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Although social support is typically associated with a number of health benefits, for some individuals support worsens outcomes, likely because receiving support can undermine feelings of competence. Some have argued that invisible support (i.e., support that recipients do not recognize as help) can reduce negative support-related health consequences (Bolger, Zuckerman, & Kessler, 2000); still, the physiological benefits of invisible support have yet to be established and likely differ as a function of self-efficacy. The purpose of this study was to investigate how visibility of support and self-efficacy interact to affect the cortisol reactivity of a support recipient. In a 2 (self-efficacy: high vs. low) × 2 (support visibility: visible vs. invisible) between-subjects, experimental design, 74 undergraduate students were primed for either high or low self-efficacy using false feedback. Participants then received either visible or invisible support from a confederate while preparing a speech as part of the Trier Social Stress Task (Kirschbaum, Pirke, & Hellhammer, 1993). A series of repeated measures analyses of variance revealed that individuals primed to have high self-efficacy experienced cortisol increases in response to the speech task when they received visible support but not invisible support. By contrast, individuals primed to have low self-efficacy experienced increased cortisol when they received invisible support but not visible support. This research suggests that although invisible support can effectively buffer stress, it is not always the best support strategy.

Objective To devise and validate a system to categorize GreenLight photoselective vaporization of prostate (PVP) complications according to Clavien score (CS), to report complications of PVP using this categorization, and to determine risk factors. Materials and Methods A survey questionnaire was distributed to all participants of the second meeting of the Group of GreenLight Users. They were asked to grade PVP complications according to CS. We calculated the mode CS for each complication from the survey data to propose a categorization system for complications of PVP. Complications encountered in a large single-center cohort of 370 patients were reported according to this system. We assessed the reproducibility of CS by estimating inter-rater agreement by the Fleiss kappa. We performed univariate and multivariate analyses to determine risk factors for complications. Results Of the 67 meeting participants, 42 (62.7%) completed the survey. Overall agreement between urologists was fair (Fleiss kappa = 0.356). Among the 370 patients, 21 (5.7%) had intraoperative complications, 147 (39.7%) had postoperative complications, and 70 (18.9%) had long-term complications. Among the postoperative complications, 125 patients (33.8%) were classified as Clavien grade I, 58 (15.7%) as Clavien grade II, 4 (1.1%) as Clavien grade IIIb, 5 (1.3%) as Clavien grade IVa, 1 (0.3%) as Clavien grade IVb, and 1 (0.3%) as Clavien grade V. In multivariate analysis, the only predictor of overall complications was a polymicrobial preoperative urine culture. Conclusion The grading of PVP complications by CS is fairly reproducible. We are the first to propose a system for the categorization of PVP complications. PVP complications are frequent but most often minor.

Resume But L’objectif principal a ete d’etudier l’efficacite clinique et radiologique a long terme de la sclerotherapie par ethanol dans le traitement des kystes simples du rein ainsi que son innocuite. L’objectif secondaire a ete d’evaluer l’efficacite d’une deuxieme alcoolisation apres un drainage de 24 heures en cas de kyste volumineux. Patients Etude retrospective de janvier 2005 a mars 2012 portant sur 24 patients ayant des kystes simples du rein traites par sclerotherapie percutanee a l’ethanol en chirurgie ambulatoire. Le succes therapeutique etait defini par la disparition des symptomes et une regression de la taille du kyste > 60 %. Une regression incomplete etait definie par une regression comprise entre 50 et 60 % et une recidive par une taille residuelle > 50 %. Le drainage a ete laisse en place 24 heures pour les patients ayant un kyste > 900 cm3 et une deuxieme alcoolisation realisee le lendemain. Tous les patients ont ete convoques pour un controle echographique dans le cadre de l’etude. Resultats Un succes therapeutique a ete observe chez 91,6 % des patients. Deux patients ont eu une regression incomplete. Aucune recidive n’a ete observee. Aucune complication per- ou postoperatoire n’a ete relevee. Conclusion La sclerotherapie des kystes simples du rein a ete une methode sure et efficace pouvant etre realisee sous anesthesie locale, dans le cadre d’une hospitalisation ambulatoire dans la grande majorite des cas. Une deuxieme alcoolisation et un drainage systematique pendant 24 heures pourraient diminuer le risque de recidive pour les kystes volumineux. Niveau de preuve 5.

