155 results on '"Xavier Gamé"'
Search Results
2. Non-continent Urinary Diversion (Ileal Conduit) as Salvage Therapy in Patients With Refractory Lower Urinary Tract Dysfunctions due to Multiple Sclerosis: Results of a National Cohort From the French Association of Urology (AFU) Neurourology Committee and the French-speaking Neurourology Study Group (GENULF)
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Sadok Chkir, Floriane Michel, William Akakpo, Eva Chinier, Gregoire Capon, Benoit Peyronnet, Christian Saussine, Maximilien Baron, Xavier Biardeau, Alain Ruffion, Xavier Gamé, Pierre Denys, Emmanuel Chartier-Kastler, Véronique Phé, and Gilles Karsenty
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Adult ,Salvage Therapy ,Multiple Sclerosis ,Urinary Bladder Neoplasms ,Urology ,Urinary Tract Infections ,Quality of Life ,Humans ,Middle Aged ,Urinary Diversion ,Cystectomy ,Aged ,Retrospective Studies - Abstract
To describe the outcomes of ileal conduit as a salvage therapy for refractory lower urinary tract dysfunctions (LUTDs) due to multiple sclerosis (MS) in a national neurourology referral center network.A retrospective multicenter French study was carried out to identify MS patients who underwent non-continent urinary diversion for refractory LUTDs from January 2010 to December 2015. Multiple sclerosis status, urological history, surgical indication and technique, postoperative complications, renal anatomy and function at last follow-up as well as number of rehospitalizations for urinary tract infections (UTI) were collected. Preoperative and postoperative urinary-related quality of life (urQoL) through the Qualiveen short-form questionnaire (QSF) and patient global impression of improvement (PGI-I) were collected and analyzed.Overall, 10 centers identified 211 patients with a mean age of 54±11 and mean preoperative EDSS (expanded disability status scale) score of 7.3±0.9. The main indication for diversion was MS progression leading to impossible intermittent self-catheterization (55%). Cystectomy was performed either by open (34.6%), laparoscopic (39.3%) or robotic (21.8%) approach (unknown: 4.2%) with cystectomy in all cases. Early complications were reported in 42% of the patients, mainly Clavien I or II grades. There was no difference in GFR (glomerular filtration rate) after surgery. After diversion, patients had fewer hospitalizations for UTI and better urQoL on QSF confirmed by evaluation of PGI-I.This study, reporting the largest series of ileal conduit in selected MS patients with end-stage LUTDs, showed significant improvement in symptomatic UTI and quality of life with a low high-grade complication rate.
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- 2022
3. Adjustable Continence Therapy (ACT®) balloons to treat female stress urinary incontinence: effectiveness, safety and risk factors of failure and complication
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Marie-Liesse de Guerry, Amélie Demeestere, Christophe Bergot, Astrid de Hauteclocque, Juliette Hascoet, Anne-Sophie Bajeot, Camille Ternynck, Xavier Gamé, Benoît Peyronnet, Grégoire Capon, Marie-Aimée Perrouin-Verbe, and Xavier Biardeau
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Urology ,Obstetrics and Gynecology - Abstract
To assess the effectiveness, safety and risk factors of failure and complications associated with Adjustable Continence Therapy (ACT®) balloons as a treatment for female stress urinary incontinence (SUI).In the present multicentric retrospective study, all women implanted with ACT® balloons between 2000 and 2018 were considered eligible. Effectiveness and safety were assessed at 1 year, and risk factors for failure and complications were sought. The effectiveness was categorized into three distinct groups: Success = maximum 1 pad/day and patient's impression of improvement using a numerical rating scale (NRS) ≥ 8/10; Improvement = decrease of daily pad use and NRS ≥ 5/10; Failure = increase or stability of daily pad use or NRS5/10. The intra- and postoperative surgical complications were collected.Over the study period, 281 women were included. Among them, 104 (37.0%), 94 (33.5%) and 83 (29.5%) were categorized as success, improvement, and failure, respectively. Intra-, early and late postoperative complications occurred in 13 (4.6%), 35 (12.5%) and 75 (26.7%) women, respectively. Most early surgical complications were minor according to the Dindo-Clavien classification. Of women that presented a late postoperative surgical complication, 64 (22.8%) underwent an explantation performed under local or general anesthesia without associated sequalae.The short-term effectiveness associated with ACT® balloons, their minimally invasive implantation and the frequent but easily manageable and sequelae-free complications suggest that they should be part of the therapeutic arsenal for female SUI.
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- 2022
4. MP71-09 WHICH REVISION STRATEGY IS THE BEST FOR NON-MECHANICAL FAILURE OF MALE ARTIFICIAL URINARY SPHINCTER?
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Tiffany Cousin, Benoit Peyronnet, Imad Bentellis, Sami Lasri, Fayek Taha, Nicolas Hermieu, Adrien Boileau, Augustin Zelmar, Clément Ciolek, Alexandre Dubois, Priscilla Léon, Jean-Francois Hermieu, Thibault Brierre, Xavier Gamé, Thibault Tricard, Christian Saussine, Pierre Lecoanet, Adrien Vidart, Franck Bruyère, Jean-Nicolas Cornu, Hervé Monsaint, Xavier Biardeau, and Grégoire Capon
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Urology - Published
- 2023
5. MP03-16 PHENOTYPING OVERACTIVE BLADDER PATIENTS: MAY MOLECULAR CHARACTERIZATION WITH URINARY BIOMARKERS BE OF HELP?
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Benoit Peyronnet, Claire Richard, Claude Bendavid, Juliette Hascoet, Camille Haudebert, Caroline Voiry, Emmanuelle Samson, Jacques Kerdraon, Andrea Manunta, Jean-Nicolas Cornu, and Xavier Gamé
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Urology - Published
- 2023
6. MP52-07 MOLECULAR CHARACTERIZATION OF NEUROGENIC INTRINSIC SPHINCTER DEFICIENCY OF SPINA BIFIDA PATIENTS
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Benoit Peyronnet, Claire Richard, Claude Bendavid, Juliette Hascoet, Camille Haudebert, Caroline Voiry, Emmanuelle Samson, Jacques Kerdraon, Andrea Manunta, and Xavier Gamé
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Urology - Published
- 2023
7. Five-year Results from the Prospective, Multicenter, Observational SOUNDS Study of Patients with Overactive Bladder Treated with the InterStim System for Sacral Neuromodulation
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Emmanuel Chartier-Kastler, Loïc Le Normand, Alain Ruffion, Christian Saussine, Raïssa Braguet, Bertrand Rabut, Evelyne Ragni, Marie-Aimée Perrouin-Verbe, Jean Pierrevelcin, Thierry Rousseau, Xavier Gamé, Yves Tanneau, François Dargent, Xavier Biardeau, Jean Pierre Graziana, Gabriel Stoica, Elena Brassart, Marc Fourmarier, Najdat Yaghi, Gregoire Capon, Jérôme Ferchaud, Nathalie Berrogain, Laurence Peyrat, François Pecoux, Pierre-Emmanuel Bryckaert, Gilles Karsenty, Shannon Song, David Urs Josef Keller, and Jean-Nicolas Cornu
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Urology - Published
- 2023
8. Impact pédagogique d’un MOOC de technique chirurgicale de transplantation rénale
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Thomas Prudhomme, Georges Karam, Mathieu Roumiguié, Florian Bardet, Féderico Sallusto, Michel Soulié, Xavier Gamé, Nassim Kamar, Véronique Phé, Benjamin Pradère, Gilles Blancho, Éric Lechevallier, Julien Branchereau, Service d'Urologie [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Institut de Transplantation et de Recherche en Transplantation [CHU Nantes] (ITERT), Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology (U1064 Inserm - CR2TI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Néphrologie - Immunologie Clinique [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-PRES Université de Toulouse, Maison de l'Urologie [Paris] (Collège français des enseignants en urologie), and Le Bihan, Sylvie
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MESH: Education, Distance* / methods ,[SDV] Life Sciences [q-bio] ,Transplantation ,Brain death ,MESH: Humans ,[SDV]Life Sciences [q-bio] ,Urology ,MESH: Educational Measurement ,Kidney transplant ,MESH: Pilot Projects ,MESH: Kidney Transplantation ,Organ donation ,Islam and organ donation - Abstract
Objective: To evaluate the educational impact of a pilot MOOC (Massive Open Online Course), validated by the French College of Urology Teachers (FCUT), on the surgical technique of kidney transplantation.Materials and methods: We developed a MOOC on the surgical technique of kidney transplantation, based on a video of a surgical procedure, performed by an expert surgeon. The MOOC has been validated by the FCUT. We have created 2 student groups: 1) MOOC-pre-QCM group: visualization of the MOOC then answer to the MCQs and satisfaction questions; 2) MOOC-post-QCM group: answer to the MCQs then visualization of the MOOC then answers to the satisfaction questions. In total, 20 MCQs on the kidney transplantation technique were completed by the 2 groups. The answers were anonymous.Results: A total of 142 people answered the MCQs (MOOC-pre-QCM group (n=66) and MOOC-post-QCM group (n=76)). Twenty-nine percent (41/142) of the participants were fellows and 71 % (101/142) were residents. The proportion of fellows and residents was identical between the 2 groups. The rate of correct answers to the 20 MCQs was statistically higher in the MOOC-pre-QCM group, compared to the MOOC-post-QCM group (88.6 % versus 73.3 %, P, ObjectifÉvaluer l’impact pédagogique d’un MOOC (Massive Open Online Course) pilote, validé par le Collège français des enseignants en urologie (CFEU), sur la technique chirurgicale de transplantation rénale.Matériel et méthodesNous avons réalisé un MOOC sur la technique chirurgicale de transplantation rénale, à partir d’une vidéo d’une intervention chirurgicale, réalisée par un chirurgien expert. Le MOOC a été validé par le CFEU. Nous avons créé 2 groupes d’étudiants : 1) groupe MOOC-pré-QCM : visualisation du MOOC, puis réponse aux QCM et aux questions de satisfaction ; 2) groupe MOOC-post-QCM : réponse aux QCM, puis visualisation du MOOC, puis réponse aux questions de satisfaction. Au total, 20 QCM sur la technique transplantation rénale ont été remplis par les 2 groupes. Les réponses étaient anonymes.RésultatsAu total, 142 personnes ont répondu aux QCM (groupe MOOC-pré-QCM (n = 66) et groupe MOOC-post-QCM (n = 76)). 29 % (41/142) des participants étaient des CCA ou assistants et 71 % (101/142) étaient des internes. La proportion de CCA/assistants et d’internes était identique entre les 2 groupes. Le taux de réponses correctes aux 20 QCM était statistiquement supérieur dans le groupe MOOC-pré-QCM, en comparaison au groupe MOOC post-QCM (88,6 % contre 73,3 %, p < 0,0001). Au total, 91 % des étudiants ont trouvé le MOOC « Très Utile » ou « Utile ». La médiane de la note du MOOC, donnée par les étudiants, était de 8/10.ConclusionCette étude a montré un impact positif du MOOC sur les connaissances théoriques de la technique chirurgicale de transplantation rénale. Ce MOOC pourrait servir de projet pilote pour le développement d’autres MOOC sur la chirurgie urologique.Niveau3.
