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Between 1989 and 1996, 1,280 patients aged 41 to 100 years were operated for BPH. 70% of patients were treated at the stage of complications such as acute urinary retention, haematuria, bladder stones or renal failure. 549 patients (42.9%) were treated by transvesical prostatectomy (TVP), 668 patients (52.18%) underwent transurethral resection (TURP) and only 63 (4.92%) were treated by bladder neck incision (BNI). Early postoperative complications essentially consisted of infections: wound infection (15%), followed by vesico-cutaneous fistula (2%), epididymo-orchitis (0.7%) and urinary tract infection (1.5%). Late post-operative assessment revealed retrograde ejaculation in 100% of cases after transvesical surgery, 80% of cases after TURP and almost no cases (4%) after BNI. The permanent urinary incontinence rate was 1.18% after TURP and 1.0% after transvesical surgery. The shortest mean postoperative stay was 5 days in the BNI group versus 12.5 days after transvesical surgery. Finally, the postoperative mortality, essentially due to septic shock and myocardial infarction, was (0.8%). The BPH complication rate is proportional to the delay in diagnosis and management. Transurethral resection remains the most effective treatment with the lowest morbidity.

27 percutaneous endopyélotomies were performed in 27 patients from February 1989 to January 1996 to treat 20 cases of congenital hydronephrosis and 7 cases of acquired stenosis. Strictures of uretero-pelvic junction were treated by electrocautery with postoperative drainage using a double J stent in 11 cases, or Redon drain in 16 cases. The evaluable results for 25 patients with a mean follow-up of 11 months showed an overall success rate of 80%. This technique is the treatment of choice for acquired stenosis and stage I and II congenital hydronephrosis (Cendron).

The authors report a case of retroperitoneal fibrosis secondary to actinomycosis with consequences on the urinary tract. They insist on the difficulty of diagnostic, the antibiotic's sensibility and the evolution towards fibrosis which can lead to renal function deterioration.