OBJECTIVE: To describe the injuries occurring during consensual or not sexual intercourses, or during particular sexual practices and their medical, surgical and forensic care. METHODS: We reviewed the literature using PubMed database to clarify the diagnostic and therapeutic approach of: (1) in men: fracture of the corpora cavernosa, penile and urethral foreign bodies (piercing, rings) as well as amputation of penis; (2) in women: trauma during consensual or not sexual intercourses. RESULTS: In men, the most common pathology is the rupture of the tunica albuginea of the corpora cavernosa on the erect penis. The diversity of sexual practices, however, exposes urologists to meet trauma less ordinary: strangulation of the penis by rings, genital piercing complications or introduction of foreign bodies into the urethra or under the skin. Less common are traumatic amputations of the penis. In women, sexual trauma are often benign in their clinical presentation but generally occur in the context of sexual violence and require psychological support, forensic and prevention of sexually transmitted infections. CONCLUSION: The literature is mainly based on expert opinion and single-center retrospective series. We summarized for each situation epidemiology, diagnosis and treatment. Language: fr

Resume Objectifs Evaluer la faisabilite et les resultats de la realisation en consultation d’une videocystoscopie souple en lumiere bleue precedee d’une instillation d’Hexvix® (GE Healthcare) pour le diagnostic initial ou la surveillance des tumeurs vesicales (TV). L’objectif de cette etude etait de comparer le nombre de lesions vues en lumiere blanche et en lumiere bleue, et d’evaluer dans quel pourcentage de cas l’utilisation de l’Hexvix® en consultation modifiait la prise en charge. Patients et methodes Trente patients (26 hommes et quatre femmes) consecutifs ont ete evalues prospectivement par videofibroscopie vesicale en lumiere bleue (videocystoscope Wolf PDD®) realisee une heure apres une instillation endovesicale Hexvix®. Tous les examens ont ete realises en consultation externe sous anesthesie locale par gel de xylocaine : 23 (76,6 %) patients dans le cadre d’une surveillance de TV et sept (23,4 %) pour le diagnostic d’une hematurie a echographie normale. Lorsqu’une lesion suspecte ou une TV etait decouverte, les patients ont beneficie d’une resection endoscopique sous anesthesie avec nouvelle cystoscopie en lumiere bleue. Resultats Des lesions suspectes ont ete mises en evidence chez dix patients sur 30, cinq en lumiere blanche et bleue, cinq en lumiere bleue uniquement. Parmi les cinq lesions uniquement visibles en lumiere bleue, trois etaient des tumeurs urotheliales (toutes pTa de bas grade, moins de 5 mm) et deux des lesions non specifiques. Aucune lesion de CIS n’a ete mise en evidence lors de cette etude. La fibroscopie en lumiere bleue a permis de diagnostiquer des lesions invisibles en lumiere blanche chez trois patients (10 %) et a modifie la prise en charge de cinq patients (16,7 %). La duree de la cystoscopie etait en moyenne de 9,5 minutes. La tolerance de l’examen a ete bonne et aucune complication n’est survenue. Conclusion L’utilisation de la videocystoscopie souple en lumiere bleue +Hexvix® a permis d’ameliorer le taux de detection des TV. En dehors des lesions de CIS, cette amelioration a ete liee au diagnostic de TV de petite taille peu agressives. Les indications doivent etre precisees par des etudes de plus grande envergure et une evaluation medico-economique.