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- 2022
9. Adjustable continence therapy (ACT®) balloons to treat neurogenic and non‐neurogenic female urinary incontinence
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Xavier Biardeau, Juliette Hascoet, Benoit Peyronnet, Marie-Aimée Perrouin-Verbe, Xavier Gamé, Marie-Liesse de Guerry, A. Demeestere, C. Bergot, Astrid de Hauteclocque, Anne-Sophie Bajeot, and Grégoire Capon
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medicine.medical_specialty ,business.industry ,Urinary Incontinence, Stress ,Urology ,Intrinsic sphincter deficiency ,Significant difference ,Urinary incontinence ,Mean age ,Prostheses and Implants ,Compression device ,Surgery ,Treatment Outcome ,Underlying disease ,Improvement rate ,Urethral Diseases ,medicine ,Humans ,Urinary Sphincter, Artificial ,Female ,Neurology (clinical) ,medicine.symptom ,business ,Retrospective Studies - Abstract
AIMS To compare efficacy and safety between neurogenic and non-neurogenic women after adjustable continence therapy (ACT®) balloons implantation to treat stress urinary incontinence (SUI) due to intrinsic sphincter deficiency. METHODS In the present retrospective multicentric study, all neurogenic and non-neurogenic women implanted with ACT® balloons between 2000 and 2018 were considered for inclusion. Efficacy was compared 1 year after implantation, and women were allocated in three different groups as follows. Success: maximum 1 pad per day and patient's impression of improvement assessed using a numeral rating scale (NRS) ≥8/10. Improvement: decrease of daily pad use and/or NRS ≥5/10. Failure: increase or stability of daily pad use or NRS
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- 2021
10. Efficacy and safety of intradetrusor botulinum toxin injections for idiopathic overactive bladder syndrome in patients with an artificial urinary sphincter
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Véronique Phé, Xavier Gamé, Benoit Peyronnet, Christian Saussine, Marie-Aimée Perrouin-Verbe, A. Ruffion, Geoffroy de Sallmard, Alexia Even, Gérard Amarenco, Charles Joussain, Ines Dominique, Xavier Biardeau, Delphine Maucort-Boulch, and Emmanuel Chartier-Kastler
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Adult ,Male ,Nephrology ,medicine.medical_specialty ,Urology ,Population ,Urinary incontinence ,Artificial urinary sphincter ,Internal medicine ,medicine ,Humans ,Botulinum Toxins, Type A ,education ,Aged ,Retrospective Studies ,education.field_of_study ,Urinary Bladder, Overactive ,business.industry ,Urethral sphincter ,medicine.disease ,Botulinum toxin ,Discontinuation ,Surgery ,Treatment Outcome ,Neuromuscular Agents ,Overactive bladder ,Urinary Sphincter, Artificial ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
To assess the efficacy and safety of intradetrusor botulinum toxin type A injections (IBTI) for idiopathic overactive bladder (iOAB) in non-neurological adults with an artificial urinary sphincter (AUS). We retrospectively selected, in the 11 French centers, members of a collaborative network (GENULF (Groupe d’etude de neuro-urologie de langue francaise)), the patients who had had an artificial urinary sphincter implantation and who had subsequently developed iOAB requiring IBTI. This study was approved by the French association of urology ethics committee (no 2018012). Between 2006 and 2020, 33 patients were included from 5 French centers. Mean follow-up after the first IBTI was 47 months. The average age of the studied population was 68 years, with 70% of females. A complete resolution of symptoms at optimal IBTI dose was experienced by 21 (64%) patients. Seven (21%) patients had partial improvement. Five non-responder patients (15%) had no improvement at all. Maximum cystometric bladder capacity was 240 ml pre-IBTI and 335 ml post IBTI. Discontinuation free survival at 60 months was 50%. Two erosions occurred during the 6 months following an IBTI both in male patients with a perineal implantation. There were four AUS balloon perforations that occurred during the 6 months following an IBTI, all of them in female patients. IBTI has a good efficacy for the treatment of iOAB in patients with an AUS. However, both patients and practicians must be aware of the risk of rare and usually mild complications.
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- 2021
11. Impact of COVID-19 pandemic on functional urology procedures in France: a prospective study
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C. Guillot-Tantay, Pierre-Luc Dequirez, Xavier Gamé, Grégoire Robert, Charles Joussain, Alain Ruffion, Benoit Peyronnet, Gilles Karsenty, Sypre Davidson, Jeanne Simon, Véronique Phé, Vassily Anastay, Lucie Vangheluwe, Raphael Fleury, Jean-Nicolas Cornu, Pierre-Vincent Campello, Marie-Aimée Perrouin-Verbe, Maximilien Baron, Tiffany Cousin, Astrid Balanca, Priscilla Léon, Xavier Biardeau, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Bordeaux [Bordeaux], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHU Toulouse [Toulouse], Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Hôpital Claude Huriez [Lille], CHU Lille, Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service Urologie, Clinique Pasteur, Paris, France., Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and douville, sabine
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Adult ,Male ,Urologic Diseases ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Time Factors ,Referral ,Coronavirus disease 2019 (COVID-19) ,Urology ,Urinary incontinence ,030232 urology & nephrology ,Psychological intervention ,Functional urology ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,Time-to-Treatment ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,Pandemic ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,ComputingMilieux_MISCELLANEOUS ,Aged ,SARS-CoV-2 ,business.industry ,Patient Selection ,COVID-19 ,Middle Aged ,[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,3. Good health ,030220 oncology & carcinogenesis ,Communicable Disease Control ,Urologic Surgical Procedures ,Female ,Original Article ,France ,Triage ,medicine.symptom ,business - Abstract
Purpose To evaluate the impact of COVID-19 pandemic on functional urology procedures in France. Methods A prospective study was conducted within 11 secondary and tertiary referral centers in France. Patients aged > 18 years who were diagnosed with a functional urology disease before the national lockdown (March 17th, 2020) and who required a surgery were included. Study period went from March 17th to September 30th 2020. The included interventions were listed according to the guidelines for functional urology enacted by the French Association of Urology and delay of reoperation was compared to the guidelines’ delay. The primary outcome was the number of procedures left unscheduled at the end of the study period. Descriptive statistics were performed. Results From March 17th 2020 to September 3 rd 2020, 1246 patients with a previous diagnosis of a functional urological disease requiring a surgery were included. The mean follow-up was 140.4 days (± 53.4). Overall, 316 interventions (25.4%) were maintained whereas 74 (5.9%) were canceled, 848 (68.1%) postponed and 8 patients (0.6%) died. At the end of the follow-up, 184 patients (21.7%) were still not rescheduled. If the intervention was postponed, the mean delay between the initial and final date was 85.7 days (± 64.4). Conclusion Overall, more than two thirds of interventions had to be postponed and the mean delay between the initial and final date was about three months.
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- 2021
12. Transcorporal vs. bulbar artificial urinary sphincter implantation in male patients with fragile urethra
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Franck Bruyère, T. Tricard, Pierre Lecoanet, Baptiste Poussot, Nicolas Hermieu, Alain Ruffion, Victor Gaillard, Hervé Monsaint, Grégoire Capon, Christian Saussine, Xavier Biardeau, Damien Robin, Daniel Chevallier, L. Corbel, Thibaut Brierre, Alice Pitout, Priscilla Bertrand-Leon, Jean-Nicolas Cornu, Benoit Peyronnet, Mehdi El-Akri, Hugo Dupuis, Xavier Gamé, I. Bentellis, Tiffany Cousin, Jean-François Hermieu, Florian Beraud, CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Strasbourg, Centre Hospitalier Universitaire Toulouse (CHU Toulouse), CHU Bordeaux [Bordeaux], Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d’urologie, hôpital Bichat-Claude-Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Centre Hospitalier Universitaire de Reims (CHU Reims), Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'Urologie, andrologie et transplantation rénale [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Clinique Oceane, Vannes, Clinique Plérin, Plérin, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), CHU Toulouse [Toulouse], and Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Male ,medicine.medical_specialty ,Urethral stricture ,Urology ,Population ,030232 urology & nephrology ,Urinary incontinence ,Risk Assessment ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,Prosthesis Implantation ,Artificial urinary sphincter ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Risk factor ,education ,Device Removal ,ComputingMilieux_MISCELLANEOUS ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,business.industry ,Urethral sphincter ,Middle Aged ,medicine.disease ,Surgery ,Urethra ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Cuff ,Urinary Sphincter, Artificial ,medicine.symptom ,business - Abstract
To compare transcorporal vs bulbar artificial urinary sphincter (AUS) implantation in men with fragile urethra and to investigate the risk factors of AUS explantation in this population. The charts of all male patients who had an AUS implantation between 2004 and 2020 in 16 centers were reviewed retrospectively. The primary endpoint was device explantation-free survival. Only patients with a fragile urethra were included in the present analysis. Fragile urethra was defined as a urethra carrying a high risk of cuff erosion because of prior radiotherapy and/or history of AUS explantation and/or history of urethral stricture surgery. The patients were divided in two groups according to the implantation site: bulbar vs transcorporal. 464 patients were included for analysis. 88 patients underwent a transcorporal AUS implantation and 376 underwent a bulbar AUS implantation. Explantation-free survival was similar in both groups (estimated 5-year explantation free survival rates 55.3% vs. 58.4%; p=0.98). In the subgroup of patients with a history of previous AUS explantation, transcorporal approach tended to bring longer explantation-free survival (2-year explantation-free survival: 61.9% vs. 58.2%; p=0.096). In multivariate analysis, the only risk factor of shorter explantation-free survival was the history of previous AUS explantation (HR=2.65; p=0.01). Transcorporal AUS implantation was not associated with longer explantation-free survival. History of previous AUS explantation was the only risk factor associated with shorter explantation-free survival and this subgroup of patients may be the only one to draw benefits of transcorporal AUS implantation.
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- 2021
13. PD24-08 ROBOT ASSISTED BLADDER NECK ARTIFICIAL URINARY SPHINCTER IMPLANTATION IN NEUROLOGICAL MALE PATIENTS: PRELIMINARY RESULTS
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Benoit Peyronnet, Thibault Tricard, Thibaut Brierre, Juliette Hascoet, Thomas Prudhomme, Baptiste Poussot, Andrea Manunta, Evelyne Castel-Lacanal, Christian Saussine, and Xavier Gamé
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Urology - Published
- 2022
14. Complete Transurethral Resection before Radical Cystectomy May Improve Oncological Outcomes
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Luc Beuzit, Gregory Verhoest, Romain Mathieu, Mathieu Roumiguié, Benoit Peyronnet, Benjamin Pradere, Karim Bensalah, Jean-Baptiste Beauval, Matthieu Thoulouzan, Xavier Gamé, Francois Guille, Alexandre Gryn, Nathalie Rioux-Leclercq, Solène-Florence Kammerer-Jacquet, V. Graffeille, Zine Eddine Khene, Quentin Alimi, and Michel Soulié
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Cystectomy ,Resection ,Urethra ,medicine ,Clinical endpoint ,Humans ,Neoplasm Invasiveness ,Stage (cooking) ,Aged ,Retrospective Studies ,Chemotherapy ,Urinary bladder ,Bladder cancer ,business.industry ,Carcinoma in situ ,medicine.disease ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Urinary Bladder Neoplasms ,Female ,business - Abstract
Objectives: The objective of this study was to assess the impact of complete transurethral resection of bladder tumors (TURBTs) before radical cystectomy on pathological and oncological outcomes of patients with muscle-invasive bladder cancer (MIBC) and high-risk non-MIBC. Materials and Methods: The charts of all patients who underwent radical cystectomy for bladder cancer in 2 academic departments of urology between 1996 and 2016 were retrospectively reviewed. Patients were divided into 2 groups according to the completeness of the last endoscopic resection before radical cystectomy: macroscopically complete transurethral resection (complete) or macroscopically incomplete transurethral resection (incomplete). The primary end point was the recurrence-free survival (RFS). Secondary end points included cancer-specific survival (CSS) and rates of pT0 and downstaging. Results: Out of 486 patients included for analysis, the TURBT immediately preceding radical cystectomy was considered macroscopically complete in 253 patients (52.1%) and incomplete in 233 patients (47.9%). In multivariate analysis, macroscopically complete TURBT was the strongest predictor of both pT0 disease (OR = 3.1; p = 0.02) and downstaging (OR = 7.1; p < 0.0001). After a median follow-up of 41 months, macroscopically complete TURBT was associated with better RFS (5-year RFS: 57 vs. 37%; p < 0.0001) and CSS (5-year CSS: 70.8 vs. 54.5%; p = 0.002). In multivariate analysis adjusting for multifocality, weight of endoscopic resection specimen, cT4 stage on preoperative imaging, interval between endoscopic resection and radical cystectomy, neoadjuvant chemotherapy, pT stage, and associated carcinoma in situ, macroscopically complete endoscopic resection remained the main predictor of better RFS (HR = 0.4; p = 0.0003) and the only preoperative factor associated with CSS (HR = 0.5; p = 0.01). Conclusion: A macroscopically complete TURBT immediately preceding radical cystectomy may improve pathological and oncological outcomes in patients with MIBC and high-risk MIBC.
