Mode of Delivery: A Modifiable Risk Factor for Subsequent Stress Urinary Incontinence?
in European Urology (2016), 70(1), 159-60Detailed reference viewed: 21 (5 ULg)
COMMENT JE TRAITE ... une colique néphrétique.
; ; et al
in Revue Médicale de Liège (2016), 71(5), 220-6
Renal colic (RC) represents nearly 2% of emergency department admissions. RC is defined by the occurrence of back pain which may radiate towards the abdomen and external genitals. In adults, the ... [more ▼]
Renal colic (RC) represents nearly 2% of emergency department admissions. RC is defined by the occurrence of back pain which may radiate towards the abdomen and external genitals. In adults, the obstruction is caused by a urinary stone in 80% of cases. The 20 % of non-stone related RCs are due either to an intrinsic obstruction (pyeloureteral junction stenosis, ureteral tumor, ...) or an extrinsic compression (pelvic tumor, lymphadenopathy ...). In over 90% of cases, an RC does not require hospitalization and is treated with medication. In contrast, complicated renal colic (CRC) requires hospitalization with specialized care. Obstructive pyelonephritis (OPN) is a form of CRC and the diagnosis should be considered in a clinical presentation of "renal colic" with acute pyelonephritis. This is a true emergency requiring surgical drainage of the upper urinary tract upstream of the obstacle, as well as antibiotic therapy. It must be kept in mind that some clinical presentations may be atypical, especially in the elderly, which can delay the diagnosis and, thus, the management. The gold standard for diagnosis is CT urography. [less ▲]Detailed reference viewed: 23 (2 ULg)
18F-FPRGD2 PET/CT imaging of integrin αvβ3 in renal carcinomas: Correlation with histopathology
WITHOFS, Nadia ; ; SOMJA, Joan et al
in Journal of Nuclear Medicine (The) (2015)Detailed reference viewed: 60 (16 ULg)
Epidémiologie de la lithiase urinaire sur base d'une analyse morpho-constitutionnelle
Castiglione, Vincent ; JOURET, François ; Bruyère, Olivier et al
in Néphrologie & Thérapeutique (2015), 11
Urolithiasis is a common condition, with a prevalence of 10% and a male/female ratio above 1 according to large national series. Various types of urinary stones have been described upon their mineral ... [more ▼]
Urolithiasis is a common condition, with a prevalence of 10% and a male/female ratio above 1 according to large national series. Various types of urinary stones have been described upon their mineral content and/or their morphology. Hence, a combined morpho-constitutional (M-C) classification has been proposed. In order to detail the prevalence of urolithiasis in general and of each M-C type in particular upon age and gender in Belgium, we retrospectively studied the database of a reference center for urolithiasis analysis. Between 2010 and 2013, 2195 stones were characterized. We excluded 45 nonbiological stones and 281 stones, which originated from outside the study zone. Among 1869 stones,1293 (69.2%) affected men. Prevalence peak of urolithiasis was observed between 50–60 years of age in both genders. The M-C analysis was available for 1854 stones (99.2%): multiple morphological types were concomitantly identified in 49.3%. In the whole population, the main mineral constituent was whewellite (54.4%), mainly organized as type Ia (94%). Weddellite was found in 19.8%, with an equal distribution between types IIa and IIb. Uric acid was the 3rd most frequent constituent in man, with a similar distribution between IIIa and IIIb. Phosphate was uncommon in man (8.2%), but frequent in woman (26.6%) with a type IVa1 organization. Prevalence of M-C types changes with aging, i.e. decrease of weddellite and increase of whewellite and uric acid in both genders. This retrospective analysis of a single-center database of urinary stones helps characterize the M-C epidemiology of urolithiasis in Belgium. [less ▲]Detailed reference viewed: 127 (43 ULg)
Le TOM-Sling(R), un nouveau sling transobturateur de dedans en dehors pour le traitement de l'incontinence urinaire d'effort post-prostatectomie radicale : procedure d'implantation.
