Characteristics and expectations of patients with erectile dysfunction: results of the SCORED

in International Journal of Impotence Research: The Journal of Sexual Medicine (2008)

Lipomatose pelvienne associee a une cystite glandulaire: rapport de deux cas

in Progrès en Urologie (2005), 15(1), 81-4

The authors report two cases of pelvic lipomatosis associated with glandular cystitis. This is a rare disease with variable and nonspecific clinical features. Complementary investigations useful for the ... [more ▼]

The authors report two cases of pelvic lipomatosis associated with glandular cystitis. This is a rare disease with variable and nonspecific clinical features. Complementary investigations useful for the diagnosis of pelvic lipomatosis are CT and especially MRI, intravenous urography and biopsies. The clinical features, radiological findings and therapeutic approach are discussed in the light of a review of the literature. [less ▲]

New technique for hydaulic penile prosthesis insertion and corporeal closure

in Journal of Sexual Medicine (2004), 1 Suppl 1

An original technique of insertion and corporotomy closure on the level proximal is described. Proximal angle of corporotomy is closed on the pipe of the hydraulic cylinder by a point of vicryl which was ... [more ▼]

An original technique of insertion and corporotomy closure on the level proximal is described. Proximal angle of corporotomy is closed on the pipe of the hydraulic cylinder by a point of vicryl which was installed before the device implantation. This simple technique allows correct installation of proximal extremity of the prosthesis in the tail of the cavernous body and avoids damage and perforation to the prothesis. Disclosure: Was this work supported by industry? No. [less ▲]

Composantes psychologiques des plaintes relatives à la taille du pénis après implantation d'une prothèse pénienne

in Sexologies (2004), 13(47), 26-29

A survey questionnaire completed by 39 users of penile prosthesis shows that complaints related to the size of the implanted penis involve a decrease in satisfaction towards the prosthetic device. However ... [more ▼]

A survey questionnaire completed by 39 users of penile prosthesis shows that complaints related to the size of the implanted penis involve a decrease in satisfaction towards the prosthetic device. However, a reduced penile size is not necessary considered as a problem by all patients. Beyond functional considerations, the disappointment concerning the length of the penis is mostly related to the representation of a virility debased by the notions of artifice and assistance which are associated to the penile implant. Strong correlations are actually reported between a lower satisfaction, complaints related to the length of the implanted penis, feelings of shame, a lower self-esteem due to the idea of an "artificial virility" and a trend to attribute a negative attitude towards penile implant to the partner. On the whole, these variables appear to be the expression of a global castration experience that makes the psychosexual assimilation of the prosthesis rather precarious. This castration experience is derived from a certain representation of male erotic quality which requires long, natural and spontaneous erections. From this point of view, the injurious impact of reduced erections seems inseparable from an injurious representation of prosthetic sexuality globally perceived as a “parodic”, “reduced” virility. It is remarkable that none of these variables correlates with the partners' actual opinions concerning prosthesis and sexuality permitted by penile implant. Parallel questionnaires completed separately by 27 partners show that part of the men's injurious representation partakes of projective mechanisms. Such observations underline the relevance of a psychosexological approach of the couple in addition of the surgical approach. [less ▲]

Hematurie causee par un "nutcracker syndrome" ou "syndrome du casse-noisettes": confirmation peroperatoire de sa realite

in Progrès en Urologie (2002), 12(6), 1323-6

Nutcracker syndrome should be considered in the case of left ureteric haematuria based on computed tomography with vascular reconstruction of the hilar region of the kidney. The best confirmation is ... [more ▼]

Nutcracker syndrome should be considered in the case of left ureteric haematuria based on computed tomography with vascular reconstruction of the hilar region of the kidney. The best confirmation is obtained by studying the pressure gradient between the left renal vein and the inferior vena cava during cavography. Various modalities of surgical treatment have been proposed by a few authors, but have been criticised by some authors who question the clinical reality of this syndrome and the efficacy of treatment. The decision to operate may be difficult and other investigations may be useful to confirm the diagnosis. We report the case of a patient in whom the diagnosis of nutcracker syndrome was confirmed intraoperatively by the immediate appearance of massive, reversible haematuria induced by clamping of the renal vein during vein dissection and augmentation plasty. In the light of this original case, we believe that a preoperative percutaneous haematuria provocation test by temporary obstruction of the left renal vein during venography could allow a more formal diagnosis of nutcracker syndrome when this syndrome is highly suspected. [less ▲]

Efficacy of upper urinary tract stones treatment by ESWL under local anesthesia, with the use of the Dornier Compact alpha Lithotriptor.