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- 2021
15. IMAGINE-IMpact Assessment of Guidelines Implementation and Education: The Next Frontier for Harmonising Urological Practice Across Europe by Improving Adherence to Guidelines
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Philip Cornford, Emma Jane Smith, Steven MacLennan, Nuno Pereira-Azevedo, Monique J. Roobol, Nicolaas Lumen, Louise Fullwood, Eilidh Duncan, Jennifer Dunsmore, Karin Plass, Maria J. Ribal, Thomas Knoll, Anders Bjartell, Hendrick Van Poppel, James N’Dow, Alberto Briganti, Karl Dorfinger, Irene Resch, Mischinger Johannes, Isabel Heidegger, Christophe Assenmacher, Thierry Roumeguère, Karel Decaestecker, Lieven Goeman, Thomas Adams, Marincho Georgiev, Krassimir Yanev, Aleksandar Timev, Igor Tomašković, Tomislav Kuliš, Stavros Charalampous, Dimitris Kontaxis, Marko Babjuk, Roman Zachoval, Tomáš Pitra, Vojtěch Novák, Lars Lund, Martin Kivi, Peep Baum, Toomas Tamm, Pritt Veskimae, Rauno Okas, Kanerva Lahdensuo, Kimmo Taari, Heikki Seikkula, Pyry Jämsä, Xavier Gamé, George Fournier, Alexandre Ingels, Gaelle Fiard, Guillaume Ploussard, Jens Rassweiler, Stefanie Schmidt, Jennifer Kranz, Susanne Krege, Ioannis Gkialas, Anthanasios Dellis, Nikolaos Ferakis, Dionysios Mitropoulos, Peter Ryan, John Paul Sweeney, Eamonn Rogers, Derek Hennessy, Niall. F. Davis, Walter Artibani, Francesco Porpiglia, Salvatore Giuseppe Voce, Maurizio Brausi, Maria A. Cerruto, Francesco Esperto, Matteo Manfredi, Mindaugas Jievaltas, Aušvydas Patašius, Albertas Čekauskas, Stasys Auškalnis, Peter Mulders, Frank Martens, Kathleen W.M. D'Hauwers, Piotr Chlosta, Anna Katarzyna Czech, Katarzyna Gronostaj, Mikołaj Przydacz, Pedro Coelho Nunes, Luís Abranches-Monteiro, Ricardo Pereira e Silva, Frederica Furriel, Pedro Gomes Monteiro, Ioanel Sinescu, Cristian Surcel, Catalin Baston, Robert Ionut Stoica, Vlad Olaru, Boris Kollárik, Ivan Mincik, Ľuboš Rybár, Viktor Kováčik, Ivan Perečinský, Boris Kosuta, Marko Zupancic, Milena Taskovska, Uros Kacjan, Andraz Miklavzina, Manuel Esteban Fuertes, Mario Alvarez-Maestro, Antoni Vilaseca, Rodrigo García-Baquero, Lotta Renström Koskela, Johan Styrke, Gezim Galiqi, Bilbil Hoxha, Evisa Zhapa, Rezart Xhani, Sergey Fanarjyan, Ruben Hovhannisyan, Avoyan E. Armen, Rafael Badalyan, Mustafa Hiroš, Davor Tomić, Damir Aganović, Archil Chkhotua, David Nikoleishvili, Zara Tchanturaia, Sigurdur Gudjónsson, Eirikur Orri Gudmundsson, Rafn Hilmarsson, Emil Ceban, Vitalii Ghicavii, Adrian Tanase, Vladislav Vasiliev, Dragoljub Perovic, Marko Vukovic, Stanisavljevic Rade, Nenad Radovic, Emil Nasufovic, Yuri Alyaev, Igor Korneyev, Sergei Kotov, Vigen Malkhasyan, Dragoslav Basic, Miodrag Aćimović, Saša Vojinov, Aleksandar Vuksanovic, Uroš Bumbaširević, Bojan Čegar, Branko Stanković, Hansjörg Danuser, Tullio Sulser, Valentin Zumstein, Ates Kadioglu, Hakan Kilicarslan, Nusret Can Cilesiz, Erhan Demirelli, Bülent Önal, Aydin Mungan, Serdar Tekgül, Levent Türkeri, Adil Esen, Oleksandr Shulyak, Sergiy Vozianov, Alexandr Shulyak, Serhii Volkov, Andrii Nesterchuk, Urology, Cornford, P., Smith, E. J., Maclennan, S., Pereira-Azevedo, N., Roobol, M. J., Lumen, N., Fullwood, L., Duncan, E., Dunsmore, J., Plass, K., Ribal, M. J., Knoll, T., Bjartell, A., Van Poppel, H., N'Dow, J., and Briganti, A.
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Supplementary data ,Physicians' ,Impact assessment ,business.industry ,Urology ,030232 urology & nephrology ,MEDLINE ,Guideline ,Practice Patterns ,Clinical Practice ,Europe ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,03 medical and health sciences ,Frontier ,0302 clinical medicine ,Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] ,Nursing ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Medicine ,Humans ,Guideline Adherence ,Practice Patterns, Physicians' ,Baseline (configuration management) ,business - Abstract
Contains fulltext : 237261.pdf (Publisher’s version ) (Closed access) Adherence to national and international clinical practice guidelines is suboptimal throughout Europe. The European Association of Urology Guidelines Office project "IMAGINE" (IMpact Assessment of Guidelines Implementation and Education) has been developed to measure baseline adherence to urological guideline recommendations across Europe and to identify issues that drive nonadherence.
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- 2021
16. Long‐term outcomes of artificial urinary sphincter in female patients with spina bifida
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Marie-Aimée Perrouin-Verbe, Loic Lenormand, M. Jezequel, C. Voiry, E. Bey, Grégoire Capon, Juliette Hascoet, Xavier Gamé, B. Perrouin-Verbe, A. Gasmi, Benoit Peyronnet, and Andrea Manunta
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medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Spina bifida ,business.industry ,Urology ,Urethral sphincter ,Intrinsic sphincter deficiency ,030232 urology & nephrology ,Urinary incontinence ,medicine.disease ,Predictive factor ,Surgery ,Artificial urinary sphincter ,03 medical and health sciences ,0302 clinical medicine ,Female patient ,Long term outcomes ,medicine ,Neurology (clinical) ,medicine.symptom ,business - Abstract
AIMS To report the long-term functional outcomes of artificial urinary sphincter (AUS) implantation in female patients with spinal dysraphism and stress urinary incontinence (SUI) related to intrinsic sphincter deficiency (ISD). METHODS The charts of all spina bifida female patients with SUI due to ISD who underwent AUS (AMS 800) implantation between 2005 and 2019 at three academic departments of urology were retrospectively reviewed. Reoperation was defined as either revision or explantation of the AUS device. Reoperation-free survival of the AUS device was estimated using the Kaplan-Meier method. Continence status as per patients' subjective assessment was categorized as follows: complete continence (no pads), improved continence, unchanged SUI or worsened SUI. RESULTS Twenty-three patients were included, 69.6% were self-catheterizing. The median follow-up was 14 years. Median time to first reoperation was 10 years. Survival rates without reoperation were 85.9%, 41.8%, 34.6%, and 20.9% at 5, 10, 15, 20 years, respectively. Survival rates without AUS explantation were 90.7%, 66.3%, 55.2%, and 41.4% at 5, 10, 15, 20 years, respectively. None of the patients who underwent device explantation had a new AUS implanted. The only predictive factor of reoperation-free survival was the type of spinal dysraphism (hazards ratio = 3.60 for closed vs. open dysraphism; p = .04). At last follow-up, 17 of the 23 patients were fully continent (73.9%). CONCLUSION AUS in female patients with spina bifida may be associated with satisfactory long-term functional outcomes and a high reoperation rate. The median time to first reoperation was similar to what is reported in the male AUS literature (10 years).
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- 2020
17. Recommandations CCAFU sur la prise en charge des cancers de l’appareil urogénital en période d’épidémie au Coronavirus COVID-19
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Morgan Rouprêt, Pierre Mongiat-Artus, Xavier Gamé, Xavier Rebillard, François Rozet, A. Faix, Arnaud Mejean, Thibaut Murez, Karim Bensalah, Richard Mallet, Georges Fournier, and Yann Neuzillet
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Gynecology ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,education.field_of_study ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Genitourinary system ,Urology ,Population ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,Genital tract ,Expert opinion ,medicine ,business ,education ,Coronavirus Infections ,Healthcare system - Abstract
AIM: The French population is facing the COVID-19 pandemic and the health systems have been reoriented in emergency for the care of patients with coronavirus The management of cancers of the urinary and male genital tracts must be adapted to this context MATERIAL AND METHOD: An expert opinion documented by a literature review was formulated by the Cancerology Committee of the French Association of Urology (CCAFU) RESULTS: The medical and surgical management of patients with any cancers of the urinary and male genital tracts must be adapted by modifying the consultation methods, by prioritizing interventions according to the intrinsic prognosis of cancers, taking into account the patient's comorbidities The protection of urologists from COVID-19 must be considered CONCLUSION: The CCAFU issues an expert opinion on the measure to be taken to adapt the management of cancers of the male urinary and genital tract to the context of pandemic by COVID-19 [[[fr]]]Resume Objectif: La population francaise est confrontee a la pandemie de COVID-19 et le systemes de sante a ete reoriente en urgence pour la prise en charge des patients atteint du coronavirus La prise en charge des cancers de l'appareil urinaire et genital masculin doit etre adaptee a ce contexte Materiel et methode: Un avis d'experts documente par une revue de la litterature a ete formule par le Comite de Cancerologie de l'Association Francaise d'Urologie (CCAFU) Resultats: La prise en charge medicale et chirurgicale des patients atteint de cancers de l'appareil urinaire et genital masculin doit etre adaptee en modifiant les modalites de consultation, en priorisant les interventions en fonction du pronostic intrinseque des cancers en tenant compte des comorbidites du patient La protection des urologues vis-a-vis du COVID-19 doit etre prise en consideration CONCLUSION: Le CCAFU emet un avis d'experts quant aux mesures a prendre pour adapter la prise en charge des cancers de l'appareil urinaire et genital masculin au contexte de pandemie par COVID-19
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- 2020
18. Benign Prostatic Hyperplasia Endoscopic Surgical Procedures in Kidney Transplant Recipients: A Comparison Between Holmium Laser Enucleation of the Prostate, GreenLight Photoselective Vaporization of the Prostate, and Transurethral Resection of the Prostate
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Jérôme Rigaud, P.M. Patard, T. Marquette, Julien Branchereau, Grégoire Robert, P. Glemain, Federico Sallusto, Clément Michiels, Michel Soulié, Morgane Pere, Georges Karam, Pascal Rischmann, Xavier Gamé, Gilles Blancho, Thomas Prudhomme, and Nassim Kamar
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Enucleation ,Prostatic Hyperplasia ,030232 urology & nephrology ,Holmium laser ,Pilot Projects ,Lasers, Solid-State ,Holmium ,03 medical and health sciences ,0302 clinical medicine ,Prostate ,medicine ,Humans ,Postoperative Period ,Kidney transplantation ,Aged ,Retrospective Studies ,Transurethral resection of the prostate ,Prostatectomy ,business.industry ,Transurethral Resection of Prostate ,Endoscopy ,Middle Aged ,Prostate-Specific Antigen ,Urinary Retention ,Surgical procedures ,Hyperplasia ,medicine.disease ,Kidney Transplantation ,Transplant Recipients ,humanities ,Treatment Outcome ,medicine.anatomical_structure ,Creatinine ,030220 oncology & carcinogenesis ,Kallikreins ,Photoselective vaporization ,France ,Laser Therapy ,Volatilization ,business ,Immunosuppressive Agents ,Follow-Up Studies - Abstract
Purpose: The main objective of this multicentric retrospective pilot study was to evaluate the 1-year follow-up safety (i.e., minor [Clavien–Dindo I–II] and major [Clavien–Dindo ≥III] complications...