de Leval, Jean ; ; Waltregny, David
in Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie (2015), 25(13), 865Detailed reference viewed: 32 (5 ULg)
Épidémiologie de la lithiase urinaire en Province de Liège
Castiglione, Vincent ; JOURET, François ; Bruyère, Olivier et al
Conference (2014, October 17)Detailed reference viewed: 42 (5 ULg)
Épidémiologie de la lithiase urinaire en Province de Liège
Castiglione, Vincent ; Jouret, François ; Bruyère, Olivier et al
in Néphrologie & Thérapeutique (2014, October 01), 10(5), 270Detailed reference viewed: 48 (22 ULg)
Epidémiologie de la lithiase urinaire en Province de Liège
GADISSEUR, Romy ; Castiglione, Vincent ; JOURET, François et al
in Néphrologie & Thérapeutique (2014, September), 10(5), 270Detailed reference viewed: 48 (21 ULg)
Le catheterisme intermittent, methode de choix dans la prise en charge des dysfonctionnements neurologiques vesico-sphincteriens : notre experience a propos de 154 patients atteints d'une sclerose en plaques.
; ; et al
in Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie (2014), 24(13), 842-3Detailed reference viewed: 7 (1 ULg)
A Review of the Current Status of Laparoscopic and Robot-assisted Sacrocolpopexy for Pelvic Organ Prolapse.
; ; et al
in European urology (2014), 65(6), 1128-1137
CONTEXT: Abdominal sacrocolpopexy (ASC) represents the superior treatment for apical pelvic organ prolapse (POP) but is associated with increased length of stay, analgesic requirement, and cost compared ... [more ▼]
CONTEXT: Abdominal sacrocolpopexy (ASC) represents the superior treatment for apical pelvic organ prolapse (POP) but is associated with increased length of stay, analgesic requirement, and cost compared with transvaginal procedures. Laparoscopic sacrocolpopexy (LSC) and robot-assisted sacrocolpopexy (RSC) may offer shorter postoperative recovery while maintaining equivalent rates of cure. OBJECTIVE: This review evaluates the literature on LSC and RSC for clinical outcomes and complications. EVIDENCE ACQUISITION: A PubMed search of the available literature from 1966 to 2013 on LSC and RSC with a follow-up of at least 12 mo was performed. A total of 256 articles were screened, 69 articles selected, and outcomes from 26 presented. A review, not meta-analysis, was conducted due to the quality of the articles. EVIDENCE SYNTHESIS: LSC has become a mature technique with results from 11 patient series encompassing 1221 patients with a mean follow-up of 26 mo. Mean operative time was 124min (range: 55-185) with a 3% (range: 0-11%) conversion rate. Objective cure was achieved in 91% of patients, with similar satisfaction rates (92%). Six patient series encompassing 363 patients treated with RSC with a mean follow-up of 28 mo have been reported. Mean operative time was 202min (range: 161-288) with a 1% (range: 0-4%) conversion rate. Objective cure rate was 94%, with a 95% subjective success rate. Overall, early outcomes and complication rates for both LSC and RSC appeared comparable with open ASC. CONCLUSIONS: LSC and RSC provide excellent short- to medium-term reconstructive outcomes for patients with POP. RSC is more expensive than LSC. Further studies are required to better understand the clinical performance of RSC versus LSC and confirm long-term efficacy. PATIENT SUMMARY: Laparoscopic and robot-assisted sacrocolpopexy represent attractive minimally invasive alternatives to abdominal sacrocolpopexy. They may offer reduced patient morbidity but are associated with higher costs. [less ▲]Detailed reference viewed: 30 (2 ULg)
Incidence and risk factors of postoperative stress urinary incontinence following laparoscopic sacrocolpopexy in patients with negative preoperative prolapse reduction stress testing
LERUTH, Julie ; FILLET, Marc ; Waltregny, David
in International Urogynecology Journal & Pelvic Floor Dysfunction (2013), 24(3), 485-491
Introduction and hypothesis: The objectives of this study were to evaluate the incidence of postoperative stress uri- nary incontinence (SUI) after laparoscopic sacrocolpopexy (LSCP) in women with ... [more ▼]