Resume But L’evaluation de la maladie de Lapeyronie (MLP) est clinique en l’absence de questionnaire valide ou d’examen paraclinique standardise. L’ international index of erectile function (IIEF) et le score de Lue sont utilises pour l’evaluation clinique. Le pharmaco-echo-doppler penien (PED) est considere dans les recommandations 2010 comme « utile mais pas indispensable ». L’objectif de cette etude etait d’evaluer l’utilite des scores et du PED dans la prise en charge diagnostique et therapeutique chez les patients souffrant d’une MLP. Patients Vingt et un patients ont ete inclus dans cette etude monocentrique prospective. Tous les patients ont eu un examen clinique avec photographies et une evaluation utilisant l’IIEF-5 et le score de Lue et un PED. Resultats L’âge moyen etait de 57,7 ans (34 a 77) avec une duree d’evolution moyenne de 38,9 mois. L’IIEF-5 n’etait pas adapte a l’evaluation de la fonction erectile preoperatoire dans le cadre de la MLP car les questions 3 a 5 etaient modifiees par la courbure. Le resultat du score de Lue ne nous a pas semble avoir d’interet dans la decision therapeutique car il integrait des criteres heterogenes. Les plaques ont ete classees selon des criteres echographiques : echogeneicite et presence de calcifications. L’application de criteres differentiels pertinents s’est averee delicate. Le PED a mis en evidence des anomalies des flux vasculaires pour 61,9 % des patients. Neuf patients ont ete operes et le PED a modifie le geste chirurgical pour deux. Conclusion La recherche de criteres objectifs d’evaluation de la MLP est indispensable mais ceux actuellement proposes, cliniques ou echographiques, nous ont paru peu adaptes ou difficilement applicables.

Objective:To report a rare case of a laryngeal paraganglioma related to succinate dehydrogenase gene mutation C.Method:A case report and a review of the world literature concerning succinate dehydrogenase mutations and laryngeal paraganglioma are presented.Results:We identified a laryngeal paraganglioma in a 38-year-old woman, related to a very rare, deleterious in exon 4 of the succinate dehydrogenase mutation C. This mutation was a non-sense mutation: c.183G >A leading to p.Trp61X. No other neuroendocrine tumour was identified in this case, but a thyroid papillary carcinoma was concomitantly discovered and cured.Conclusion:To our knowledge, this is the first report in the world literature of laryngeal paraganglioma related to a succinate dehydrogenase mutation C. The case presented underlines the fact that every patient with paraganglioma should be tested for succinate dehydrogenase genetic mutations, even if a family history of paraganglioma is absent, in order to enable appropriate clinical management and to improve our knowledge of familial paraganglioma.

The main objective was to investigate the long-term clinical and radiological effectiveness/safety of ethanol sclerotherapy for treating simple kidney cysts.The secondary objective was to evaluate the effectiveness of a second alcohol treatment after 24 hours of drainage for large cysts.A retrospective study was carried out from January 2005 to March 2012 on 24 patients with simple kidney cysts treated by percutaneous ethanol sclerotherapy during ambulatory surgery. Therapeutic success was defined as symptom resolution and regression of cyst size by60%. Incomplete regression was defined as a decrease between 50 and 60% and a recurrence as a residual size50%. Drainage was left in place for 24 hours for patients with a cyst900 cm(3) and a second alcohol treatment was performed the next day. All patients were invited for ultrasound follow up as part of the study.Treatment success was observed in 91.6% of patients. Two patients had incomplete regression. No recurrence was observed. No intraoperative or postoperative complications were found.Sclerotherapy for simple kidney cysts is a safe and effective procedure that can be performed under local anesthesia and an outpatient setting in most cases. Systematic drainage for 24 hours followed by a second alcohol treatment may reduce the risk of recurrence for large cysts.