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- 2020
19. Urinary biomarkers profiles in patients with neurogenic detrusor overactivity according to their neurological condition
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C. Voiry, C. Richard, Laurent Siproudhis, Benoit Peyronnet, Quentin Alimi, Zine-Eddine Khene, Charlène Brochard, Juliette Hascoet, Andrea Manunta, Claude Bendavid, Jacques Kerdraon, Xavier Gamé, and Guillaume Bouguen
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Adult ,Male ,Nephrology ,medicine.medical_specialty ,Multiple Sclerosis ,Urology ,Urinary system ,030232 urology & nephrology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Urinary Bladder, Neurogenic ,Spinal Dysraphism ,Spinal cord injury ,Spinal Cord Injuries ,Aged ,Creatinine ,Urinary bladder ,Urinary Bladder, Overactive ,business.industry ,Spina bifida ,Multiple sclerosis ,Middle Aged ,medicine.disease ,Pathophysiology ,medicine.anatomical_structure ,chemistry ,030220 oncology & carcinogenesis ,Female ,business ,Biomarkers - Abstract
The aim of this study was to investigate the disease-specific urinary levels variations of neurotrophins (NGF, BDNF), mediators of inflammation (TGFβ-1, PGE-2) and markers of extracellular matrix alterations (TIMP-2) in patients with multiple sclerosis (MS) spinal cord injury (SCI), or spina bifida (SB), and neurogenic detrusor overactivity (NDO). A prospective single-center study was conducted between March 2015 and March 2017. Patients aged over 18 years old, with neurological disease, with a urodynamic diagnosis of NDO were included. The urinary levels of NGF, BDNF, TIMP-2, PGE 2, and TGF-β1 were measured using dedicated ELISA kits. Forty-one patients were included: 6 with MS, 20 with SCI, and 15 with spina bifida. The average urinary level of NGF/Cr was significantly higher in MS patients compared to other neurologic populations (8 vs. 0.56 vs. 1.25 pg/mg of creatinine; p = 0.001) as well for the average urinary level of BDNF (88.3 vs. 5 vs. 4.8 pg/mg of creatinine; p
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- 2019
20. Robot-Assisted Bladder Neck Artificial Urinary Sphincter Implantation
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V. Cardot, Xavier Gamé, Frank Van der Aa, Grégoire Capon, A. Vidart, A. Descazeaud, Olivier Belas, B. Peyronnet, and Georges Fournier
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Artificial urinary sphincter ,medicine.medical_specialty ,Neck of urinary bladder ,business.industry ,Urology ,medicine ,business - Published
- 2021
21. Prevalence and Risk Factors of Artificial Urinary Sphincter Revision in Nonneurological Male Patients
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Daniel Chevallier, Benoit Peyronnet, Christian Saussine, Priscilla Bertrand-Leon, Nicolas Hermieu, Victor Gaillard, Thibaut Brierre, Tiffany Cousin, Pierre Lecoanet, Xavier Biardeau, M Durand, Jean-François Hermieu, Hugo Dupuis, Mehdi El-Akri, Jean-Nicolas Cornu, T. Tricard, Grégoire Capon, I. Bentellis, Xavier Gamé, Franck Bruyère, Service de Neurologie [CHU Nice], Hôpital Pasteur [Nice] (CHU)-Centre Hospitalier Universitaire de Nice (CHU Nice), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), service d'urologie [CHU Bordeaux], CHU Bordeaux [Bordeaux], Service d'Urologie [Strasbourg], CHU Strasbourg, Service d’urologie, hôpital Bichat-Claude-Bernard, Hôpitaux Universitaires Paris Nord Val de Seine, Service d'urologie Reims, Service d'urologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service d'Urologie, andrologie et transplantation rénale [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Université Côte d'Azur (UCA), CNRS UMR7284, INSERM U1081, Institute for Research on Cancer and Aging, Nice (IRCAN), Centre Antoine Lacassagne, douville, sabine, Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Urologie [Toulouse], and CHU Toulouse [Toulouse]
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medicine.medical_specialty ,business.industry ,Urology ,Urinary incontinence ,medicine.disease ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,Artificial urinary sphincter ,Urethra ,medicine.anatomical_structure ,Male patient ,Lower urinary tract symptoms ,Medicine ,medicine.symptom ,business ,ComputingMilieux_MISCELLANEOUS - Abstract
Purpose:The main objective of this study was to assess the prevalence and risk factors of male artificial urinary sphincter (AUS) mechanical failures and nonmechanical failures.Materials and Method...
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- 2021
22. PD04-04 TRANSCORPORAL VS. BULBAR ARTIFICIAL URINARY SPHINCTER IMPLANTATION IN MALE PATIENTS WITH FRAGILE URETHRA
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Pierre Lecoanet, L. Corbel, Imad Bentellis, Hervé Monsaint, Xavier Gamé, Nicolas Hermieu, Franck Bruyère, T. Tricard, Tiffany Cousin, Grégoire Capon, Daniel Chevallier, Baptiste Poussot, Victor Gaillard, Damien Robin, Hugo Dupuis, Mehdi El Akri, Xavier Biardeau, Thibault Brierre, Christian Saussine, Jean-Nicolas Cornu, Benoit Peyronnet, Priscilla Bertrand-Leon, Alain Ruffion, and Jean-François Hermieu
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Artificial urinary sphincter ,medicine.medical_specialty ,Urethra ,medicine.anatomical_structure ,Male patient ,business.industry ,Urology ,medicine ,business - Published
- 2021
23. MP52-16 LONG-TERM OUTCOMES OF ARTIFICIAL URINARY SPHINCTER IN FEMALE PATIENTS WITH SPINA BIFIDA
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Xavier Gamé, Loic Lenormand, Elsa Bey, Juliette Hascoet, M. Jezequel, Benoit Peyronnet, A. Gasmi, Marie-Aimée Perrouin-Verbe, Grégoire Capon, C. Voiry, Andrea Manunta, and Brigitte Perrouin-Verbe
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Artificial urinary sphincter ,medicine.medical_specialty ,business.industry ,Spina bifida ,Urology ,Female patient ,medicine ,Long term outcomes ,business ,medicine.disease ,Surgery - Published
- 2021
24. Early Efficacy and Safety Outcomes of Artificial Urinary Sphincter for Stress Urinary Incontinence Following Radical Prostatectomy or Benign Prostatic Obstruction Surgery: Results of a Large Multicentric Study
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Franck Bruyère, Priscilla Léon, Xavier Gamé, Alice Pitout, Christian Saussine, L. Corbel, T. Tricard, Matthieu Durand, Thibaut Brierre, Baptiste Poussot, Grégoire Capon, Mehdi El-Akri, Tiffany Cousin, Jean-Nicolas Cornu, Daniel Chevallier, Damien Robin, Florian Beraud, Nicolas Hermieu, I. Bentellis, Jean-François Hermieu, Xavier Biardeau, Benoit Peyronnet, Pierre Lecoanet, Hervé Monsaint, Hugo Dupuis, Victor Gaillard, Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Universitaire de Nice (CHU Nice), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'Urologie [Toulouse], CHU Toulouse [Toulouse], service d'urologie [CHU Bordeaux], CHU Bordeaux [Bordeaux], Departement d' Urologie, Université de Strasbourg, Departement d'Urology, Université de Strasbourg, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'urologie Reims, Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'Urologie, andrologie et transplantation rénale [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'urologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Clinique Oceane, Vannes, Clinique Plérin, Plérin, Clinique Pasteur,Royan, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), and Normandie Université (NU)-Normandie Université (NU)
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Urinary Incontinence, Stress ,Population ,Brachytherapy ,030232 urology & nephrology ,Urinary incontinence ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,Cystectomy ,Artificial urinary sphincter ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Clinical endpoint ,Humans ,education ,ComputingMilieux_MISCELLANEOUS ,Transurethral resection of the prostate ,Retrospective Studies ,Prostatectomy ,education.field_of_study ,business.industry ,3. Good health ,Surgery ,Treatment Outcome ,Urinary Incontinence ,030220 oncology & carcinogenesis ,Urinary Sphincter, Artificial ,medicine.symptom ,business - Abstract
Background Artificial urinary sphincter (AUS) is the gold standard for the management of moderate to severe stress urinary incontinence (SUI) in the male population. While outcomes of this device in postprostatectomy incontinence (PPI) are widely described, those obtained for incontinence after benign prostatic obstruction (BPO) surgery remains poorly explored. Objective To compare continence outcomes after AUS implantation in a PPI population with those obtained in men incontinent after BPO surgery. Design, setting, and participants A retrospective review of all cases of AUS implantation between 2005 and 2020 in 16 different French centers was conducted. Only patients with primary implantation whose indication was moderate to severe SUI after prostatectomy or BPO surgery were included (excluding those with a history of radiation therapy, brachytherapy, cystectomy, high-intensity focused ultrasound therapy, or neurogenic disease). Outcome measurements and statistical analysis The primary endpoint was the rate of social continence (zero or one pad per day) at 3 mo. Complications were also noted within 90 d of implantation. Results and limitations A total of 417 patients were included in the PPI group and 50 in the BPO surgery group. Social continence rates at 3 mo were similar between the groups (79% vs 72%, p = 0.701). Complication rate was significantly higher in the BPO group (8% vs 18%, p = 0.044). The same was found for the Clavien-Dindo type 2 complication rate (20.6% vs 44.4%, p = 0.026). The retrospective nature and lack of precise definition of incontinence are the main limitations of this study. Conclusions This multicentric study strengthens the position of AUS as gold standard for SUI after radical prostatectomy. Comparable efficacy results were found for incontinence after BPO surgery, with nevertheless a higher rate of complications. Patient summary Artificial urinary sphincter represents the gold standard for the treatment of moderate to severe stress urinary incontinence. Efficacy results are comparable between postprostatectomy incontinence and incontinence after benign prostatic obstruction surgery.
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- 2021
25. PD36-05 URINARY MMP-2 IS SIGNIFICANTLY ASSOCIATED WITH THE RISK OF INTRADETRUSOR TOXIN INJECTIONS FAILURE IN PATIENTS WITH SPINA BIFIDA
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Juliette Hascoet, Xavier Gamé, Charlène Brochard, Andrea Manunta, C. Voiry, C. Richard, Emmanuelle Samson, Jacques Kerdraon, M. Jezequel, Claude Bendavid, Guillaume Bouguen, and Benoit Peyronnet
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congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,business.industry ,Spina bifida ,Toxin ,Urology ,Urinary system ,Matrix metalloproteinase ,medicine.disease ,medicine.disease_cause ,complex mixtures ,Gastroenterology ,nervous system diseases ,Botulinum toxin a ,Internal medicine ,Medicine ,In patient ,business - Abstract
INTRODUCTION AND OBJECTIVE:Several studies have suggested that spina bifida patients may have a poorer response to intradetrusor botulinum toxin A (BTX-A) injections than other neurological populat...
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- 2021
26. MP52-19 ADJUSTABLE CONTINENCE THERAPY (ACT®) BALLOONS AND FEMALE URINARY INCONTINENCE: EFFICACY, SAFETY AND RISK FACTORS FOR FAILURE AND COMPLICATIONS
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Juliette Hascoet, Anne-Sophie Bajeot, A. Demeestere, Marie-Liesse de Guerry, Astrid de Hauteclocque, Marie-Aimée Perrouin-Verbe, Xavier Gamé, Grégoire Capon, C. Bergot, Xavier Biardeau, and Benoit Peyronnet
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medicine.medical_specialty ,business.industry ,Urology ,Intrinsic sphincter deficiency ,Medicine ,Urinary incontinence ,medicine.symptom ,business ,Surgery - Abstract
INTRODUCTION AND OBJECTIVE:Adjustable Continence Therapy (ACT®) balloons has been underused and often underestimated to treat urinary incontinence (UI) due to intrinsic sphincter deficiency (ISD) i...
