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1. Tuberculose disséminée révélée par une insuffisance rénale aiguë obstructive et fonctionnelle

Author

Guillaume Queffeulou, Fabrice Dugardin, Hélène Roger, Bertrand Sauneuf, Mathilde Beaumier, and Philippe Camparo

Subjects
03 medical and health sciences, 0302 clinical medicine, Nephrology, 030232 urology & nephrology
Abstract

Resume Un marin philippin âge de 56 ans, sans antecedent medical connu, a presente une insuffisance renale aigue fonctionnelle et obstructive aux larges des cotes normandes. La severite de l’atteinte renale compliquee d’une hyperkaliemie et d’une hyperphosphoremie associee a des troubles de la conscience ont justifie une hospitalisation initiale en reanimation. L’imagerie abdominale montrait un rein gauche detruit, une dilatation des cavites pyelocalicielles a droite et de multiples stenoses ureterales typiques d’une tuberculose urinaire. La recherche de bacille acido-alcoolo-resistant urinaire s’est averee positive confirmant le diagnostic. Le scanner thoracique, l’IRM cerebrale et la ponction lombaire ont mis en evidence une miliaire et une meningoencephalite tuberculeuse. Une rehydratation intraveineuse et la derivation des urines par une pose de sonde JJ ont permis une amelioration de la fonction renale avec persistance d’une insuffisance renale chronique stade IV. Une quadritherapie antituberculeuse et une corticotherapie pour l’atteinte neuromeningee ont ete debutees. Nous discutons ici de la tuberculose urinaire en reprenant les donnees de la litterature sur l’epidemiologie, la physiopathologie, le diagnostic et le traitement.

Published
2019

2. Surgical Outcomes of Urinary Tract Deep Infiltrating Endometriosis

Author

Guillaume Defortescu, Emanuela Stochino-Loi, Fabrice Dugardin, Geoffroy Pasquier, Carole Abo, Basma Darwish, Horace Roman, Service de gynécologie et obstétrique [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d'urologie [Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), and Normandie Université (NU)-Normandie Université (NU)-Université de Lille

Subjects
Adult, medicine.medical_specialty, health care facilities, manpower, and services, Bladder, Urinary system, medicine.medical_treatment, education, Endometriosis, Ureterolysis, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Anastomosis, Peritoneal Diseases, urologic and male genital diseases, Postoperative complications, 03 medical and health sciences, Gynecologic Surgical Procedures, 0302 clinical medicine, Ureter, Pregnancy, Recurrence, medicine, Humans, Ureteral Diseases, health care economics and organizations, Retrospective Studies, 030219 obstetrics & reproductive medicine, business.industry, Urinary Bladder Diseases, Obstetrics and Gynecology, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Retrospective cohort study, Deep endometriosis, medicine.disease, female genital diseases and pregnancy complications, Nephrectomy, 3. Good health, Surgery, Fertility, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Urologic Surgical Procedures, Female, Laparoscopy, Segmental resection, business
Abstract

Objective To report the outcomes of surgical management of urinary tract endometriosis. Design Retrospective study based on prospectively recorded data (NCT02294825) (Canadian Task Force classification II-3). Setting University tertiary referral center. Patients Eighty-one women treated for urinary tract endometriosis between July 2009 and December 2015 were included, including 39 with bladder endometriosis, 31 with ureteral endometriosis, and 11 with both ureteral and bladder endometriosis. Owing to bilateral ureteral localization in 8 women, 50 different ureteral procedures were recorded. Intervention Procedures performed included resection of bladder endometriosis nodules, advanced ureterolysis, ureteral resection followed by end-to-end anastomosis, and ureteroneocystostomy. Measurements and Main Results The main outcome measure was the outcome of the surgical management of urinary tract endometriosis. Fifty women presented with deep infiltrating endometriosis (DIE) of the bladder and underwent either full-thickness excision of the nodule (70%) or excision of the bladder wall without opening of the bladder (30%). Ureteral lesions were treated by ureterolysis in 78% of the patients and by primary segmental resection in 22%. No patient required nephrectomy. Histological analysis revealed intrinsic ureteral endometriosis in 54.5% of cases. Clavien–Dindo grade III complications were present in 16% of the patients who underwent surgery for ureteral nodules and in 8% of those who underwent surgery for bladder endometriosis. Overall delayed postoperative outcomes were favorable regarding urinary symptoms and fertility. Patients were followed up for a minimum of 12 months and a maximum of 7 years postoperatively, with no recorded recurrences. Conclusion Surgical outcomes of urinary tract endometriosis are generally satisfactory; however, the risk of postoperative complications should be taken into consideration. Therefore, all such procedures should be managed by an experienced multidisciplinary team.

