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Objective: Emergency nephrectomies are rare because of the improvement of the management of urinary tract infections and the development of radio-embolization. Few series of patients have been reported. The objective of our study is to assess the indication, the morbi-mortality and the outcome of the emergency nephrectomy performed in our hospital., Patients: Between January 2011 and November 2012, eight patients underwent an emergency nephrectomy at the University Hospital Center of Caen. The present review reports the characteristics of this emergency nephrectomy and their morbi-mortality., Results: Six women and two men were analyzed retrospectively between January 2011 and November 2012. All patients except one needed intensive care for a multiple-organ failure. All these eight emergency nephrectomies concerned a native kidney with a surgical approach as a lombotomy or subcostal laparotomy. Both patients survived. One patient need a renal dialysis support., Conclusion: Emergency nephrectomy are rare. Uncontrolled urinary sepsis represents the main indication. Identifying the population at risk of evolution to the toxic shock is indispensable for a better and faster care and to reduce the mortality bound to the sepsis., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objective: To evaluate the feasibility and the efficiency of intraoperative ex vivo ultrasound of resection margins in patients undergoing partial nephrectomy by urologist., Patients and Methods: Patients undergoing partial nephrectomy from July 2010 to November 2012 for T1-T2 renal tumors were included in analysis. Tumor margin status was immediately determined by ex vivo ultrasound done by the surgeon himself. Results were compared with margin status on definitive pathological evaluation., Results: A total of 26 men and 15 women with a median age of 61 (30-82) years old were included in analysis. Intraoperative ex vivo ultrasound revealed negative surgical margins in 38 cases and positive margins in two. Final pathological results revealed negative margins in all except one case. Ultrasound sensitivity and specificity were 100% and 97%, respectively. Mean ultrasound duration was 1minute±1. Mean tumor and margin sizes were 3.4±1.8cm and 2.38±1.76mm, respectively., Conclusion: Intraoperative ex vivo ultrasound of resection margins in patients undergoing partial nephrectomy by a urologist seemed to be feasible, efficient and easy., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Objectives: In departments of urology, intradetrusor botulinum toxin injections are routinely performed in ambulatory outpatient clinic. The aim of the study was to assess the satisfaction level of patients treated with this technique., Patients and Methods: A satisfaction questionnaire was carried out by telephone for all patients treated in ambulatory outpatient clinic from 2009 to 2010., Results: Twenty-six patients were treated in consultation during the studied period for a total of 46 sessions of injections. The average age was 48.81 (±16.78) years. An injection programme containing 20 or 30 points was performed after a local anesthetic. Twenty patients answered the questionnaire. As regards the organization of the injections, 12 patients (60%) declared to have been satisfied and seven very satisfied (35%). Eight patients (40%) were very satisfied with the management of the pain and six (30%) satisfied versus only one (5%) not satisfied at all. For the time spent in the hospital during the injections, 10 (50%) were satisfied and seven (35%) very satisfied. Only 4 patients (20%) would have preferred to be hospitalized in an outpatient facility. In cases of new injections, 18 (90%) patients would have preferred an identical coverage. Finally, 17 (85%) would recommend this procedure to one of their close relations., Conclusion: Our results showed that the majority of patients were completely satisfied with the injection programme. However, as patients are not currently covered by the national health system for these injections, this might hinder the development of this procedure., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Objectives: To adapt in daily practice, in a urology department, recommendations for good clinical practice for follow-up of neurological patients with neurogenic detrusor overactivity treated with injections of botulinum toxin type A by involving a referent nurse in neuro-urology., Method: A nurse consultation in neuro-urology has been created in June 2007 to intervene at each follow-up consultation at D0, D8, D45, then by phone until reappearance of functional signs to organize a new injection of botulinum toxin. This pilot study evaluated the faisability, the input on clinical workload, and the benefit on relationship between the patient and the caregiver., Results: An improvement of the quality of care has been given to the patient since first contact to follow-up. The number of neurological patient transfers and waiting time between the recurrence of functional signs and new therapeutic care were reduced. The number of medical consultations has been reduced saving time to redistribute on other activities. Knowledge improvement and privileged relationship with the patient and the doctor were reported by the referent nurse., Conclusion: The participation of a referent nurse in neuro-urology has improved the quality of care of these patients from first contact to follow-up and has allowed adaptation of the recommendations in the practice of caring of an urology department., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)