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- 2021
27. MP38-17 EN BLOC VERSUS CONVENTIONAL TRANSURETHRAL BLADDER RESECTION: A PROPENSITY SCORE MATCHING COMPARING SURVIVAL OUTCOMES AND PERI OPERATIVE MORBIDITY
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Mathieu Roumiguié, Michel Soulié, Jean Baptiste Beauval, Marine Lesourd, Bernard Malavaud, Edward Assaf, Sarah Péricart, and Xavier Gamé
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medicine.medical_specialty ,business.industry ,Urology ,Propensity score matching ,Transurethral bladder resection ,Medicine ,Perioperative ,business ,Surgery - Published
- 2021
28. The Changing Face of Artificial Urinary Sphincter Use in France: The Future is Female
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Jean-Nicolas Cornu, Xavier Gamé, Lucie-Marie Scailteux, Juliette Hascoet, Benoit Peyronnet, CHU Pontchaillou [Rennes], Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), CHU Toulouse [Toulouse], CHU Rouen, Normandie Université (NU), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
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Male ,medicine.medical_specialty ,business.industry ,[SDV]Life Sciences [q-bio] ,Urology ,030232 urology & nephrology ,Surgery ,Artificial urinary sphincter ,03 medical and health sciences ,0302 clinical medicine ,Male patient ,030220 oncology & carcinogenesis ,medicine ,Humans ,Urinary Sphincter, Artificial ,Female ,France ,business ,Procedures and Techniques Utilization ,Forecasting - Abstract
International audience; Analyzing concurrently data from the manufacturer and from a national comprehensive administrative claim database (PMSI)we found that, overall, the total number of AUS implanted (male+female) increased from 2012 to 2017 (+8.8%). This growth was driven by a strong increase in the number of female implants from 2015 to 2017 (+28.9%). Meanwhile, the number of AUS implanted in male patients remained roughly stable and the total number of anti-incontinence surgery in men (slings+AUS) decreased steadily over the period studied.
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- 2020
29. A study of the immunohistochemical profile of bladder cancer in neuro-urological patients by the French Association of Urology
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Floriane Michel, Fabiana Cancrini, Géraldine Cancel-Tassin, Xavier Gamé, Eric Huyghe, Aurélien Rock, Grégoire Léon, Audrey Uzan, François-Régis Desfemmes, Benoît Peyronnet, Jérémy Fallot, Priscilla Léon, Emmanuel Rolland, Marie-Aimée Perrouin-Verbe, Jacques Wodey, Grégoire Capon, Gilles Karsenty, Morgan Rouprêt, Olivier Cussenot, Hussa Alshehhi, Eva Comperat, and Véronique Phé
- Subjects
urinary bladder neurogenic ,Ki-67 Antigen ,Urinary Bladder Neoplasms ,Carcinogenesis ,inflammation ,Urology ,immunohistochemistry ,Biomarkers, Tumor ,urinary bladder neoplasms ,Humans ,squamous cell carcinoma ,Tumor Suppressor Protein p53 - Abstract
To establish whether the expression of markers of cell differentiation (CK7, CK14, CK20, GATA3), apoptosis (p53), proliferation (Ki67, STAG2) and peri-tumoural lymphocytes (CD3, CD8), provides specific information about urothelial carcinogenesis in neuro-urological patients with bladder cancer (NBC).Tissue samples from NBC were retrieved from 15 centres in France and compared to control samples from non neuro-urological patients with bladder cancer (NNBC) and from neuro-urological patients without bladder cancer (NB). The expression of CK7, CK14, CK20, GATA3, p53, Ki67, STAG2, CD3 and CD8 markers was analysed using immunohistochemistry of tissue microarray sections.Overall, tissue samples from 124 patients were included in the study (n = 72 NBC, n = 26 NNBC and n = 26 NB). Muscle invasive bladder cancer (MIBC) was found in 52 NBC patients (72.2%) and squamous cell differentiation in 9 (12.5%). In NBC samples, the expression of CK20 and GATA3 was significantly more frequent in NMIBC compared to MIBC (p = 0.015 and p = 0.004, respectively). CK20 and GATA3 were significantly more expressed in NBC compared to NNBC (p 0.001 and p = 0.010, respectively). The expression of CK14, Ki67, CD3 and CD8 was significantly more frequent in NBC than in NNBC samples (p = 0.005, p 0.001, p 0.001 and p 0.001, respectively). The expression of CD3 and CD8 was similar in NBC and NB samples.In NBC, markers of basal differentiation, proliferation and peri-tumoural lymphocytes were significantly more expressed compared to NNBC controls. These results suggest the aggressiveness of NBC and the role of chronic inflammation in the carcinogenesis of bladder cancer in neuro-urological patients.
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- 2022
30. Stop à 'l’anticholinergic bashing' !
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Benoit Peyronnet, Gérard Amarenco, Claire Hentzen, and Xavier Gamé
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medicine.medical_specialty ,Urinary bladder ,medicine.anatomical_structure ,medicine.drug_class ,business.industry ,Urology ,Internal medicine ,medicine ,Anticholinergic ,MEDLINE ,business - Published
- 2019
31. Botulinum Toxin Type A Injection After Failure of Augmentation Enterocystoplasty Performed for Neurogenic Detrusor Overactivity: Preliminary Results of a Salvage Strategy. The ENTEROTOX Study
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Brigitte Perrouin-Verbe, Loïc Le Normand, Marianne de Sèze, Xavier Gamé, Benjamin Bernuz, Alexia Even, Alain Ruffion, Romain Boissier, Brigitte Schurch, Gilles Karsenty, Carine Ciceron, F. Michel, Hubert Tournebise, Philippe Grise, Pierre Denys, Emmanuel Chartier-Kastler, Andrea Manunta, Véronique Forin, Christian Saussine, and Sarah Gaillet
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Adult ,Male ,Adolescent ,Side effect ,Urology ,Urinary Bladder ,030232 urology & nephrology ,Enlarged bladder ,Injections ,Botulinum toxin a ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,In patient ,Treatment Failure ,Clinical efficacy ,Botulinum Toxins, Type A ,Urinary Bladder, Neurogenic ,Retrospective Studies ,Salvage Therapy ,Respiratory distress ,Urinary Bladder, Overactive ,business.industry ,Retrospective cohort study ,Neuromuscular Agents ,030220 oncology & carcinogenesis ,Anesthesia ,Urologic Surgical Procedures ,Detrusor pressure ,Female ,business - Abstract
Objective To evaluate the clinical efficacy, urodynamic effect and safety of Botulinum Toxin A (BTXA) injections after failure of augmentation enterocystoplasty (AE) performed for neurogenic detrusor overactivity. Patients and Methods We performed a multicenter retrospective study that included patients who had AE and at least one injection of BTXA after AE in 15 GENULF (French Speaking Neuro-Urology Study Group) centers. Clinical and urodynamic data were collected from medical files according to a standardized questionnaire and colligated in an anonymous database. Results Thirty-three patients with an injection of BTXA after AC in 9 out of 15 centers were included. Mean age at the time of AE was 24 ± 15 years. Overall efficacy (defined by clinical efficacy associated with a request by the patient for reinjection) was observed in 58% of the patients. Mean maximum cystomanometric capacity increased by 28% (333 ± 145 vs 426 ± 131 mL; P = .007) and maximum detrusor pressure (Pdet max) decreased by 43% (44 ± 37 vs 25 ± 18 cm H2O; P = .02) after BTXA. Only one side effect was recorded out of the 152 procedures (transient generalized muscle weakness without respiratory distress). Conclusion In patients with failure after AE performed for neurogenic detrusor overactivity, injection of BTXA in the enlarged bladder was effective in over half of the cases with low morbidity. If this therapeutic approach were confirmed, it could be proposed as an alternative to AE surgical revision.
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- 2019
32. A Multicenter, Randomized, Placebo-Controlled Study Evaluating the Efficacy of a Combination of Propolis and Cranberry (Vaccinium macrocarpon) (DUAB®) in Preventing Low Urinary Tract Infection Recurrence in Women Complaining of Recurrent Cystitis
- Author
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Franck Bruyère, Albert Sotto, Vincent Misrai, Bertrand Issartel, Alain Ruffion, Patrick Coloby, Jean-Philippe Lavigne, Gilles Karsenty, Francois-André Allaert, Abdel Rahmene Azzouzi, Stéphane Droupy, and Xavier Gamé
- Subjects
2. Zero hunger ,medicine.medical_specialty ,business.industry ,Urology ,Urinary system ,Incidence (epidemiology) ,030232 urology & nephrology ,Placebo-controlled study ,Propolis ,Placebo ,Gastroenterology ,3. Good health ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Clinical endpoint ,Vaccinium macrocarpon ,business - Abstract
Objectives: The purpose of the study was to compare the efficacy of a product containing cranberry and propolis (DUAB) to placebo for reducing frequency of cystitis in women with recurrent acute cystitis. Method: A multicenter, placebo-controlled, randomized study of women aged >18 years with at least 4 episodes of cystitis in the previous 12 months was performed. The number of cystitis episodes over a 6-month follow-up was the primary end point. Results: Forty-two women were included in the cranberry + propolis group, and 43 women were in the placebo group. The mean age was 53 ± 18 years, with 6.2 ± 3.6 cystitis episodes in the previous year, with no differences between the 2 groups. The mean number of infections was lower in the propolis + cranberry group (respectively, 2.3 ± 1.8 vs. 3.1 ± 1.8). The total number of cystitis episodes in the first 3 months was lower in the propolis + cranberry group (0.7 ± 1.1 vs. 1.3 ± 1.1, p = 0.0257) after adjusting for water consumption. The mean time to onset of the first urinary tract infection (UTI) was also significantly longer in the propolis + cranberry group (69.9 ± 45.8 days vs. 43.3 ± 45.9, p = 0.0258). Tolerance to the treatments was good and comparable in both groups. Conclusions: We demonstrate for the first time that cranberry and propolis supplementation significantly reduces the incidence of UTIs during the first 3 months and delays the onset of an episode of cystitis.
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- 2019
33. Sacral Neuromodulation with the InterStim System for Overactive Bladder: 3-Year Results from the French Prospective, Multicenter, Observational SOUNDS Study
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Marie-Aimée Perrouin-Verbe, Bertrand Rabut, Grégoire Capon, François Dargent, Evelyne Ragni, Christian Saussine, Elena Brassart, D.U.J. Keller, L. Peyrat, Marc Fourmarier, François Pecoux, Thierry Rousseau, Jean-Nicolas Cornu, N. Berrogain, A. Melotti, Najdat Yaghi, Yves Tanneau, Pierre-Emmanuel Bryckaert, A. Abouihia, Emmanuel Chartier-Kastler, Alain Ruffion, Raïssa Braguet, Gabriel Stoica, Jean Pierrevelcin, Xavier Gamé, Xavier Biardeau, Loïc Le Normand, Jean Pierre Graziana, Jérôme Ferchaud, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), HC Strasbourg, Strasbourg, France., CHP Saint Brieuc, Clinique Mutualiste de L'Orient, Hôpital de la Timone [CHU - APHM] (TIMONE), Polyclinique Courlancy, Reims, Clinique Urologie Nantes Atlantis, CHU Toulouse [Toulouse], Polyclinique Ormeau, Tarbes, Hopital Privé Sévigné [Cesson-Sévigné, France], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Intercommunal Alençon-Mamers (CHICAM), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHI Aix Pertuis CHPA-CHIAP, CH Sarreguemines France, CHU Bordeaux [Bordeaux], Hôpital privé Robert-Schuman, Metz, France., Clinique Ambroise Pare Toulouse, AP Hôpital Diaconesses, CHU Roubaix, Clinique Chirurgicale du Pré, LE MANS, Medtronic Diabetes, International Trading Sàrl , Tolochenaz, Switzerland, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Medtronic Diabetes, International Trading Sàrl [Tolochenaz, Switzerland ] (MDITS), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and douville, sabine
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medicine.medical_specialty ,[SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,Urology ,Urinary system ,030232 urology & nephrology ,Electric Stimulation Therapy ,Disease ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Disease severity ,Numeric Rating Scale ,[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,Medicine ,Humans ,Prospective Studies ,ComputingMilieux_MISCELLANEOUS ,business.industry ,Urinary Bladder, Overactive ,medicine.disease ,humanities ,3. Good health ,Treatment Outcome ,Overactive bladder ,Sacral nerve stimulation ,030220 oncology & carcinogenesis ,Physical therapy ,Quality of Life ,Observational study ,business - Abstract
SOUNDS strengthens the evidence basis of sacral neuromodulation (SNM) for overactive bladder (OAB) through real-world data.To analyze diary-based effectiveness, quality of life (QoL), disease severity, symptom bother, and safety data for SNM with the InterStim system up to 3 yr after implantation.Twenty-five representative French sites enrolled 291 patients with OAB followed according to the local standard of care. Overall, 229 patients received a de novo or replacement InterStim implant and had four follow-up visits, two within the first yr and annually thereafter. A total of 190 patients completed the fourth follow-up visit after a mean of 33.7 ± 3.7 mo.The effectiveness outcomes measured were changes in daily voids and leaks and the therapy responder rates. Other outcomes included validated QoL data (Ditrovie and EuroQol 5-dimension 5-level questionnaires), disease severity (Urinary Symptom Profile [USP]), symptom bother rated using a numeric rating scale (NRS), and safety data. Follow-up data were compared to baseline results using the Wilcoxon signed-rank test.Average daily voids and leaks were significantly reduced at all time points up to 3 yr after implantation (p0.05) except for voids at 21 mo in the group receiving a replacement device. The therapeutic response for urinary urge incontinence at the fourth follow-up was 72% for the de novo group and 86% for the replacement group. Disease-specific QoL (Ditrovie), OAB-specific symptom severity (USP domain 2), and NRS-rated disease bother were significantly improved at all visits (p0.001). Device- or procedure-related adverse events occurred in 49% of patients, with 68% of the events classified as minor (Clavien-Dindo grade I or II). Surgical revisions were performed in 33% of patients, including permanent removal in 13%, over a mean exposure time of 44.4 ± 15.3 mo.This study confirms the safety and effectiveness of SNM for OAB and improvements in QoL and disease bother in real life.Our study in French patients with overactive bladder showed that disease symptoms and bother were significantly reduced and quality of life was significantly improved over a study duration of approximately 3 yr after implantation of a device to stimulate nerves that control the bladder. This trial is registered at ClinicalTrials.gov as NCT02186041.
