using localized hyperthermia. A preliminary study].

The LDMWH (Promeditech 2000), a hyperthermia apparatus emitting microwaves with a frequency of 915 MHz, has been used since July 1988 in the Urology Department of Hôpital Cochin and the Polyclinic of Montreuil for the treatment of prostatic obstructions. Patients are selected on the basis of objective criteria (flowmetry, post-micturating residue) and subjective criteria (standard clinical history). Only patients with objective obstruction are treated by localized hyperthermia, which constitutes a real alternative to surgery. Treatment is performed as an outpatient procedure without anaesthesia as one one-hour session per week for a period of six weeks. The results are evaluated one and three months after completion of treatment by assessing the same objective and subjective criteria as before treatment. The results of the first 26 patients with sufficient follow-up reveals 45% good objective results and 65% good subjective results.

Aged↗
PubMed1990

[Palliative diversion using an autostatic ureteral stent after endoscopic resection of the ureteral meatus in T4 pelvic tumors].

Seven patients with renal failure secondary to bilateral ureteric obstruction by pelvic carcinoma underwent palliative urinary diversion. In 3 cases, an autostatic ureteric stent was inserted after endoscopic resection of the trigone invaded by the tumour in the presumed zone of the ureteric meatus, and retrograde catheterisation of the ureter. This method has very limited indications, but may improve the comfort of survival of certain patients.

Adenocarcinoma↗
PubMed1990

[Ureteral endometriosis].

Endometriosis, initially believed to be a gynecologic disease, occasionally involves the urinary bladder, and less frequently the ureters. Use of ureteral stents with an appropriate hormonal treatment can obviate the need for open surgery.

Adult↗
PubMed1990

[Treatment of traumatic rupture of the urethra. Apropos of 30 patients].

Thirty patients with traumatic rupture of the urethra were treated in the Urology Department of Cochin Hospital between 1975 and 1985: 11 as an emergency procedure, 7 for an early complication and 12 for a late complication. In the patients treated early, urethrorrhaphy or one-stage urethroplasty gave the best results. Two stage urethroplasty constituted best treatment for patients with a complication of earlier treatment. In patients with late complications, endoscopic urethrotomy is rarely sufficient on its own and two-stage urethroplasty is generally indicated.

Adult↗
PubMed1989

[Benign prostatic hypertrophy. Treatment using local hyperthermia].

The authors have used local hyperthermia in the treatment of benign prostatic hypertrophy (BPH). The "Promeditech" device consists of a computer-controlled microwave hyperthermia system which warms up the prostate through a probe inserted into the rectum. Forty-three patients aged from 57 to 81 years were treated. All presented with severe voiding symptoms and were considered for surgery. Treatment was applied once a weeks for 5 weeks without anaesthesia and on an out-patient basis. At each session, hyperthermia was maintained at 42.5 to 43.5 degrees C for 60 minutes. Objective and subjective criteria for treatment were: post-voiding residual volume, voided volume, maximum flow rate and frequency, urgency, dysuria and nocturia respectively. These parameters were determined for all patients before and after treatment. Results were evaluated at 3 months and 6 months. Objective improvement was observed in 45 p. 100 of the patients, and subjective improvement in 58 p. 100. In 4 out of 5 patients fitted with an in-dwelling catheter for more than 3 months, it was possible to remove the catheter. This procedure must be more widely tested, but it seems to be particularly appropriate for two kinds of patients: those who do not accept retrograde ejaculation and those who are considered poor surgical risks.

Aged↗
PubMed1989

[Treatment of epidermoid carcinoma of the penis].

Epidermoid carcinoma of the penis is a rare type of cancer. Treatment of the primary lesion consists of amputation, although curietherapy can be effective in some cases as a conservative treatment. The prognosis is determined by the presence of absence of lymph node invasion, but the therapeutic strategy to be used when invaded lymph nodes are present remains controversial. Lymph node dissection is the only effective treatment of metastatic adenopathy, but its high morbidity rate limits its indications.

Adult↗
PubMed1989

Delayed nonurothelial metastatic lesions to the penis: a report of two cases.

Metastatic lesions to the penis are uncommon and originate most often from other genitourinary primaries. Diagnosis is usually easy, as the primary is already known in most cases. The metastases can very rarely be isolated and delayed for several years after the treatment of the primary tumor. We report two cases of penile metastases from nonurothelial primary lesions. A sigmoid adenocarcinoma was the primary in one case, a renal adenocarcinoma in the other. These two cases were distinctly unusual, as the metastases were delayed for several years after the treatment of the primary. Treatment was palliative with early death in both cases.

Adenocarcinoma↗
PubMed1989

[2 cases of testicular seminoma associated with HIV infection. Analysis of treatment tolerance].

Two homosexuals with advanced HIV infection and testicular seminoma stage IIb and IIc were treated with irradiation associated with chemotherapy in one patient. Subdiaphragmatic irradiation was followed by moderate diarrhoea. Initial chemotherapy consisted of cisplatinum, vinblastine, bleomycin replaced by cyclophosphamide after radiotherapy. The use of cyclophosphamide was discontinued after 2 courses due to neutropenia (less than 1500/mm3). Complete tumor remission was achieved in both patients without infection in spite of an aggravation of the CD4 deficit (5/mm3, 52/mm3). The patients died of opportunistic infections 14 and 12 months after terminating treatment. We conclude that cytotoxic and radiation treatment can be administered safely if carefully monitored in these severely immunodepressed patients.

Adult↗
PubMed1989

[Does rectal examination modify the blood level of specific prostatic antigen? A study of 40 cases].

Prostatic specific antigen has become an essential laboratory parameter in prostatic cancer; it may rise transiently after various manipulations of prostatic tissue. We decided to investigate a possible modification in PSA after rectal examination. The PSA level, studied before and after rectal examination in 40 patients, confirmed the almost constant rise in PSA after thorough rectal examination. The biokinetic features of PSA are also discussed as they are important to determine the time of PSA assay after a transient rise.

Aged↗