Published
2017

3. [Disseminated tuberculosis revealed by obstructive and prerenal acute kidney failure]

Author

Mathilde, Beaumier, Hélène, Roger, Bertrand, Sauneuf, Fabrice, Dugardin, Philippe, Camparo, and Guillaume, Queffeulou

Subjects
Male, Tuberculosis, Miliary, Humans, Acute Kidney Injury, Middle Aged
Abstract

A 56-year-old Philippine seaman without any medical history presented an obstructive and prerenal acute kidney failure near the coasts of Normandy. He was hospitalized in intensive care units because of the seriousness of kidney failure and because of impaired consciousness. Abdominal computed tomography showed a destroyed left kidney, a right hydronephrosis and ureteral strictures, which is typical of urinary tuberculosis. Koch bacillus was positive in urine sample, confirming the diagnosis. Thoracic computed tomography, brain magnetic resonance imaging revealed a tuberculosis miliary with concomitant tuberculous meningitis and intracranial tuberculoma. Intravenous hydration and a double J ureteral catheter improved renal function. Stage 4 chronic kidney disease persisted. A four antituberculous therapy associated with corticotherapy for the meningitis was initiated. We discuss of urinary tuberculosis based on literature data about epidemiology, physiopathology, diagnosis and treatment.

Published
2018

4. Nephron sparing surgery for De Novo kidney graft tumor: results from a multicenter national study

Author

L. Salomon, M.O. Timsit, D. Chambade, M. Devonec, Arnaud Doerfler, F. Salusto, A. Erauso, Gregory Verhoest, H. Bensadoun, Fabrice Dugardin, C. Sénéchal, Ricardo Codas, Jacques Hubert, François Kleinclauss, Nicolas Terrier, Rodolphe Thuret, K. Guleryuz, Georges Karam, Xavier Tillou, Service d'Urologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'Urologie [CHU Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d'Urologie (BREST - Urologie), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Urologie [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Service d'Urologie [Toulouse], CHU Toulouse [Toulouse], Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Service d'urologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Service d'urologie [Montpellier], Hôpital Lapeyronie [Montpellier] (CHU), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and UL, IADI

Subjects
Male, medicine.medical_treatment, kidney disease, 030232 urology & nephrology, 030230 surgery, Clinical research, 0302 clinical medicine, malignant, Immunology and Allergy, Medicine, Pharmacology (medical), Aged, 80 and over, education.field_of_study, Kidney, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Middle Aged, practice, Kidney Neoplasms, 3. Good health, neoplasia, medicine.anatomical_structure, Treatment Outcome, Cohort, National study, Female, Nephron sparing surgery, Immunosuppressive Agents, Adult, medicine.medical_specialty, Adolescent, Urology, Population, nephrology, surgical technique, 03 medical and health sciences, Humans, education, Carcinoma, Renal Cell, Dialysis, Aged, Transplantation, business.industry, Nephrons, Kidney Transplantation, Surgery, urology cancer, business, Clear cell, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, malignancy
Abstract

International audience; Nephron sparing surgery (NSS) results in the transplanted population remain unknown because they are only presented in small series or case reports. Our objective was to study renal sparing surgery for kidney graft renal cell carcinomas (RCC) in a multicenter cohort. Data were collected from 32 French transplantation centers. Cases of renal graft de novo tumors treated as RCC since the beginning of their transplantation activity were included. Seventy-nine allograft kidney de novo tumors were diagnosed. Forty-three patients (54.4%) underwent renal sparing surgery. Mean age of grafted kidneys at the time of diagnosis was 47.5 years old (26.1-72.6). The mean time between transplantation and tumor diagnosis was 142.6 months (12.2-300). Fifteen tumors were clear cell carcinomas (34.9%), and 25 (58.1%) were papillary carcinomas. Respectively, 10 (24.4%), 24 (58.3%) and 8 (19.5%) tumors were Fuhrman grade 1, 2 and 3. Nine patients had postoperative complications (20.9%) including four requiring surgery (Clavien IIIb). At the last follow-up, 41 patients had a functional kidney graft, without dialysis and no long-term complications. NSS is safe and appropriate for all small tumors of transplanted kidneys with good long-term functional and oncological outcomes, which prevent patients from returning to dialysis.

