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The authors report the results of 63 internal urethrotomies for urethral stenosis performed during a four year period. The essential sites were perineal and the most frequent aetiology iatrogenic, particularly after prostatectomy. Overall, the authors obtained 18 satisfactory results, 2 severe complications, 24 failures and 17 patients are too recent to assess or were lost from sight. A second endoscopic urethrotomy gave only very little chance of a definitive recovery. Although the results were not constantly excellent, the series studied by the authors shows that endoscopic internal urethrotomy offers the possibility by a simple technique of obtaining a certain number of durable successes whilst not interfering with the subsequent performance of other types of urethroplasty. Finally, in a certain number of cases endoscopic internal urethrotomy facilitates subsequent dilatations.

The authors report some forty cases of renal masses, cystic in appearance and having raised a certain number of diagnostic or therapeutic problems. These masses included 7 cystic carcinomas, 3 benign tumors of cystic appearance and 28 cysts including 2 infected and 2 hydatid cysts. No paraclinical investigation is infallible in confirming the nature of the mass in doubtful cases, and pre-operative diagnosis is more easily obtained by investigation including the majority of standard imaging methods often completed by puncture. Amongst clinical factors which raise doubts as to the benign nature of the cystic mass seen, hematuria remains the most important, other symptoms and signs being of little significance. With regard to imaging, septate calcified masses with echoes within them, with a thick wall or high CT scan density are theoretically suspect. The same applies to masses having rapidly increased at two successive investigations or where puncture fluid is bloody. In all cases if proof of the benign nature cannot be obtained, surgical exploration would appear to be required.

This is a comparative study in 183 patients of the treatment of urethral stenoses by two-stage urethroplasty, internal endoscopic urethrotomy and urethrotomy via the Olbert catheter. Urethroplasty (39 patients) was preferentially carried out in patients with moniliform stenosis greater than 2 cm long in the penile and penoscrotal urethra. There was no significant difference in the indications for the two forms of urethrotomy. Good results were obtained for the 3 techniques in about 80% of cases but there was significantly higher complication rate with surgical urethroplasty. The failure rate of the 3 techniques did not differ significantly. The cost of treatment, on the other hand, greatly differed depending on the technique. Surgical urethroplasty was 2.8 times more costly than internal endoscopic urethrotomy and 10.4 times more costly than Olbert catheter urethrotomy. Olbert catheter urethrothomy was 3.7 times cheaper than internal endoscopic urethrotomy.

In the last 110 cases of genital prolapse examined, IVU formed part of the prior urological investigation. 14 cases of ureteropelvic distension were thus discovered (13.6% of cases). In ten cases the prolapse was sufficiently largee as to exterioris the uterus or bring it to of the vulva. In 13 cases out of 15 a larg cystocoele was visible at the vulva with a full bladder. The precise urological consequences of these prolapses was greater than had been expected: 13 cases of incomplete vesical retention, 4 of unilateral ureteropelvic distension and 10 bilateral, including 3 only symmetrical. Bilateral high distension was in general associated with a large cystocoele. Severe renal insufficiency was seen in only one case, and 5 moderate elevations in blood urea, in 5 cases. The mechanism of such ureteropelvicalyceal distension is not clear, but the prolapse is directly responsible, since mechanical (insertion of a pessary) or surgical reduction of the prolapse restores the upper excretory tract to normal. Renal function recovered all the more rapidly when the prolapse had been present for a shorter time.

Case-reports of 85 patients with upper urinary tract tumors were reviewed. Mainly affected were males (87% of cases), particularly over 60 years of age, the principal presenting sign being hematuria. Other signs such as renal colic, lumbago or infections were observed more rarely. The renal pelvis was affected in 52 of the 85 patients (two of these were bilateral), multiple tumor foci being present in only 6 cases. Most tumors were epitheliomas (62 papillary and 13 non-papillary), with 52 of these at the superficial stage (0 or A), 21 at stage B 1 and 5 at stage B II or C. Based on Broders' classification, 48 were grade II and 16 grade III tumors. Prognosis was routinely poor in 5 patients with a stage B or C tumor and lymph node extension. Diagnosis is by intravenous urography, although retrograde ureteropyelography has its place, with increasing interest being given to ultrasound and computed tomography examinations combined with routine cystoscopy. If no particular contraindications exist, the preferred treatment is a total one-stage nephro-ureterectomy without curettage (52 cases), although curettage was performed at the same time in 9 other patients. Conservative surgery has only a limited application: 6 patients had segmental resections of the ureter and 2 patients underwent tumorectomy. Postoperative mortality was particularly loco: 4 patients (4,7%), mainly from vascular or respiratory diseases. (4,7%), mainly from vascular or respiratory diseases. Bone (5 cases), pulmonary (3 cases) and medullary (1 case) metastases represented the main cause of death during the year following surgery, all these patients having infiltrating tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical and urodynamical study of 108 patients old of more than 70 years and presenting urinary incontinence showed the frequency of vesical instability and dysuria (maximum out put less than 15 ml/s).