Poster (2002, September)

Adult mullerian duct or utricle cyst: clinical significance and therapeutic management of 65 cases.

in Journal of Urology (The) (2002), 167(4), 1740-4

PURPOSE: We define guidelines for the exploration and treatment of adult mullerian duct cysts. MATERIALS AND METHODS: From January 1988 through September 1999 a diagnosis of enlarged prostatic utricle was ... [more ▼]

PURPOSE: We define guidelines for the exploration and treatment of adult mullerian duct cysts. MATERIALS AND METHODS: From January 1988 through September 1999 a diagnosis of enlarged prostatic utricle was made in 65 adults based on transrectal ultrasound findings. Echographic criteria to define simple versus complicated cysts were detailed. We reviewed the clinical presentation, diagnostic modalities, indications for invasive procedures and postoperative outcome. RESULTS: The usual clinical presentations were hematospermia in 40% of cases, other ejaculatory disturbances in 20%, recurrent testicular or pelviperineal pain in 33%, lower urinary tract irritation symptoms in 25%, lower urinary tract infection in 18.5%, male infertility in 12% and incidental finding in 18.5%. Cyst dimensions did not influence the indication for invasive procedures, which were performed in only 27 of the 65 patients (41.5%) to treat disabling symptoms in 28% and obstructive infertility in 5%, and investigate complicated cysts on transrectal ultrasound in 6%. These procedures included transperineal or transrectal puncture in 9 patients, simple endoscopic section of the utricle meatus in 12 and large marsupialisation in 6. Complete and sustained cure was noted in half of the patients treated with cyst puncture only, although echographic relapse was the rule. Endoscopic procedures definitely improved or cured 82% of the patients at a mean followup of 51 months, during which neither early nor late complications were noted. CONCLUSIONS: Since almost 60% of adults diagnosed with a mullerian duct cyst did not experience any cyst related symptoms or ejaculatory-fertility impairment, we recommend that investigation and/or treatment should only be done in symptomatic or infertile patients. [less ▲]

Pyelonephrite xanthogranulomateuse pseudotumorale: diagnostic par la biopsie percutanee et succes du traitement conservateur

in Progrès en Urologie (2001), 11(6), 1274-6

Focal xanthogranulomatous pyelonephritis is an unusual form of chronic renal infection that is difficult to diagnose prior to surgery. We report on a 19-year-old woman who presented with a renal mass that ... [more ▼]

Focal xanthogranulomatous pyelonephritis is an unusual form of chronic renal infection that is difficult to diagnose prior to surgery. We report on a 19-year-old woman who presented with a renal mass that mimicked malignancy. The diagnosis of focal xanthogranulomatous pyelonephritis was first suspected by radiological findings and further confirmed by histopathologic examination of percutaneous biopsy specimens of the lesion. Successful treatment of the patient was achieved with antibiotic therapy alone. Maximal efforts, including percutaneous renal biopsy, should be made to establish the diagnosis of focal xanthogranulomatous pyelonephritis before a therapeutic decision is reached. We recommend the use of antibiotics as a first-line treatment for patients with focal xanthogranulomatous pyelonephritis. [less ▲]

Prothèses péniennes : taille du pénis implanté et dimensions de la virilité

in Cahiers de Sexologie Clinique (2001), 27(149), 18-27

The implantation of a penile prosthesis frequently results in a reduction of the erectile length compared with natural erections. Some patients complain about this fact and their satisfaction at ... [more ▼]

The implantation of a penile prosthesis frequently results in a reduction of the erectile length compared with natural erections. Some patients complain about this fact and their satisfaction at prosthesis assisted sexuality is significantly diminished. Obviously, the degree of complaint is not proportional to the objective degree of penile reduction. For an objective reality to lead to complaints, subjective criteria of appreciation have to intervene. A survey questionnaire completed by 39 implanted patients and 30 partners shows that complaints about the size of the implanted penis are mostly related to a social representation of sexuality which associates the male erotic value to criteria of erectile length, spontaneity and “naturalness”. This representation also tends to be projected in the partner’s mind, independently of her actual attitudes and feelings. Therefore, the injurious impact of penile reduction on satisfaction at the prosthetic device seems to be inseparable from a global representation of prosthetic sexuality which is experienced as a “parodic”, “reduced” virility. The reduced size of the penis focuses feelings of vexation which cannot be reduced to simple functional considerations, it embodies the painful and complex image of a lost virility. From this point of view, psychosexological counselling would be indicated in order to help some couples to improve their adaptation to penile prosthesis. Moreover, an Attitude scale towards Penile Implant (API) derived from the survey questionnaire might enable the identification of risk-patients. [less ▲]

Consensus clinique de l'approche raisonnee des troubles erectiles chez un patient cardio-vasculaire

in Revue Médicale de Liège (2000), 55(5), 454-8

The most common physical risk factors for erectile dysfunction (ED) are atherosclerosis, heart disease, hypertension and diabetes. Since accessibility to easy and efficacy drug for ED therapy, GPs are ... [more ▼]

The most common physical risk factors for erectile dysfunction (ED) are atherosclerosis, heart disease, hypertension and diabetes. Since accessibility to easy and efficacy drug for ED therapy, GPs are increasingly at the front line in the management of ED and are often best-placed to discuss this problem with cardiovascular male patients. This consensus aims to provide practical advice on the management of ED in patients with diagnosed cardiovascular disease and also addresses the assessment of the cardiovascular risk in restoring sexual activity in these patients. A risk assessment algorithm has been drawn up to aid clinicians in deciding the level of cardiovascular risk that would be associated with a return of sexual activity as well as criteria for referral to specialists for further cardiac evaluation. Treatment options are briefly reviewed and follow-up process identified. [less ▲]