Published
2014

5. L’hémospermie par amylose des vésicules séminales. Traitement par vésiculectomie coelioscopique. A propos d’un cas

Author

Thomas Petit, Jacques Petit, A. Paul, Nicolas Surga, Fabrice Dugardin, and J. Vandwalle

Subjects
Gynecology, medicine.medical_specialty, business.industry, Urology, medicine, Hemospermia, business
Abstract

Resume L’amylose des vesicules seminales responsable d’hemospermie est rare. Nous rapportons le cas d’un patient de 42 ans qui avait une hemospermie recidivante depuis 2 ans, avec anomalies d’une vesicule seminale a l’echographie et a l’IRM, qui a justifie l’exerese par voie coelioscopique. L’analyse histologique a mis en evidence une amylose localisee, d’origine inflammatoire. A 1 an, il n’y a pas eu de recidive. Il s’agit de la premiere observation publiee de vesiculectomie coelioscopique pour amylose.

Published
2007

6. Outcomes of surgical management of deep infiltrating endometriosis of the ureter and urinary bladder

Author

Francisc, Rozsnyai, Horace, Roman, Benoit, Resch, Fabrice, Dugardin, Juan, Berrocal, Gérôme, Descargues, Remi, Schmied, Malik, Boukerrou, Loïc, Marpeau, and G, Barau

Subjects
Adult, Diagnostic Imaging, medicine.medical_specialty, endocrine system, Anastomotic fistula, endocrine system diseases, Ureterectomy, Urinary system, Bladder, Endometriosis, Ureterolysis, urologic and male genital diseases, Postoperative complications, Ureter, Scientific Papers, Medicine, Humans, Ureteral Diseases, Radical surgery, Retrospective Studies, Urinary bladder, business.industry, fungi, Urinary Bladder Diseases, food and beverages, medicine.disease, Colorectal surgery, Surgery, medicine.anatomical_structure, Treatment Outcome, Deep infiltrating endometriosis, Female, Laparoscopy, France, business
Abstract

Conservative surgery can be proposed for cases of urinary tract endometriosis associated with postoperative amenorrhea; however, there is a risk of concomitant colorectal surgery and postoperative complications., Objectives: To report the outcomes of surgical management of urinary tract endometriosis and discuss the choice between conservative and radical surgery. Materials and Methods: We reviewed data concerning women managed for ureteral or bladder deep infiltrating endometriosis in 5 surgical departments participating in the CIRENDO prospective database. Preoperative data, surgical procedure data, and postoperative outcomes were analyzed. Results: Data from 30 women pooled in the database showed 15 women presenting with ureteral endometriosis, 14 women with bladder nodules, and 1 with both types of lesions. Ureterolysis was performed in 14 cases; the ureter was satisfactorily freed in 10 of these. In 4 women over 40 years old, who were undergoing definitive amenorrhea, moderate postoperative ureteral stenosis was tolerated and later improved in 3 cases, while the fourth underwent secondary ureteral resection and ureterocystoneostomy. Primary ureterectomy was carried out in 4 women. Two cases of intrinsic ureteral endometriosis were found in 5 ureter specimens. Four complications were related to surgical procedures on ureteral nodules, and 2 complications followed the removal of bladder endometriosis. Delayed postoperative outcomes were favorable with a significant improvement in painful symptoms and an absence of unpleasant urinary complaints, except for one patient with prolonged bladder denervation. Conclusion: Conservative surgery, in association with postoperative amenorrhea, can be proposed in a majority of cases of urinary tract endometriosis. Although the outcomes are generally favorable, the risk of postoperative complications should not be overlooked, as surgery tends to be performed in conjunction with other complex procedures such as colorectal surgery.