Introduction and hypothesis: The objectives of this study were to evaluate the incidence of postoperative stress uri- nary incontinence (SUI) after laparoscopic sacrocolpopexy (LSCP) in women with negative preoperative prolapse re- duction stress testing (PPRST) and to identify associated risk factors. Methods: This was a retrospective cohort study comprising women who consecutively underwent double-mesh LSCP without concomitant SUI surgery after a negative PPRST at a tertiary referral center. Negative PPRST was defined by the absence of SUI during cough testing and urodynamic studies with prolapse reduction. Results: Fifty-five patients were assessed in the final analy- sis. No significant complication was encountered during and after LSCP. Mean follow-up was 25±11 (range 12–48) months. No patient developed recurrent pelvic organ pro- lapse (POP) or mesh erosion at last follow-up. Thirty (54.5 %) patients reported the symptom of SUI (subjective SUI) postoperatively, 13 (23.6 %) had a positive cough test (objective SUI) at last visit, and nine (16.4 %) underwent a sling procedure. In univariate analyses, advanced cystocele (stage 3–4) and a history of patient-reported SUI before surgery were associated with a higher risk of postoperative subjective and objective SUI after LSCP. Multivariate anal- yses identified preoperative SUI as the sole independent predictor of subjective SUI [risk ratio (RR04.03; 95% con- fidence interval (CI)01.16–14.09), objective SUI, (RR0 4.67; 95% CI01.14–19.23), and subsequent anti-SUI sur- gery after LSCP (RR06.17; 95% CI01.30–29.41). Conclusions: SUI is far from uncommon in women after LSCP despite negative PPRST, especially in those with advanced cystocele and a history of SUI preoperatively; after at least 1 year of follow-up, approximately one in six women eventually underwent a sling surgery. These data are useful for counseling patients. [less ▲]Detailed reference viewed: 62 (6 ULg)
TVT-O: a new gold standard surgical treatment of female stress urinary incontinence?
in European Urology (2013), 63(5), 879-880Detailed reference viewed: 36 (1 ULg)
New surgical technique for treatment of stress urinary incontinence TVT-ABBREVO: From development to clinical experience
Waltregny, David ; de Leval, Jean
in Surgical Technology International (2012), XXII(pii), 2223
Tension-free suburethral tapes have revolutionized the surgical treatment of female stress urinary incontinence (SUI). These tapes are inserted by way of a retropubic or transobturator route. The inside ... [more ▼]
Tension-free suburethral tapes have revolutionized the surgical treatment of female stress urinary incontinence (SUI). These tapes are inserted by way of a retropubic or transobturator route. The inside-out tension-free vaginal tape transobturator approach, or TVT-Obturator system (TVT-O®, Ethicon Women's Health and Urology, Somerville, NJ), was developed ten years ago with the aim of minimizing the risk of urinary tract injuries associated with retropubic and outside-in transobturator tapes while reproducibly ensuring minimal tissue dissection. Cadaveric studies have shown that the anatomical trajectory of the TVT-O tape is strictly perineal and courses away from neighboring obturator and pudendal neurovascular structures. Several meta-analyses have shown similar SUI cure rates after retropubic and transobturator tape procedures. Yet, the transobturator route may be associated with less voiding dysfunction, blood loss, bladder perforation, and shorter operating time. The original TVT-O procedure was modified with the aim of reducing the incidence of postoperative groin pain as well as the rather theoretical risk of obturator nerve injury. This modified procedure, named TVT-ABBREVO® (Ethicon Women's Health and Urology, Somerville, NJ), utilizes a shortened, 12-cm-long polypropylene tape. In addition, perforation of the obturator membrane with the scissors and guide is avoided in order to reduce the depth of lateral dissection, and consequently, to maximize securing of the tape within the obturator muscular/aponeurotic structures. In a comparative anatomical study, it was indeed observed that the shorter tape traversed less muscular structures (with no or only a minimal amount of tape lying in the adductor muscles) than its original counterpart, while still consistently anchoring in the obturator membrane at a similarly safe distance from the obturator canal. In a single-center randomized clinical trial, after a 3-year minimum follow-up, the modified TVT-O procedure with a shorter tape and reduced dissection was found to be as safe and efficient as the primal procedure for treating female SUI, with less severe and frequent groin pain in the immediate postoperative period. [less ▲]Detailed reference viewed: 72 (6 ULg)
(18F)FPRGD2 PET/CT imaging of integrin αvβ3 in renal carcinomas : correlation with histopathology.
