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Many authors use a preliminary orthopedic procedure before cleft lip and palate surgical closure in order to prevent possible bone distortion following the rupture of the muscle belts resulting from the cleft. Actually, this is generally not only an orthopedic treatment but rather a surgical orthopedic step which includes lip adhesion before the surgical closure of the clefts. Following the procedures proposed by Georgiade and Latham, we have used since 1996 a treatment based on traction applied with an elastic chain on splints attached by transmaxillary pins for certain types of clefts, namely unilateral complete clefts with endognathy of the small fragment, unilateral complete clefts larger than 7 mm, bilateral wide complete clefts with premaxilla protrusion, and bilateral wide complete clefts with collapsus and premaxillary protrusion. Technical procedures vary with the type of cleft. Standard procedures with or without jacks are used for the other types of complete clefts. These orthopedic procedures with elastic traction are performed between the 3rd and 6th week, before lip adhesion of the upper part of the lip (combined with release of skin and subcutaneous tissues from the underlying alar cartilage). A palatine plate with or without a jack, fitted most of the time with a spring for nostril support, is then inserted until surgical closure.

Usual imaging diagnostic for salivary glands is sialography. Sialography is not stripped of disadvantages and failures. The MRI-sialography is an examination which is carried out without any injection of contrast's product (without catheterization or intravenous injection). It is thus noninvasive and painless. The complete study of salivary gland and its ducts is always possible and could not be blocked by local or loco-regional conditions. It allows exploration of several salivary glands in the same time. We think that the MRI-sialography must find its place in the diagnosis arsenal for salivary pathology in spite of its current handicaps represented by its cost and the difficulty of access to the apparatuses.

The authors describe the main techniques for rapid prototyping used in the medical field, with particular emphasis on Laser stereolithography. They describe the basics of the technique as well as the procedures they currently use to construct anatomic specimens from scanned images. For more than 10 years, the targets of researchers in the field of bone reconstruction in craniofacial surgery have been: to design a system to acquire data directly from CT-scans, to optimize modelling, processing and materials, to verify the possibility of producing prefabricated prostheses with data from preoperative models (22 cases). The target of integrating this technique into therapeutic protocols has been reached. The current trend in research is to produce prostheses from biocompatible materials directly from CT scan data by Laser stereolithography.

Objective: Infravesical obstruction can occur after surgical cure for urinary stress incontinence (USI). Apart from palliative treatments with limited effects, this iatrogenic complication can be corrected by complete urethrolysis. The various indications and techniques of this surgery are presented., Method: Urethrolysis is designed to release the urethra and bladder neck and can be performed via a transvaginal or retropubic approach. Some authors then recommend resuspension of the bladder neck, while others use a Martius or omentum flap to reduce the risk of restenosis., Results: The success of urethrolysis is measured by the return of normal micturition with complete disappearance of the irritating and/or obstructive symptoms. The success rate for the transvaginal procedure varies from 65% to 92% according to different teams, while the success rate via an abdominal incision was 93% in one series., Conclusion: Urethrolysis is a difficult surgical technique, whose long-term results have not yet been precisely determined. The transvaginal route is associated with a low morbidity and remains our personal preference to release the obstructed urethra after operation for USI.

Complete destruction of the urethra is one of the long-term complications of continuous bladder catheterization in women with advanced neurogenic bladder, resulting in a continuous urine leak around the catheter. This type of incontinence can be treated by closure of the bladder neck associated with suprapubic bladder drainage. Several approaches hve been proposed: abdominal, vaginal and mixed abdominal-vaginal. Each of these techniques is described, together with their results. Closure of the bladder neck decreases the nursing care, reduces the risk of perineal infectious and cutaneous complications and improves the patient's quality of life. Ileal urinary diversion is not always possible in these patients who often have a poor general status. Transvaginal closure of the bladder neck therefore constitutes one of the treatment options.

The Martius pedicle adipose flap can be used as an interposition flap during complex vaginal operations. It is a simple, rapid technique allowing raising of a well vascularized adipose flap with a mean length of 8 to 12 cm. It can be used in certain forms of vaginal repair, such as high supratrigonal vesicovaginal fistula, after bladder perforation, for obstructed urethra after colposuspension, after urethral destruction following prolonged bladder catheterization in a neurological patient, during repair of a complex urethral diverticulum or during transvaginal insertion of an artificial sphincter. After describing the flap raising operative technique, the various operative indications are presented.

Objectives: We report our experience of renal and/or adrenal manifestations of von Hippel-Lindau disease and propose a practical approach., Methods: Eight patients (mean age: 43 years) presented with predominant renal and adrenal lesions in 6 cases and 2 cases, respectively., Results: All patients are alive with a mean follow-up of 8.1 years. A local recurrence after partial nephrectomy was observed in two cases. Two patients are in renal failure and are treated by dialysis and two patients require hormone replacement therapy for adrenal insufficiency., Conclusions: The predegenerative nature of simple renal was not observed. Conservative renal surgery is adapted to small renal tumours, with a low cytological grade and without any distant lesions in the same kidney. Radical nephrectomy is reserved for large lesions (greater than 5 cm) with a high cytological grade. The presence of pheochromocytoma must be systematically excluded. Preservation of the adrenal gland in the case of homolateral renal surgery for cancer is recommended. The reliability of the genetic test allows early diagnosis of this disease.

Metastases of renal cell carcinoma are exceptional in the spermatic cord and epididymis (17 cases reported in the literature). The authors report two cases of metastases occurring 30 and 44 months after radical nephrectomy, respectively. Both patients are alive without metastases after surgical resection, with a follow-up of 4 and 8 years after the diagnosis of renal cancer, respectively. The mechanism of development, usually retrograde venous spread, and the particular features of these metastatic sites are discussed.

The development of helicoidal CT acquisition allows 3D reconstruction of vessels, cavities or parenchyma of mobile organs such as the kidney. The value of this 3D surface reconstruction was investigated in various areas of urology: congenital malformations (horseshoe kidney, megaureter, ectopic organs), acquired malformations (diverticulum, trabeculated bladder), renal stones, particularly staghorn calculi, and renal transplantation. The fields of interest of 3D CT scans are still poorly defined, but are probably threefold: diagnostic, therapeutic and for teaching purposes. 3D representation completes classical axial scans and, in some cases, competes with other more invasive imaging techniques.