Published
2012

7. Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population

Author

Laurent Salomon, Lionel Badet, Georges Karam, Jacques Tostain, Pierre Bigot, Nathalie Rioux-Leclercq, Sébastien Barbet, Jean-Etienne Terrier, Bernard Escudier, Michel Soulié, Hicham Elkentaoui, Abdel-Rahmène Azzouzi, Fabrice Dugardin, Yann Neuzillet, Jean-Christophe Bernhard, Jacques Hubert, Aurélien Descazeaux, Karim Fehri, Nicolas Brichart, Philippe Paparel, J.M. Boutin, Laurent Guy, Baptiste Tisserand, Arnaud Mejean, Ismaël Galliot, Marc-Olivier Timsit, Laurence Bastien, Jérôme Rigaud, Antoine Valeri, Jacques Petit, Laurent Zini, Benoit Barrou, Christian Pfister, Xavier Tillou, Franck Bruyère, Fabien Saint, Herve Lang, Jean-Jacques Patard, Marie-Dominique Azemar, Denis Chautard, Julien Branchereau, Hervé Wallerand, Pascal Rischmann, Laura Poissonnier, Charles Deruelle, Lucille Martin, Laurence Albiges, Jacques Irani, Arnauld Villers, Thierry Lebret, Hervé Baumert, François Kleinclauss, Nicolas Terrier, Jean-Alexandre Long, Pierre-Etienne Theveniaud, M. Gigante, Frédéric Staerman, Jean-Marie Ferriere, Romain Mathieu, Morgan Rouprêt, F. Sallusto, Benoit Feuillu, Service d'urologie, Hôpital Foch [Suresnes], CHU Amiens-Picardie, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Grenoble-Hôpital Michallon, Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] ( UJM ) -Hôpital nord, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Hôpital Saint-Joseph, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy ( IGR ), CHU Strasbourg, Service d'anatomie et cytologie pathologiques [Rennes], Université d'Angers ( UA ) -CHU Angers, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Institut Mondor de recherche biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service d'urologie [Tours], Hôpital Bretonneau-CHRU Tours, Hôtel-Dieu, Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de Chirurgie urologique et andrologie [CHU Limoges], CHU Limoges, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Service de Néphrologie et Urologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Service d'urologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Université de Reims Champagne-Ardenne ( URCA ), Centre hospitalier universitaire de Poitiers ( CHU Poitiers ) -Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -CHU Necker - Enfants Malades [AP-HP], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Université de Brest ( UBO ) -Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, members of the Comité de Transplantation de l'Association Française d'Urologie, the Comité de Cancérologie de l'Association Française d'Urologie, Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut Gustave Roussy (IGR), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'urologie et transplantation rénales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Université de Reims Champagne-Ardenne (URCA), Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service d'Urologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, De Villemeur, Hervé, CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)

Subjects
Male, [ SDV.MHEP.UN ] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Chi-Square Distribution, Time Factors, MESH : Retrospective Studies, 030232 urology & nephrology, MESH : Aged, Kaplan-Meier Estimate, MESH: Risk Assessment, urologic and male genital diseases, Gastroenterology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, MESH : Carcinoma, Renal Cell, 0302 clinical medicine, Renal cell carcinoma, MESH: Risk Factors, Risk Factors, MESH : Female, MESH : Neoplasm Staging, MESH : Risk Assessment, MESH: Treatment Outcome, MESH: Aged, education.field_of_study, Univariate analysis, MESH: Middle Aged, MESH: Carcinoma, Renal Cell, MESH: Neoplasm Staging, Middle Aged, MESH : Adult, MESH : Survival Rate, MESH : Risk Factors, Kidney Neoplasms, 3. Good health, Survival Rate, Treatment Outcome, MESH: Kidney Failure, Chronic, 030220 oncology & carcinogenesis, Female, France, MESH : Time Factors, Adult, medicine.medical_specialty, MESH: Survival Rate, Urology, MESH : Male, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Risk Assessment, MESH : Kidney Failure, Chronic, End stage renal disease, MESH : Kaplan-Meier Estimate, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, MESH : Middle Aged, education, MESH : France, Survival rate, Carcinoma, Renal Cell, MESH: Kaplan-Meier Estimate, Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, MESH: Humans, Chi-Square Distribution, MESH : Chi-Square Distribution, business.industry, MESH: Time Factors, MESH : Humans, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH : Proportional Hazards Models, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH : Kidney Neoplasms, Surgery, Transplantation, MESH: France, Kidney Failure, Chronic, MESH: Kidney Neoplasms, business, Kidney cancer, MESH: Female, Kidney disease
Abstract