WITHOFS, Nadia ; ; et al
in Journal of Nuclear Medicine (The) (2012), 53(SUPPL), 1647Detailed reference viewed: 29 (8 ULg)
The Inside-Out Transobturator Male Sling for the Surgical Treatment of Stress Urinary Incontinence After Radical Prostatectomy: Midterm Results of a Single-Center Prospective Study.
LERUTH, Julie ; Waltregny, David ; de Leval, Jean
in European Urology (2012), 61(3), 608-615
BACKGROUND: Transobturator slings are currently promoted for the treatment of stress urinary incontinence (SUI) after radical prostatectomy (RP), but data on outcome remain limited. OBJECTIVE: To assess ... [more ▼]
BACKGROUND: Transobturator slings are currently promoted for the treatment of stress urinary incontinence (SUI) after radical prostatectomy (RP), but data on outcome remain limited. OBJECTIVE: To assess, at midterm, the efficacy and safety of the inside-out transobturator male sling for treating post-RP SUI and to determine factors associated with failure. DESIGN, SETTING, AND PARTICIPANTS: Prospective one-center trial involving 173 consecutive patients without detrusor overactivity, treated between 2006 and 2011 for SUI following RP. INTERVENTION: Placement of an inside-out transobturator sling. MEASUREMENTS: Baseline and follow-up evaluations included uroflowmetry and continence and quality-of-life (QoL) questionnaires. Cure was defined as no pad use and improvement as a number of pads per day reduced by >/=50% and two or fewer pads. Complications were recorded, and factors associated with treatment failure were evaluated. RESULTS AND LIMITATIONS: Preoperatively, 21%, 35%, and 44% of the patients were using two, three to five, and more than five pads per day, respectively. After a median follow-up of 24 mo (range: 12-60 mo), 49% were cured, 35% improved, and 16% not improved. QoL was enhanced (p<0.001), and 72% of patients were moderately to completely satisfied with the procedure. Maximum flow rates were slightly reduced (p=0.004); postvoid residual volumes were similar (p=0.097). Complications were urinary retention after catheter removal (15%), perineal/scrotal hematoma (9%), pain lasting >6 mo (3%), and sling infection (2%); all were managed conservatively. Severe SUI before sling surgery was not associated with a worse outcome, whereas obesity and a history of pelvic irradiation or bladder neck stenosis were independent risk factors of failure, with risk ratios of 7.9 (95% confidence interval [CI], 3.3-18.9), 3.3 (95% CI, 1.4-7.8), and 2.6 (95% CI, 1.1-6.5), respectively. CONCLUSIONS: The inside-out transobturator male sling is an efficient and safe treatment for post-RP SUI at midterm. Patients with prior pelvic irradiation may not be suitable candidates. [less ▲]Detailed reference viewed: 77 (4 ULg)
Les traitements chirurgicaux de l'incontinence urinaire d'effort féminine: Où en sommes-nous en 2011?