To describe the injuries occurring during consensual or not sexual intercourses, or during particular sexual practices and their medical, surgical and forensic care.We reviewed the literature using PubMed database to clarify the diagnostic and therapeutic approach of: (1) in men: fracture of the corpora cavernosa, penile and urethral foreign bodies (piercing, rings) as well as amputation of penis; (2) in women: trauma during consensual or not sexual intercourses.In men, the most common pathology is the rupture of the tunica albuginea of the corpora cavernosa on the erect penis. The diversity of sexual practices, however, exposes urologists to meet trauma less ordinary: strangulation of the penis by rings, genital piercing complications or introduction of foreign bodies into the urethra or under the skin. Less common are traumatic amputations of the penis. In women, sexual trauma are often benign in their clinical presentation but generally occur in the context of sexual violence and require psychological support, forensic and prevention of sexually transmitted infections.The literature is mainly based on expert opinion and single-center retrospective series. We summarized for each situation epidemiology, diagnosis and treatment.

Estimate the feasibility and the results of the realization in consultation of a flexible videocystoscopy in blue light preceded by an instillation of Hexvix(®) (GE Healthcare) for the initial diagnosis or the surveillance of vesicals tumors (VT). The objective of this study was to compare the number of hurts seen in white light and in blue light, and to estimate in which percentage of case the use of the Hexvix(®) in consultation modified the care.Thirty consecutive patients (26 men and four women) were estimated prospectively by vesical videofibroscopy in blue light (Wolf's PD videofibroscope) realized 1 hour after an endovesical instillation of Hexvix(®). All the examinations were realized in external consultation under local anesthetic by xylocaine gel: 23 (76.6%) patients within the framework of a surveillance of VT and seven (23.4%) for the diagnosis of a hematuria with normal echography. When a suspect hurt or a VT was discovered, the patients benefited from an endoscopic resection under anesthesia with new cystoscopy in blue light.Suspect hurts were revealed in 10 out of 30 patients, five in white and blue light, five in blue light only. Among the five only visible hurts in blue light, three were urothelial tumors (any pTa of bottom-rank, less of 5 mm) and two non-specific hurts. No CIS's hurt was revealed during this study. The fibroscopy in blue light allowed to diagnose invisible hurts in white light in three patients (10%) and has modified the care of five patients (16.7%). The duration of the cystoscopy was on average of 9.5 minutes. The tolerance of the examination was good and no complication arose.The use of the flexible videocystoscopy in blue light +Hexvix(®) has allowed to improve the rate of detection of VT. Except CIS's hurts, this improvement was bound to the diagnosis of little aggressive small-sized VT. The indications must be specified by studies of bigger scale and a medical economic evaluation.

Assessment of the Peyronie's disease (PD) is clinical in absence of validated questionnaire or of para-clinical standardized test. The international index of erectile function (IIEF) and Lue's score are used for the clinical evaluation. Penile dynamic duplex ultrasound (PDU) was considered in the 2010 recommendations as "useful but not necessary test". The objective of this study was to estimate the utility of the scores and of the PDU in the diagnostic and in the therapeutic decision at the patients suffering from a PD.Twenty-one patients were included in this forward-looking single-center study over 12 months. All the patients had a clinical examination with photos, an evaluation using the IIEF-5 and the Lue's score and a PDU.The average age was of 57.7 years (34-77) with an average evolution duration of 38.9 months. IIEF-5 was not adapted to the assessment of the preoperative erectile function of the PD because the questions 3 to 5 were modified by the penil deformity. The result of Lue's score did not seem to us to have interest in the therapeutic decision because it is not recommended to operate a patient in evolution. Plaques were classified according to ultrasonographic patterns : presence of hyperechoic or/and calcified lesion. The application of relevant differential ultrasound criteria turned out delicate. The PDU found abnormalities of the vascular flows for 61.9 % of the patients. Nine patients were operated and PDU modified the surgical gesture for two of them.The search for objective criteria of evaluation of the PD is essential, but those currently proposed, clinical or ultrasound seemed to us a little adapted or difficult to apply.