International audience; BACKGROUND: Patients with end-stage renal disease (ESRD) are at risk of developing renal tumours. OBJECTIVE: Compare clinical, pathologic, and outcome features of renal cell carcinomas (RCCs) in ESRD patients and in patients from the general population. DESIGN, SETTING, AND PARTICIPANTS: Twenty-four French university departments of urology participated in this retrospective study. INTERVENTION: All patients were treated according to current European Association of Urology guidelines. MEASUREMENTS: Age, sex, symptoms, tumour staging and grading, histologic subtype, and outcome were recorded in a unique database. Categoric and continuous variables were compared by using chi-square and student statistical analyses. Cancer-specific survival (CSS) was assessed by Kaplan-Meier and Cox methods. RESULTS AND LIMITATIONS: The study included 1250 RCC patients: 303 with ESRD and 947 from the general population. In the ESRD patients, age at diagnosis was younger (55 ± 12 yr vs 62 ± 12 yr); mean tumour size was smaller (3.7 ± 2.6 cm vs 7.3 ± 3.8 cm); asymptomatic (87% vs 44%), low-grade (68% vs 42%), and papillary tumours were more frequent (37% vs 7%); and poor performance status (PS; 24% vs 37%) and advanced T categories (≥ 3) were more rare (10% vs 42%). Consistently, nodal invasion (3% vs 12%) and distant metastases (2% vs 15%) occurred less frequently in ESRD patients. After a median follow-up of 33 mo (range: 1-299 mo), 13 ESRD patients (4.3%), and 261 general population patients (27.6%) had died from cancer. In univariate analysis, histologic subtype, symptoms at diagnosis, poor PS, advanced TNM stage, high Fuhrman grade, large tumour size, and non-ESRD diagnosis context were adverse predictors for survival. However, only PS, TNM stage, and Fuhrman grade remained independent CSS predictors in multivariate analysis. The limitation of this study is related to the retrospective design. CONCLUSIONS: RCC arising in native kidneys of ESRD patients seems to exhibit many favourable clinical, pathologic, and outcome features compared with those diagnosed in patients from the general population.

Published
2011

8. Néphrectomie partielle du transplant rénal : étude multicentrique

Author

R. Codas, Georges Karam, François Kleinclauss, L. Viart, Xavier Tillou, L. Salomon, A. Erauso, Gregory Verhoest, Nicolas Terrier, C. Sénéchal, Fabrice Dugardin, Damien Chambade, F. Salusto, Marian Devonec, K. Guleryuz, Jacques Hubert, Henri Bensadoun, Arnaud Doerfler, Rodolphe Thuret, and M.O. Timsit

Subjects
Gynecology, medicine.medical_specialty, business.industry, Urology, medicine, business
Abstract

Objectifs Etudier les resultats des nephrectomies partielles du greffon renale (NPGR) pour tumeur renale de novo. Methodes Etude retrospective nationale, multicentrique. Les donnees ont ete recueillies dans 32 centres de transplantation francais. De janvier 1988 a avril 2012, les patients traites pour tumeur renale d’un greffon fonctionnel ont ete inclus. Soixante-dix -neuf tumeurs de novo du greffon renal ont ete diagnostiquees. Resultats 43 patients ont eu une NPGR. Le temps moyen entre la transplantation et le diagnostic de la tumeur etait de 142,6 mois (12,2 a 300). Quinze tumeurs etaient des carcinomes a cellules claires (34,9 %), vingt-cinq (58,1 %) des carcinomes papillaires. Respectivement 10 (24,4 %), 24 (58,3 %) et 8 (19,5 %) tumeurs etaient Fuhrman grade 1, 2 et 3. Neuf patients ont eu des complications post-operatoires (20,9 %) dont 4 necessitant une intervention chirurgicale (Clavien IIIb) et sans retour en dialyse dans les suites de la NPGR. Toutes les marges chirurgicales etaient negatives avec un diametre moyen de 26 mm. La duree moyenne de suivi etait de 29,6 mois (0,65 - 100,6) et 41 patients avaient un greffon renal fonctionnel, sans dialyse et sans complications a long terme. Conclusion La NPGR est une indication sure et appropriee pour toutes les petites tumeurs du rein transplante avec des resultats fonctionnels et oncologiques tres bons a long terme evitant aux patients un retour en dialyse.

Published
2014

9. 2064 RENAL CELL CARCINOMAS ARISING IN NATIVE KIDNEYS OF DIALYZED AND TRANSPLANT PATIENTS: ARE THEY DIFFERENT ENTITIES?