- Published
- 2021
34. External Validation of a Predictive Model to Estimate Renal Function After Living Donor Nephrectomy
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Charles Dariane, Thomas Prudhomme, N. Kamar, Arnaud Mejean, Aurélien Adypagavane, Marc Olivier Timsit, Christophe Legendre, Mathieu Roumiguié, Thibaut Benoit, Michel Soulié, Bernard Malavaud, and Xavier Gamé
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Transplantation ,medicine.medical_specialty ,Kidney ,Receiver operating characteristic ,business.industry ,Concordance ,Urology ,Renal function ,medicine.disease ,Kidney Transplantation ,Nephrectomy ,Pearson product-moment correlation coefficient ,External validity ,symbols.namesake ,medicine.anatomical_structure ,symbols ,Living Donors ,Medicine ,Humans ,business ,Kidney disease ,Glomerular Filtration Rate ,Retrospective Studies - Abstract
BACKGROUND Transplantation from living donor nephrectomy (LDN) is the best treatment for end-stage renal disease but observed decrease in donor renal function is a major concern. The aim of this study was to externally validate a predictive model to estimate 1-y postdonation estimated glomerular filtration rate (eGFR) and risk of chronic kidney disease (CKD) in living donors. METHODS All LDN performed at Necker Hospital from January 2006 to May 2018 were retrospectively included. Observed eGFR (using CKD-EPI formula) at 1-y post LDN was compared with the predicted eGFR calculated with a formula developed at Toulouse-Rangueil and based on predonation eGFR and age. Pearson correlation, receiver operating characteristics curve (ROC curve), and calibration curve were used to assess external validity of the proposed prognostic model to predict postoperative eGFR and occurrence of CKD in donors. RESULTS Four hundred donors were evaluated with a mean postoperative eGFR of 62.1 ± 14 mL/min/1.73m2. Significant correlation (Pearson r = 0.66; P < 0.001) and concordance (Bradley-Blackwood F = 49.189; P < 0.001) were observed between predicted and observed 1-y eGFR. Area under the receiver operating characteristic curve of the model relevant accuracy was 0.86 (95% CI, 0.82-0.89). CONCLUSIONS This study externally validated the formula to predict 1-y postdonation eGFR. The calculator could be an accurate tool to improve the selection of living kidney donor candidate.
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- 2021
35. Pain Management in a Model of Interstitial Cystitis/Bladder Pain Syndrome by a Vaccinal Strategy
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Sophie Chabot, Céline Augé, Catherine Blanpied, Nathalie Vergnolle, Philippe Lluel, Gilles Dietrich, Lilian Basso, and Xavier Gamé
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0301 basic medicine ,medicine.medical_specialty ,Cyclophosphamide ,business.industry ,Analgesic ,Urology ,Interstitial cystitis ,Visceral pain ,Chronic Cystitis ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Nociception ,Opioid ,medicine ,medicine.symptom ,Bladder Pain ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Current analgesic treatments for Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) are limited. Here, we propose a novel antinociceptive strategy exploiting the opioid-mediated analgesic properties of T lymphocytes to relieve from bladder pain. In a chronic model of IC/BPS in rats, we show that a secondary T cell response against intravesically administered ovalbumin prevents from visceral pain in OVA-primed animals. The analgesic effect is associated with the recruitment of T lymphocytes within the inflamed mucosa and is reversed by naloxone-methiodide, a peripheral opioid receptor antagonist. Similarly, intravesical instillation of BCG or tetanus toxoid antigens in vaccinated rats protects from pain in the same model. We show opioid-dependent analgesic properties of local vaccine antigen recall in a preclinical rat model of chronic cystitis. Since BCG bladder instillation is regularly used in humans (as anticancer therapy), our results open it as a new therapeutic positioning for a pain management indication for IC/BPS patients.
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- 2020
36. Sacral Neuromodulation with the InterStim™ System for Intractable Lower Urinary Tract Dysfunctions (SOUNDS): Results of Clinical Effectiveness, Quality of Life, Patient-Reported Outcomes and Safety in a French Multicenter Observational Study
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François Dargent, Raïssa Braguet, Emmanuel Chartier-Kastler, Xavier Biardeau, D.U.J. Keller, Alain Ruffion, Christian Saussine, Gilles Karsenty, Gabriel Stoica, Jérôme Ferchaud, N. Berrogain, Jean Pierre Graziana, Thierry Rousseau, Grégoire Capon, Elena Brassart, Jean-Nicolas Cornu, Najdat Yaghi, Loïc Le Normand, Xavier Gamé, A. Abouihia, François Pecoux, Yves Tanneau, Evelyne Ragni, A. Melotti, Pierre Emmanuel Bryckaert, L. Peyrat, Jean Pierrevelcin, Bertrand Rabut, Marc Fourmarier, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hopital Privé Sévigné [Cesson-Sévigné, France], CHU de Saint-Brieuc, CHU Strasbourg, Polyclinique de l'Ormeau, Clinique Mutualiste de L'Orient, Hôpital Nord [CHU - APHM], Clinique Urologie Nantes Atlantis, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Polyclinique Courlancy (PC), Polyclinique de Courlancy, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre Hospitalier d'Aix en Provence [Aix-en-Provence] (CHIAP ), CHIC Aleçon Mamers, Clinique Ambroise Pare Toulouse, CH Sarreguemines France, CHU Roubaix, CHU Bordeaux [Bordeaux], CH Metz -Robert Schuman Vantoux, AP Hôpital Diaconesses, Clinique du Pré, APM Hôpital de la Conception, Medtronic International Trading Sarl [Tolochenaz], Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), douville, sabine, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
medicine.medical_specialty ,Urology ,Urinary system ,030232 urology & nephrology ,Electric Stimulation Therapy ,Disease ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,medicine ,Humans ,Patient Reported Outcome Measures ,Prospective Studies ,Adverse effect ,Non-obstructive urinary retention ,ComputingMilieux_MISCELLANEOUS ,Urinary retention ,business.industry ,Urinary Bladder, Overactive ,Overactive bladder ,Sacral neuromodulation ,Urinary Incontinence, Urge ,medicine.disease ,Double incontinence ,[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,humanities ,3. Good health ,Treatment Outcome ,Sacral nerve stimulation ,030220 oncology & carcinogenesis ,Quality of Life ,Observational study ,medicine.symptom ,business - Abstract
International audience; BackgroundReal-world data that support the use of sacral neuromodulation (SNM) for lower urinary tract dysfunctions are of continued interest.ObjectiveTo evaluate the effectiveness, quality of life (QoL), patient-reported outcomes (PROs), and safety of SNM with the InterStim™ system in real life during 1-yr postimplant.Design, setting, and participantsThis is a prospective, multicenter, observational study at 25 representative public and private French sites. Eligible patients received SNM therapy for overactive bladder (OAB) and non-obstructive urinary retention based on local standard of care. Overall, 320 patients were enrolled; 247 received permanent implant or replacement; 204 implanted patients completed second follow-up after mean of 10.0 ± 3.8 mo.Outcome measurements and statistical analysisEffectiveness outcomes were change in voids, leaks, and catheterizations/day. Other outcomes included validated QoL and disease severity scores as well as PROs and adverse event data. Outcomes at follow-ups were compared with baseline using the Wilcoxon signed-rank test.Results and limitationsVoids in urinary frequency (UF) and leaks/day in urinary urge incontinence (UI) patients were significantly reduced after 10 mo in both de novo (mean baseline voids/day UF de novo: 12.7 vs 8.6 after 10 mo; p < 0.001; mean baseline leaks/day UI de novo: 4.3 vs 1.1 after 10 mo; p < 0.001) and replacement patients (mean baseline voids/day UF replacement: 11.5 vs 7.9 after 10 mo; p < 0.001; mean baseline leaks/day UI replacement: 5.4 vs 1.0 after 10 mo; p < 0.001). Disease bother, Urinary Symptom Profile score, and Ditrovie questionnaire score were also significantly improved. Revisions postimplant occurred in 20% of patients including in 9% due to permanent explantation during a mean exposure time of 24.3 mo.ConclusionsThrough a real-life study, SOUNDS (Sacral neuromOdUlation with InterStim™ therapy for intractable lower uriNary tract DySfunctions) confirms the clinical effectiveness, safety, and positive effect of SNM on QoL and PROs for the treatment of OAB patients.Patient summaryThese analyses on French patients who received sacral neuromodulation (SNM) for retention or OAB during a 10-mo period showed that SNM improved OAB symptoms, quality of life, and reduced disease bother.Trial registrationClinicalTrials.gov: NCT02186041
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- 2020
37. Unilateral versus bilateral sacral neuromodulation test in the treatment of refractory idiopathic overactive bladder: A randomized controlled pilot trial
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Laurent Wagner, A. Faix, Christel Castelli, Xavier Gamé, Sarah Kabani, Sandrine Alonso, Loïc Le Normand, Jean-Nicolas Cornu, E. Bey, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Laboratoire de Biostatistique, Epidémiologie clinique, Santé Publique Innovation et Méthodologie [CHU Nîmes] (BESPIM), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre hospitalier universitaire de Nantes (CHU Nantes), Clinique Médicale Beausoleil, CHU Toulouse [Toulouse], Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'urologie [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Normandie Université (NU)
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Adult ,Male ,medicine.medical_specialty ,Sacrum ,Urinary urgency ,sacral neurostimulation ,Urology ,Urinary system ,030232 urology & nephrology ,overactive ,Pilot Projects ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Refractory ,Medicine ,Humans ,bilateral ,Aged ,030219 obstetrics & reproductive medicine ,business.industry ,Urinary Bladder, Overactive ,Pilot trial ,Significant difference ,Urinary Incontinence, Urge ,Middle Aged ,medicine.disease ,3. Good health ,Surgery ,Treatment Outcome ,Sacral nerve stimulation ,Overactive bladder ,Quality of Life ,Transcutaneous Electric Nerve Stimulation ,Female ,sacral nerve stimulation ,Neurology (clinical) ,medicine.symptom ,business ,urinary bladder - Abstract
International audience; AimTo compare treatment success rate in terms of improvement of bladder overactivity between unilateral and bilateral sacral neuromodulation testing.MethodsA multicentric, parallel, randomized, open pilot trial (October 2012‐September 2017) was conducted. Participants presented primary overactive bladder resistant to first‐line treatments. Patients were excluded in case of secondary bladder, pelvic, or neurological condition. Patients were randomized between bilateral testing (n = 28) or unilateral testing (n = 27), to determine the best functional response before final implantation. The primary outcome was the rate of patients presenting at least 50% of clinical improvement at 1 month on urinary frequency, number of urge incontinence episodes or number of urinary urgency episodes. Symptom severity, implantation success rate, uroflowmetry, device tolerance, complications, and quality of life were also assessed.ResultsFifty‐five patients have been included. The rate of patients presenting at least one significant clinical improvement at month 1 was 62% in the bilateral group versus 84% in the unilateral group (P = .0891), RR = 0.74 (0.51; 1.07). There was no significant difference between bilateral and unilateral groups in terms of improvement of urinary frequency (0% and 17%; P = .1115), number of urge incontinence episodes (52% and 63%; P = .4929) or number of urinary urgency episodes (57% and 74%; P = .2411). More complications were reported in the bilateral group than in the unilateral group (9 [47%] vs 4 [16%], respectively; P = .0239).ConclusionSystematic bilateral sacral neuromodulation testing before final implantation did not appear to increase success rate compared with unilateral stimulation in the treatment of overactive bladder.
