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Objective: To evaluate the complications of retroperitoneal laparoscopy for upper urinary tract surgery., Methods: From 1994 to 2003, 500 retroperitoneal laparoscopy procedures were performed: 143 radical nephrectomies, 104 simple nephrectomies, 95 adrenalectomies, 47 ureteropelvic junction plasties, 44 partial nephrectomies, 22 nephroureterectomies, 20 cyst resections, 9 diverticulectomies, 8 lymphadenectomies, 4 pyelotomies and 4 ureteric procedures. The standardized technique uses 5 trocars., Results: There were 23 conversions (4.60%): 5 for retroperitoneal adhesions, 11 for intraoperative bleeding, 7 for technical impossibility. 14 patients (2.8%) required surgical revision: 5 urinomas and 2 urocutaneous fistulas treated by ureteric drainage, 2 deep abscesses, 2 cases of secondary bleeding, 2 colostomies for gastrointestinal fistula after colonic injury, 1 incisional hernia on a trocar orifice. There were postoperative 2 deaths (0.4%) due to septic shock and haemorrhagic shock. 21 patients (4.2%) presented medical postoperative complications: haematoma, hyperthermia, phlebitis and pulmonary infections. 15 patients (3%) were transfused. The most frequent complications occurred after partial nephrectomies and the most serious complications occurred after radical nephrectomies., Conclusion: The complication rate is low. Retroperitoneal laparoscopy allows reproducible and effective upper urinary tract surgery, but it is not recommended in patients with a history of retroperitoneal surgery.

Unlabelled: The value of intracavernosal corticosteroid infiltration remains controversial or may even be contraindicated in Peyronie's disease, as it is considered to be ineffective and a source of morbidity., Objective: To retrospectively analyse the efficacy and safety of intracavernosal corticosteroid infiltration in a selected population only presenting clinical criteria of the acute phase of Peyronie's disease (pain and/or recent onset < 6 months)., Material and Method: Intracavernosal corticosteroid infiltration (weekly or twice-weekly) was performed in or around the plaque. Evaluation was based on clinical criteria according to the course of pain, the nodule and curvature and the rates of improvement, resolution, stabilization and deterioration of these criteria were studied., Results: In a series of 271 patients, 123 presented criteria of the acute phase of Peyronie's disease. Forty five of these patients were treated exclusively by intracavernosal corticosteroid infiltration. The mean age was 52 +/- 8 years. The number of intracavernosal infiltrations was usually less than 10 (n = 40) with less than 8 injections in the majority of patients (n = 36). Follow-up was 6 months. There were no cases of clinical deterioration. The best results were observed on pain, which decreased (13.6%) or totally resolved (61.4%). Curvature was decreased (20.5%), the plaque decreased (25%) or disappeared (9%). When intracavernosal corticosteroid infiltration is ineffective, it appears useless to administer more than 3 injections. No morbidity was observed., Conclusion: In our population, the reputation of inefficacy and morbidity of local corticosteroid therapy appears to be unjustified. There were no cases of deterioration, but, on the contrary, stabilization and especially very marked and rapid efficacy on pain, but a lesser efficacy on curvature and plaque. Local steroid therapy appears justified during the acute phase, as the injection allows corticosteroids to exert their anti-inflammatory action in situ in line with the pathophysiology of the disease. A standardized, multicentre, prospective, randomized, placebo-controlled study could confirm our impressions.

Introduction: This study was designed to evaluate the efficacy of ESWL in the management of acute renal colic., Material and Method: From January 2003 to August 2003, 102 patients were hospitalised for renal colic. We treated 57 patients by ESWL using an EDAP LT 02 apparatus. Successful treatment was defined by stone fragmentation on the plain abdominal x-ray at 24 hours associated with resolution of pain after only one ESWL session., Results: The overall complete success rate after only one ESWL session was 49%. Results according to site: UPJ stones: 46% of success, lumbar ureter: 14%, iliac ureter: 33%, pelvic ureter: 66%. According to size: < 5 mm: 57% of success, 6 to 10 mm: 70%, 11 to 15 mm: 27%, > 15 mm: 0%. No difference in success rate was observed according to the cumulative energy delivered or according to the duration of ESWL sessions., Conclusion: ESWL can be considered to be a first-line treatment for acute renal colic. Its best indications correspond to pelvic or UPJ stones less than 10 mm in diameter. We believe that it is useless to exceed a duration of 30 min per ESWL session at a frequency of to 2 Hz.

Percutaneous nephrolithotomy is associated with a high risk of complications, particularly bleeding, which makes it a potentially invasive technique. Management of haemorrhagic complications sometimes requires the use of embolization. Recurrence after embolization can occur as a result of revascularization or recanalization of vessels, but post-embolization infarction can also lead to persistent haematuria. The authors report the clinical case of a 36-year-old patient presenting with recurrence of severe haematuria after two successive highly selective embolizations. Analysis of the mean corpuscular volume of red cells in the urine confirmed the parenchymal and non-vascular origin of the bleeding, corresponding to a post-embolization syndrome. This analysis therefore constitutes a simple way to avoid repeated embolization or surgical exploration.