Author

Nicolas Brichart, Laurent Guy, Yann Neuzillet, Baptiste Tisserand, Jean-Alexandre Long, M. Gigante, Hicham Elkentaoui, Georges Karam, Pierre-Etienne Theveniaud, Jacques Petit, Laurent Zini, Abdel-Rahmène Azzouzi, Arnaud Mejean, Aurélien Descazeaux, Jean-Marie Ferriere, Antoine Valeri, Hervé Lang, Laurence Bastien, Fabien Saint, Denis Chautard, Julien Branchereau, Bernard Escudier, Hervé Baumert, Thierry Lebret, Benoit Barrou, Morgan Rouprêt, Jacques Hubert, Jean-Michel Boutin, Pascal Rischmann, Nathalie Rioux-Leclercq, Lucille Martin, Romain Mathieu, Sébastien Barbet, Jérôme Rigaud, Jean-Michel Correas, Jean-Etienne Terrier, Benoit Feuillu, Christian Pfister, Xavier Tillou, Federico Sallusto, Jean-Jacques Patard, Hervé Wallerand, Fabrice Dugardin, Philippe Paparel, Karim Fehri, François Kleinclauss, Nicolas Terrier, Charles Deruelle, Jacques Irani, Arnauld Villers, Jacques Tostain, Franck Bruyère, Marc-Olivier Timsit, Ismaël Galliot, Michel Soulié, Frédéric Staerman, Laurent Salomon, Lionel Badet, Pierre Bigot, Marie-Dominique Azemar, and Laura Poissonnier

Subjects
Pathology, medicine.medical_specialty, medicine.anatomical_structure, business.industry, Urology, Cell, Medicine, Transplant patient, business
Published
2010

10. 505 CLINICO-PATHOLOGICAL AND OUTCOME FEATURES OF RENAL CELL CARCINOMAS IN PATIENTS WITH END STAGE RENAL DISEASE

Author

Bernard Escudier, Arnaud Mejean, Nicolas Brichart, Jean-Michel Boutin, Yann Neuzillet, Pierre-Etienne Theveniaud, Nathalie Rioux-Leclercq, Georges Karam, Marc-Olivier Timsit, Sébastien Barbet, Jean-Alexandre Long, Jean-Etienne Terrier, Jean-Michel Correas, Fabrice Dugardin, Philippe Paparel, Lucille Martin, M. Gigante, Hervé Baumert, Laurence Bastien, Benoit Feuillu, Laurent Guy, Federico Sallusto, Aurélien Descazeaux, Morgan Rouprêt, Christian Pfister, Xavier Tillou, Hervé Wallerand, Thierry Lebret, Jean-Jacques Patard, Benoit Barrou, Jacques Tostain, François Kleinclauss, Nicolas Terrier, Michel Soulié, Pascal Rischmann, Abdel-Rahmène Azzouzi, Jérôme Rigaud, Hicham Elkentaoui, Jean-Marie Ferriere, Antoine Valeri, Frédéric Staerman, Karim Fehri, Baptiste Tisserand, Jacques Petit, Laurent Zini, Charles Deruelle, Jacques Irani, Hervé Lang, Arnauld Villers, Denis Chautard, Julien Branchereau, Romain Mathieu, Jacques Hubert, Ismaël Galliot, Franck Bruyère, Marie-Dominique Azemar, Laura Poissonnier, Fabien Saint, Laurent Salomon, Lionel Badet, and Pierre Bigot

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Urology, Internal medicine, Cell, medicine, Clinico pathological, In patient, business, Gastroenterology, End stage renal disease
Published
2010

11. 2164 DE NOVO KIDNEY GRAFT TUMORS: RESULTS FROM A MULTICENTRIC RETROSPECTIVE NATIONAL STUDY

Author

Laurent Guy, Jean Michel Boutin, Bertrand Doré, Christophe Legendre, Xavier Tillou, Francois Kleinclaus, Maxime Audet, Thomas Perez, Jean Jacques Patard, Laurent Salomon, Georges Karam, Lionel Badet, Thierry Lebret, Benoit Barrou, Benoit Feuillu, Federico Sallusto, Julien Deturmeny, Jean Marie Ferriere, Ricardo Codas, Jean Philippe Rerolle, Pierre Bigot, Henri Bensadoun, Rodolphe Thuret, Marian Devonec, Jacques Dantal, Bernard Gattegno, Eric Lechevallier, Jacques Petit, Yann Neuzillet, Arnaud Doerfler, Damien Chambade, Nicolas Terrier, M. Gigante, Cédric Sénéchal, Gregory Verhoest, A. Erauso, Christiane Mousson, Emilie Berthoux, Fabrice Dugardin, and Ivan Bouzguenda

Subjects
Kidney, medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, Incidence (epidemiology), medicine.disease, Nephrectomy, Surgery, Transplantation, medicine.anatomical_structure, Cohort, medicine, Stage (cooking), business, Kidney transplantation, Dialysis
Abstract