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- 2020
38. Pregnancy and Delivery in Women with Lower Urinary Tract Reconstruction: A National Multicenter Retrospective Study from the French-Speaking Neuro-Urology Study Group (GENULF) and the Neuro-Urology Committee of the French Association of Urology
- Author
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Jacques Kerdraon, Véronique Phé, C. Duport, Alain Ruffion, V. Quenneville, L. Le Normand, A. Charlanes, E. Bey, Maximilien Baron, Xavier Gamé, C. Saussine, Bernard Boillot, E. Chartier Kastler, Grégoire Capon, B. Perrouin-Verbe, Jean-Nicolas Cornu, R. Walder, Marie-Aimée Perrouin-Verbe, T. Tricard, C. Garabedian, Quentin Manach, Alexia Even, Xavier Biardeau, and Benoit Peyronnet
- Subjects
Adult ,medicine.medical_specialty ,Multiple Sclerosis ,Adolescent ,Urology ,Urinary system ,medicine.medical_treatment ,Urinary Bladder ,030232 urology & nephrology ,Urinary Diversion ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Postoperative Complications ,Pregnancy ,medicine ,Neuro urology ,Humans ,Renal Colic ,Spinal Dysraphism ,Spinal Cord Injuries ,Retrospective Studies ,business.industry ,Cesarean Section ,General surgery ,Urethral sphincter ,Urinary diversion ,Retrospective cohort study ,Plastic Surgery Procedures ,medicine.disease ,3. Good health ,Clinical Practice ,Pregnancy Complications ,Urinary Incontinence ,Urinary Tract Infections ,Premature Birth ,Urinary Sphincter, Artificial ,Female ,France ,business - Abstract
Management of pregnancy and delivery in women with lower urinary tract reconstruction is challenging and the currently available literature is insufficient to guide clinical practice. We report pregnancy and delivery outcomes in this specific population.We conducted a national multicenter retrospective study (16 centers) including 68 women with 96 deliveries between 1998 and 2019. These women had at least 1 successful pregnancy and delivery after augmentation enterocystoplasty, catheterizable channel creation and/or artificial urinary sphincter implantation. Maternal and fetal complications during pregnancy and delivery were reported, as well as postpartum functional outcomes, according to the delivery mode. The chi-square test and Student's t-test were used to compare categorical and continuous variables, respectively.Overall 32% of reported pregnancies were complicated by febrile urinary tract infections, 13.5% by renal colic and 14.6% required upper urinary tract diversion. In addition, 10% of patients reported transient self-catheterization difficulties and 13.5% reported de novo or increased urinary incontinence. The preterm delivery rate was 35.3%. Elective C-section was performed in 61% of pregnancies. Twenty complications occurred during delivery (20%), including 19 during elective C-section. Urinary continence at 1 year was unchanged for 93.5% of deliveries. Delivery mode (p=0.293) and multiparity (p=0.572) had no impact on urinary continence.In this population C-section appeared to be associated with a high risk of complications. In the absence of any obstetric or neurological contraindications, vaginal delivery should be proposed as the first line option to the majority of these women.
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- 2020
39. Long-term outcomes of artificial urinary sphincter in female patients with spina bifida
- Author
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B. Peyronnet, J. Hascoet, Isabelle Bonan, M. Jezequel, Charlène Brochard, S. Odent, L. Siproudhis, A. Manunta, Xavier Gamé, and Jacques Kerdraon
- Subjects
medicine.medical_specialty ,business.industry ,Spina bifida ,Urology ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,lcsh:RC254-282 ,Surgery ,Artificial urinary sphincter ,Female patient ,Long term outcomes ,Medicine ,business - Published
- 2020
40. MP52-14 ROBOT-ASSISTED KIDNEY TRANSPLANTATION IN THE OBESE: UPDATE OF A MONOCENTRIC STUDY WITH 28 PATIENTS
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Nicolas Doumerc, Lesourd Marine, Michel Soulié, Mathieu Roumiguié, Nassim Kamar, Jean Baptiste Beauval, Pascal Rischmann, Xavier Gamé, and Federico Sallusto
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medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Robot ,business ,medicine.disease ,Kidney transplantation ,Surgery - Published
- 2020
41. MP48-14 URINARY TIMP-2 AND MMP-2 ARE SIGNIFICANTLY ASSOCIATED WITH POOR BLADDER COMPLIANCE IN ADULT PATIENTS WITH SPINA BIFIDA
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Zineddine Khene, Andrea Manunta, Claude Bendavid, Quentin Alimi, M. Jezequel, Juliette Hascoet, Jacques Kerdraon, Guillaume Bouguen, Xavier Gamé, Charlène Brochard, C. Richard, and Benoit Peyronnet
- Subjects
medicine.medical_specialty ,Adult patients ,business.industry ,Spina bifida ,Bladder compliance ,Urology ,Urinary system ,Medicine ,Matrix metalloproteinase ,business ,medicine.disease - Published
- 2020
42. V06-11 ROBOT-ASSISTED IMPLANTATION OF ARTIFICIAL URINARY SPHINCTER IN WOMEN: A STANDARDIZED SURGICAL TECHNIQUE
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Xavier Gamé, V. Cardot, Juliette Hascoet, Grégoire Capon, Aurélien Descazeaud, Benoit Peyronnet, Xavier Biardeau, Frank Van der Aa, Frederic Dubois, Quentin Alimi, Olivier Belas, Andrea Manunta, Georges Fournier, and Vidart Adrien
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Artificial urinary sphincter ,medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Robot ,business ,Surgery - Abstract
INTRODUCTION AND OBJECTIVE:The main drawback of the artificial urinary sphincter (AUS) in women is the technical complexity of its implantation. Over the past five years, several teams have reporte...
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- 2020
43. Quality of life associated with orthotopic neobladder and ileal conduit in women: A multicentric cross-sectional study
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Michel Soulié, M. Kyheng, L. Tondut, Xavier Gamé, N. Lamande, François Marcelli, Jean-Christophe Fantoni, B. Peyronnet, Xavier Biardeau, Gregory Verhoest, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Lille, Hôpital de Rangueil, and CHU Toulouse [Toulouse]
- Subjects
medicine.medical_specialty ,Cross-sectional study ,Urology ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,030232 urology & nephrology ,Statistical difference ,Urinary Diversion ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Surveys and Questionnaires ,Internal medicine ,Clinical endpoint ,medicine ,Humans ,Aged ,Aged, 80 and over ,Bladder cancer ,Pelvic exenteration ,business.industry ,Urinary Reservoirs, Continent ,social sciences ,Middle Aged ,University hospital ,medicine.disease ,humanities ,3. Good health ,Anterior pelvic exenteration ,Cross-Sectional Studies ,Urinary Bladder Neoplasms ,Quality of Life ,Female ,business - Abstract
PURPOSE To compare quality of life and functional outcomes associated with orthotopic neobladder (ONB) and ileal conduit (IC) after anterior pelvic exenteration for bladder cancer in women, through a multicentric cross-sectional study. METHODS All women who have undergone an anterior pelvic exenteration associated with ONB or IC for a bladder cancer between January 2004 and December 2014 within the three participating university hospital centers and that were still alive in February 2016 were included. Three distinct auto-administered questionnaires were submitted to the patients: the EORTC QLQ-C30, the EORTC QLQ-BLmi30 and the SF-12. Comparison of response to these questionnaires between women with ONB and those with IC were studied with Mann-Whitney U tests, with a statistically significant P-value set at
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- 2020
44. Living-donor kidney transplantation: comparison of sequential and simultaneous surgical organizations
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Nicolas Doumerc, Julien Branchereau, Mathieu Roumiguié, Georges Karam, François Iborra, Michel Soulié, Delphine Kervella, L. Broudeur, B. Mesnard, Shruti Mittal, Federico Sallusto, Rodolphe Thuret, Gilles Blancho, M. Binhazzaa, Thibaut Benoit, Xavier Gamé, Nassim Kamar, Thomas Prudhomme, Le Bihan, Sylvie, Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Nuffield Department of Surgical Sciences, University of Oxford, National Institute for Health Research (NHS), Département d'Urologie et de Transplantation Rénale [CHU Montpellier], Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], and University of Oxford [Oxford]
- Subjects
Nephrology ,Male ,medicine.medical_specialty ,Multivariate analysis ,Time Factors ,Urology ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,030232 urology & nephrology ,Living-donor kidney transplantation ,030204 cardiovascular system & hematology ,Living donor ,Nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Living Donors ,Humans ,Kidney transplantation ,Retrospective Studies ,Kidney ,Univariate analysis ,business.industry ,Cold Ischemia ,Delayed graft function ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Delayed Graft Function ,Sequential ,3. Good health ,[SDV] Life Sciences [q-bio] ,medicine.anatomical_structure ,Female ,business ,Simultaneous - Abstract
International audience; PURPOSE: The objective of this study was to compare living-donor kidney transplantation (LDKT) performed either sequentially, in one operating room, leading to extended cold ischemia time (CIT) or simultaneously, in two different operating room, with shorter CIT.METHODS: We retrospectively included all living-donor nephrectomies and kidney transplantations, performed from March 2010 to March 2014, in three French university centers. In the first one (C1), LDKTs were performed in sequential manner (Sequential group) and in C2 and C3, LDKTs were performed in simultaneous manner (Simultaneous group).RESULTS: A total of 324 LDKT were performed: 176 LDKT in Sequential group and 148 LDKT in Simultaneous group. Patients characteristics were equivalent between groups, except nephrectomy side, ABO mismatch rate and previous kidney transplantation rate. CIT, rewarming time, transfusion and delayed graft function (DGF) were significantly higher in Sequential group. Overall survival and graft survival of kidney transplant recipients were similar in the Sequential and Simultaneous groups. 5-year eGFR was similar between groups. In univariate analysis, number of graft arteries, recipient BMI, previous kidney transplantation status and CIT were significant predictors of DGF. Only previous kidney transplantation status was an independent predictive factor of DGF in the multivariate analysis.CONCLUSIONS: Sequential surgical organization results in the same functional results as simultaneous surgical organization. DGF was higher for LDKT performed sequentially but at 5-year overall survival, graft survival and eGFR were similar between these two types of transplant organizations.