in Bulletin et Mémoires de l'Académie Royale de Médecine de Belgique (2011), 166(3-4), 157-168
L’incontinence urinaire d’effort (IUE) féminine est principalement liée à une hypermobilité cervico-urétrale. Les bandelettes synthétiques placées sans tension sous l’urètre pour corriger cette ... [more ▼]
L’incontinence urinaire d’effort (IUE) féminine est principalement liée à une hypermobilité cervico-urétrale. Les bandelettes synthétiques placées sans tension sous l’urètre pour corriger cette hypermobilité ont révolutionné le traitement chirugical de l’IUE féminine depuis 15 ans. La technique rétropubienne, à savoir le “tension-free vaginal tape” (TVT), a été mise au point en 1996. Elle génère des taux de guérison de l’IUE élevés mais est associée à un risque de saignement intrapelvien et de perforation vésicale et intestinale. La voie transobturatrice de dedans en dehors, développée il y a huit ans dans notre Institution, connaît une diffusion mondiale. La technique est simple et reproductible et l’incidence des complications péri- et post-opératoires est réduite. Les taux de guérison de l’incontinence d’effort sont de près de 90% après 3-5 ans de suivi, similaires à ceux obtenus après pose d’une bandelette par voie rétropubienne. Nous avons récemment amélioré notre technique originale en utilisant une bandelette plus courte tout en réduisant la dissection nécessaire pour l’insertion de celle-ci. Après un suivi minimal d’un an, cette nouvelle technique apparaît aussi efficace et sécurisante que la technique transobturatrice ‘traditionnelle’ mais occasionne moins de douleurs de cuisse post-opératoires. Nous introduisons ainsi pour la première fois le concept du “midi sling” transobturateur. [less ▲]Detailed reference viewed: 94 (8 ULg)
An anatomic comparison of the original versus a modified inside-out transobturator procedure
Bonnet, Pierre ; ; et al
in International Urogynecology Journal & Pelvic Floor Dysfunction (2011)Detailed reference viewed: 85 (16 ULg)
Chronic Idiopathic Penile Edema: Three Cases and a Review of the Literature
RATY, Laurent ; FAILLA, Valérie ; Andrianne, Robert et al
in Open Dermatology Journal (The) (2011), 5
Abstract: Chronic idiopathic penile edema (CIPE) is an exceptional entity with disabling persistent lymphedema of the penis, affecting accessorily the scrotum and the pubis. The onset presents with ... [more ▼]
Abstract: Chronic idiopathic penile edema (CIPE) is an exceptional entity with disabling persistent lymphedema of the penis, affecting accessorily the scrotum and the pubis. The onset presents with recurrent swelling of the external genitalia, regressing spontaneously. After 2-3 years the swelling becomes progressively persistent. Mictional and erectile dysfunctions are not uncommon. A thorough work-up including RX, ultrasound examination, CT scanning, MRI imaging, serology and extensive blood testing should be performed to exclude underlying causes, including neoplastic, infectious, vascular and inflammatory diseases. CIPE is associated with significant psychological and functional impact. Surgical correction is the sole therapeutic option. Three patients with CIPE and a review of the literature are presented in order to increase awareness of this rare condition. [less ▲]Detailed reference viewed: 273 (11 ULg)
18F-fluoride PET/CT for assessing bone involvement in prostate and breast cancers
Withofs, Nadia ; Grayet, Benjamin ; Tancredi, Tino et al
in Nuclear Medicine Communications (2011), 32(3), 168-176Detailed reference viewed: 76 (29 ULg)
Identification of stromal proteins overexpressed in nodular sclerosis Hodgkin lymphoma.
; Waltregny, David ; et al
in Proteome Science (2011), 9(1), 63
ABSTRACT: Hodgkin lymphoma (HL) represents a category of lymphoid neoplasms with unique features, notably the usual scarcity of tumour cells in involved tissues. The most common subtype of classical HL ... [more ▼]
ABSTRACT: Hodgkin lymphoma (HL) represents a category of lymphoid neoplasms with unique features, notably the usual scarcity of tumour cells in involved tissues. The most common subtype of classical HL, nodular sclerosis HL, characteristically comprises abundant fibrous tissue stroma. Little information is available about the protein composition of the stromal environment from HL. Moreover, the identification of valid protein targets, specifically and abundantly expressed in HL, would be of utmost importance for targeted therapies and imaging, yet the biomarkers must necessarily be accessible from the bloodstream. To characterize HL stroma and to identify potentially accessible proteins, we used a chemical proteomic approach, consisting in the labelling of accessible proteins and their subsequent purification and identification by mass spectrometry. We performed an analysis of potentially accessible proteins in lymph node biopsies from HL and reactive lymphoid tissues, and in total, more than 1400 proteins were identified in 7 samples. We have identified several extracellular matrix proteins overexpressed in HL, such as versican, fibulin-1, periostin, and other proteins such as S100-A8. These proteins were validated by immunohistochemistry on a larger series of biopsy samples, and bear the potential to become targets for antibody-based anti-cancer therapies. [less ▲]Detailed reference viewed: 109 (15 ULg)