De novo tumors in renal allografts are rare and their prevalence is underestimated. We therefore analyzed renal cell carcinomas arising in renal allografts through a retrospective French renal transplant cohort. We performed a retrospective, multicentric survey by sending questionnaires to all French kidney transplantation centers. All graft tumors diagnosed after transplantation were considered as de novo tumors. Thirty-two centers participated in this study. Seventy-nine tumors were identified among 41 806 recipients (Incidence 0.19%). Patients were 54 men and 25 women with a mean age of 47 years old at the time of diagnosis. Mean tumor size was 27.8 mm. Seventy-four (93.6%), 53 (67%) and 44 tumors (55.6%) were organ confined (T1-2), low grade (G1-2) and papillary carcinomas, respectively. Four patients died of renal cell carcinomas (5%). The mean time lapse between transplantation and RCC diagnosis was 131.7 months. Thirty-five patients underwent conservative surgery by partial nephrectomy (n = 35, 44.3%) or radiofrequency (n = 5; 6.3%). The estimated 5 years cancer specific survival rate was 94%. Most of these tumors were small and incidental. Most tumors were papillary carcinoma, low stage and low grade carcinomas. Conservative treatment has been preferred each time it was feasible in order to avoid a return to dialysis.

Published
2010

12. Testicular metastasis of prostatic cancer

Author

Christian Pfister, Françoise Gobet, Chemsedine Smaali, and Fabrice Dugardin

Subjects
Male, Pathology, medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, Ultrasound, Cancer, Prostatic Neoplasms, Testicular metastasis, Adenocarcinoma, Middle Aged, medicine.disease, Metastasis, Radiation therapy, Prostate cancer, Testicular Neoplasms, medicine, Hormonal therapy, Immunohistochemistry, Humans, business
Abstract

Secondary testicular tumors are rare, we report a case of a solitary testicular metastasis of prostate cancer in 58-year-old man treated using hormonal therapy associated with radiotherapy. Ultrasound is the imaging modality of choice, but metastasis might be difficult to differentiate from primary tumors. The diagnosis confirmed by histologic examination includes routine microscopic and immunohistochemical findings, and therefore systemic treatment was required.

Published
2009

13. [Medullary sponge kidney and CT fusion artefact]

Author

Gauthier, Raynal, Fabrice, Dugardin, Hakim, Hassani, and Jacques, Petit

Subjects
Adult, Diagnosis, Differential, Kidney Calculi, Nephrocalcinosis, Medullary Sponge Kidney, Image Processing, Computer-Assisted, Humans, Female, Artifacts, Tomography, X-Ray Computed, Urinary Catheterization
Published
2009

14. [Haemospermia due to seminal vesicle amyloidosis. Treatment by laparoscopic vesiculectomy. A case report]

Author

Jérôme, Vandwalle, Fabrice, Dugardin, Thomas, Petit, Nicolas, Surga, Alexandre, Paul, and Jacques, Petit

Subjects
Adult, Male, Urologic Surgical Procedures, Male, Humans, Seminal Vesicles, Laparoscopy, Amyloidosis, Genital Diseases, Male, Hemospermia
Abstract

Amyloidosis of the seminal vesicles is a rare cause of haemospermia. The authors report the case of a 42-year-old patient with recurrent haemospermia over a period of 2 years and abnormalities of one seminal vesicle on ultrasonography and MRI, justifying laparoscopic resection. Histological examination demonstrated localized amyloidosis, secondary to inflammation. No recurrence was observed with a follow-up of one.

Published
2008

15. [The surgical management of recurrent urological malignancies after primary ablative therapy]

Author

Marc, Galiano, Fabrice, Dugardin, François, Rozet, Xavier, Cathelineau, and Guy, Vallancien

Subjects
Male, Prostatectomy, Salvage Therapy, Urologic Neoplasms, Neoplasm, Residual, Ureteral Neoplasms, Prostatic Neoplasms, Nephrectomy, Kidney Neoplasms, Testicular Neoplasms, Urinary Bladder Neoplasms, Humans, Female, Retroperitoneal Neoplasms, Neoplasm Recurrence, Local
Abstract

This literature review highlights the surgical management of recurrent urological malignancies after primary ablative therapy. In particular, recurrent nonseminomatous germ cell tumours (NSGCT) post-chemotherapy, recurrent bladder cancer post-cystectomy, loco-regional recurrence of prostate cancer after radiotherapy, and loco-regional recurrence of renal cell carcinoma after radical nephrectomy. The indications, operative technique, complications and outcomes of each malignancy are discussed.

Published
2004

16. [Mixed epithelial and stromal tumour of the kidney]

Author

Simon, Battisti, Karine, Renaudin, Jérôme, Rigaud, Jean-François, Hetet, Fabrice, Dugardin, Loïc, Le Normand, Jean-Marie, Buzelin, and Olivier, Bouchot

Subjects
Adult, Mixed Tumor, Malignant, Humans, Female, Kidney Neoplasms
Abstract

The authors report the case of a patient with mixed epithelial and stromal tumour, a rare, recently described entity, as only 40 cases have been reported, mixed epithelial and stromal tumours are essentially observed in women during the perimenopausal period with a history of treatment with oestrogen-progestogens or gynaecological surgery. No clinical or radiological arguments can differentiate these tumours from other renal tumours. Histological examination reveals a tumour with an epithelial component and a stromal component presenting the characteristics of ovarian stroma and expressing oestrogen and progesterone receptors. The prognosis of these tumours is usually very favourable, although caution is advised in view of the limited number of published cases and a recent report of a malignant case.

Published
2004

17. Lexique urologique

Author

Fabrice Dugardin, Jacques Petit, Philippe Grise, Fabrice Dugardin, Jacques Petit, and Philippe Grise

Subjects
Urology--Terminology
Abstract

Qu'est-ce que le syndrome du canal d'Alcock? Comment utiliser une sonde de Churet? À quoi ressemble un rein? Ce lexique a été conçu pour être utilisé par tout professionnel de santé participant aux soins en urologie et souhaitant obtenir des explications sur une pathologie, une intervention chirurgicale ou un point anatomique. Il intéressera également les étudiants soucieux de parfaire leurs connaissances dans ce domaine. Plus de 375 termes sont ainsi expliqués de manière claire, précise et concrète. De nombreuses illustrations viennent en complément des définitions. Un ouvrage pratique et très exhaustif.

Published
2009

18. [Endoscopic incision of uretero-vesical junction after renal transplantation]

Author

Fabrice, Dugardin, Jérôme, Rigaud, Eric, Drapier, Frédéric, Maillet, Jean-François, Hetet, Olivier, Bouchot, and Georges, Karam

Subjects
Adult, Postoperative Care, Urinary Bladder, Electrosurgery, Ureteroscopy, Humans, Equipment Design, Middle Aged, Kidney Transplantation, Aged, Ureteral Obstruction
Abstract

Stenosis of the ureterovesical reimplantation is one of the most frequent urological complications after renal transplantation. It can be treated surgically or endoscopically (dilatation, ureteric stent or Acucise). The authors present the results of a new endoscopic electrode-scalpel incision technique used as first-line treatment in 9 patients with stenosis of the distal centimetre of the ureter.

Published
2003

20. 415 COMPARISON OF RENAL CELL CARCINOMAS IN END STAGE RENAL DISEASE AND GENERAL POPULATION PATIENTS

Author

Franck Bruyère, Benoit Barrou, Abdel-Rahmène Azzouzi, Jean-Etienne Terrier, Jacques Petit, Laurent Zini, Yann Neuzillet, Denis Chautard, Pascal Rischmann, Julien Branchereau, Marc-Olivier Timsit, Pierre-Etienne Theveniaud, Romain Mathieu, Nicolas Brichart, Aurélien Descazeaux, S. Saint, Charles Deruelle, Jacques Irani, François Kleinclauss, Morgan Rouprêt, Nicolas Terrier, Jacques Hubert, Laurence Bastien, Fabrice Dugardin, Lucille Martin, Philippe Paparel, Michel Soulié, Hicham Elkentaoui, Arnauld Villers, J.M. Boutin, Christian Pfister, Xavier Tillou, Ismaël Galliot, Georges Karam, Jacques Tostain, Jean-Jacques Patard, J.M. Fernere, Marie-Dominique Azemar, Nathalie Rioux-Leclercq, Antoine Valeri, Sébastien Barbet, Bernard Escudier, Jean-Alexandre Long, Frédéric Staerman, Hervé Baumert, Hervé Wallerand, Thierry Lebret, Laura Poissonnier, M. Gigante, Arnaud Mejean, Laurent Salomon, Lionel Badet, Jean-Michel Correas, Pierre Bigot, Karim Fehri, Herve Lang, Benoit Feuillu, F. Sallusto, Laurent Guy, Baptiste Tisserand, and Jérôme Rigaud

Subjects
medicine.medical_specialty, education.field_of_study, medicine.anatomical_structure, business.industry, Urology, Population, Cell, medicine, business, education, End stage renal disease
Published
2010

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