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- 2020
45. Risk of prolapse and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor using clean intermittent catheterization versus Valsalva voiding
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C. Richard, Charlène Brochard, Jacques Kerdraon, Laurent Siproudhis, Xavier Gamé, Zine-Eddine Khene, Isabelle Bonan, Quentin Alimi, M. Jezequel, Andrea Manunta, Juliette Hascoet, Mehdi El Akri, B. Peyronnet, CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de Kerpape, CHU Toulouse [Toulouse], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
- Subjects
Adult ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Urology ,Urinary system ,030232 urology & nephrology ,acontractile ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Uterine Prolapse ,Intussusception (medical disorder) ,Urinary Bladder, Underactive ,Clinical endpoint ,Humans ,Medicine ,Intermittent Urethral Catheterization ,Urinary Complication ,Urinary Bladder, Neurogenic ,Spinal Dysraphism ,Retrospective Studies ,valsalva pelvic organ prolapse ,030219 obstetrics & reproductive medicine ,Urinary bladder ,business.industry ,Spina bifida ,clean-intermittent catheterization ,medicine.disease ,spina bifida ,body regions ,Rectal prolapse ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Relative risk ,Urinary Tract Infections ,Female ,Neurology (clinical) ,urinary tract infection ,business ,urinary bladder ,rectal prolapse - Abstract
International audience; Aims - To assess the relative risks of pelvic organ prolapse (POP) and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor voiding with Valsalva versus those using clean-intermittent catheterization (CIC). Methods - We conducted a retrospective analysis including all spina bifida patients with neurogenic acontractile detrusor with a minimum follow-up of 12 months. Patients were then divided in two groups according to their bladder management: voiding with Valsalva versus CIC. The primary endpoint was any de novo or worsened rectal and/or pelvic organ prolapse (POP) diagnosed during follow-up. The secondary outcome was urinary complications defined as febrile urinary tract infections (UTI) and/or urolithiasis and/or renal failure. Results - Fifty-five patients (50.9% were males) met the inclusion/exclusion criteria: 28 voiding with Valsalva and 27 performing CIC. At baseline, the rates of vaginal prolapse (44.4% vs 50%; P = 0.99), and rectal prolapse/intussusception (25.9% vs 21.4%; P = 0.76) were similar in both groups. After a median follow-up of 80.6 and 65.6 months, respectively (P = 0.29), the rate of de novo or worsened rectal prolapse/intussusception was higher in the Valsalva voiding group than in the CIC group (32.1% vs 3.7%; P = 0.01). De novo or worsened vaginal prolapses were also more common in the Valsalva voiding group, but it did not reach statistical significance (33.3% vs 11.1%; P = 0.29). Conclusions - Valsalva voiding might be harmful in adult spina bifida patients with neurogenic acontractile detrusor as it may increase the risk of rectal prolapse/intussusception. Overall, the prevalence of POP and rectal prolapse was high in both groups.
- Published
- 2018
46. Intradetrusor Injections of Botulinum Toxin A in Adults with Spinal Dysraphism
- Author
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Marie-Aimée Perrouin-Verbe, Xavier Biardeau, Pierre Denys, Loic Lenormand, Maximilien Baron, Jean-Nicolas Cornu, Christian Saussine, Emmanuel Chartier-Kastler, Xavier Gamé, Gilles Karsenty, Marianne de Sèze, Brigitte Schurch, Véronique Phé, Genulf, Jean-Michel Boutin, Gérard Amarenco, Alexia Even, Benoit Peyronnet, Grégoire Capon, Andrea Manunta, Juliette Hascoet, CHU Pontchaillou [Rennes], Hôpital Raymond Poincaré [AP-HP], service d'urologie [CHU Bordeaux], CHU Bordeaux [Bordeaux], Clinique Saint Augustin, Service d'Urologie, andrologie et transplantation rénale [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Université de Nantes (UN), Service d'urologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Université de Strasbourg (UNISTRA), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'urologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Université de Lausanne (UNIL), Service de médecine physique et réadaptation [CHU Raymond-Poincaré], Physiologie et physiopathologie de la motricité chez l'homme, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR70-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Fédérale Toulouse Midi-Pyrénées, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Tenon [AP-HP], Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Lausanne = University of Lausanne (UNIL), and Université de Toulouse (UT)
- Subjects
Male ,medicine.medical_specialty ,type A ,Multivariate analysis ,Spinal dysraphism ,Urology ,030232 urology & nephrology ,overactive ,Urinary incontinence ,Injections, Intralesional ,Severity of Illness Index ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,Botulinum toxin a ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,medicine ,Clinical endpoint ,Humans ,Botulinum Toxins, Type A ,Retrospective Studies ,Analysis of Variance ,030219 obstetrics & reproductive medicine ,Urinary bladder ,Urinary Bladder, Overactive ,business.industry ,Spina bifida ,adult ,Prognosis ,botulinum toxins ,medicine.disease ,3. Good health ,Treatment Outcome ,medicine.anatomical_structure ,Multivariate Analysis ,Quality of Life ,spinal dysraphism ,Patient Compliance ,Detrusor pressure ,Female ,medicine.symptom ,business ,urinary bladder ,urodynamics - Abstract
International audience; Purpose:The aim of the current study was to determine the outcomes of botulinum toxin A intradetrusor injections in adult patients with spina bifida.Materials and methods:All patients with spinal dysraphism who underwent intradetrusor injections of botulinum toxin A from 2002 to 2016 at a total of 14 centers were retrospectively included in analysis. The primary end point was the global success of injections, defined subjectively as the combination of urgency, urinary incontinence and detrusor overactivity/low bladder compliance resolution. Univariate and multivariate analysis was performed to seek predictors of global success.Results:A total of 125 patients were included in study. The global success rate of the first injection was 62.3% with resolution of urinary incontinence in 73.5% of patients. All urodynamic parameters had improved significantly by 6 to 8 weeks compared to baseline, including maximum detrusor pressure (–12 cm H 2O, p
- Published
- 2018
47. Management of urinary-tract fistulas using reversible balloon nephrostomy: a single-center retrospective analysis of 56 patients
- Author
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Xavier Gamé, Jérôme Gas, Jean-Baptiste Beauval, François-Xavier Nouhaud, Michel Soulié, Eric Huyghe, Marie-Charlotte Delchier, Mathieu Roumiguié, and Séverine Lagarde
- Subjects
Male ,medicine.medical_specialty ,Urinary Tract Fistula ,Urinary Fistula ,Urology ,Urinary system ,medicine.medical_treatment ,Fistula ,030232 urology & nephrology ,Urinary Catheters ,Single Center ,Balloon ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Aged ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics and Gynecology ,Middle Aged ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,Treatment Outcome ,Nephrostomy ,Female ,Ureteral Stricture ,business ,Nephrotomy - Abstract
To evaluate the effectiveness of balloon nephrostomy (BN) for treating urinary tract fistulas. In a single-center retrospective analysis, 56 patients were treated using BN between 2003 and 2014. All causes of urinary tract fistula were included. We assessed the effectiveness of drainage, complications, and the types of reconstruction surgery used. Success was defined as fistula closure without surgery. The cohort consisted of 25 males (54%) and 31 females (55%) with a median age of 63 years who underwent BN for a urinary fistula secondary to surgery, i.e., urologic (40%; n = 22), gynecologic (34%; n = 19), or digestive (20%; n = 11). Of these patients, 48 (86%) had a history of cancer (49% had a tumor progression). Median drainage time was 90 days (10–583), with an average of three successive readjustments needed per patient. We obtained a 21% success rate (n = 12), morbidity was 6.5% (urinary sepsis, renal abscess, ureteral stricture), and 7% of patients developed ureteral stricture after balloon removal. There was no recurrence of any fistula within a median follow-up time of 15.2 months. This minimally invasive procedure can be used for selected urinary tract fistulas with few complications. It can also be used safely in populations that have several comorbidities.
- Published
- 2018
48. Intermittent Self-catheterization in Older Adults: Predictors of Success for Technique Learning
- Author
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Pierre Denys, Samer Sheikh Ismael, Xavier Gamé, Gérard Amarenco, Gilberte Robain, Rebecca Haddad, Claire Hentzen, and Benoit Peyronnet
- Subjects
medicine.medical_specialty ,Multivariate analysis ,Urinary bladder diseases ,Urology ,Urinary retention ,Population ,030232 urology & nephrology ,lcsh:RC870-923 ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Clinical Investigation ,education ,Aged ,education.field_of_study ,business.industry ,Retrospective cohort study ,Odds ratio ,lcsh:Diseases of the genitourinary system. Urology ,Functional Independence Measure ,Confidence interval ,Perineum ,medicine.anatomical_structure ,Neurology ,Physical therapy ,Original Article ,Neurology (clinical) ,Intermittent urethral catheterization ,business ,Body mass index ,030217 neurology & neurosurgery - Abstract
Purpose The main goal of this retrospective study is to explore the predictors of success in learning clean intermittent self-catheterization (CISC) in patients over 65 years of age. The secondary goal is to assess whether in this population, the risk of failure to perform CISC is greater, compared with patients under 65 with similar pathologies. Methods All patients older than 65 consulting between January 2011 and January 2016 for learning CISC were included. A control population younger than 65 matching with sex, body mass index, and pathology was selected. Results One hundred sixty-nine of the 202 patients (83.7%) over 65 succeeded in learning CISC. Obesity (P
- Published
- 2018
49. De l’urologie pédiatrique à l’urologie adulte, quelle prise en charge de l’adolescent ? État des lieux d’une consultation de transition en urologie
- Author
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S. Mouttalib, L. Even, Xavier Gamé, Michel Soulié, O. Bouali, Philippe Galinier, Pascal Rischmann, Jacques Moscovici, Nantes-Métropole, Institut de Chimie et des Matériaux Paris-Est (ICMPE), Institut de Chimie du CNRS (INC)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), Service d'Urologie - Transplantation Rénale - Andrologie, Département d'urologie, CHU Toulouse [Toulouse], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), and CHU Toulouse [Toulouse]-Hôpital de Rangueil
- Subjects
medicine.medical_specialty ,Uropathy ,Sexology ,Spina bifida ,business.industry ,[SDV]Life Sciences [q-bio] ,Urology ,General surgery ,030232 urology & nephrology ,medicine.disease ,3. Good health ,03 medical and health sciences ,0302 clinical medicine ,Hypospadias ,030220 oncology & carcinogenesis ,medicine ,Transitional care ,Young adult ,Paraplegia ,business ,ComputingMilieux_MISCELLANEOUS ,Voiding Disorders - Abstract
To provide an adequate lifelong urological care in the complex period of adolescence, a transition consultation conducted by a paediatric surgeon and an urologist was developed in our institution. As a real rite of passage, it allows the follow-up and the adapted care of urological conditions, sometimes complex, and permits the transition between childhood and the world of grown-ups. We reported our experience at the Children Hospital of our institution (paediatric surgery and urology departments). During a 6 months period (January-July 2015), forty-five young adults with a mean age of 17.8±3.6 years were seen in transition consultation. Eight patients had neurogenic voiding disorders (4 spina bifida, 1 multiple sclerosis, 1 mitochondrial encephalopathy, 1 metachromic leucodystrophy, 1 paraplegia), 9 patients had idiopathic voiding disorders, 1 patient had a non obstructive malformative uropathy; and 30 patients had surgery during infancy and childhood: hypospadias in 17 young men and malformative uropathy in 13 patients. This consultation occurred within 4.6±4.5 years after the last consultation with paediatric surgeon. For 6 patients, the transition consultation was the first for the urological problem. After this consultation, 8 patients stayed in paediatric surgery and 37 patients were referred to adult urologist. Among those 8 patients: 2 patients had cognitive and psychiatric disorders; 4 patients refused to be transferred to adult unit; 2 patients wanted to come back at transition consultation. Among the 37 patients transferred in adult urological care: 6 patients had urological surgery, and one patient was referred to a sexology consultation. The remaining 30 patients have initiated long-term monitoring. All reconvened patients came back at the follow-up visit (at least 12 months follow-up). A 16-year-old patient (spina bifida with polymalformative syndrome) developed a depressive syndrome at the end of the consultation, in the motive of an awareness of the definitive nature of his handicap and the need of medical follow-up throughout his life. Transition consultation makes easier the passage from paediatric care to adult urological care. It allows a smooth change of interlocutors, facilitates subsequent care and improves compliance to medical follow-up. It requires a good collaboration between paediatric and adult care units. Transition responds to an increasing request of adolescents, families, and medical teams, since care rupture during adolescence can have functional and psychological consequences. Level of proof 4.
- Published
- 2017
50. Urologic Disorders are Still the Leading Cause of In-hospital Death in Patients With Spina Bifida
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Jacques Kerdraon, B. Peyronnet, F. Gao, Quentin Alimi, Camille Olivari, Xavier Gamé, Emmanuel Oger, Laurent Siproudhis, Sahar Bayat, Lucie-Marie Scailteux, Zine-Eddine Khene, Juliette Hascoet, Charlène Brochard, Guillaume Bouguen, C. Voiry, Frédéric Balusson, Andrea Manunta, M. Jezequel, CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), École des Hautes Études en Santé Publique [EHESP] (EHESP), Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Jonchère, Laurent, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), and CHU Toulouse [Toulouse]
- Subjects
Adult ,Male ,Urologic Diseases ,congenital, hereditary, and neonatal diseases and abnormalities ,Pediatrics ,medicine.medical_specialty ,Cross-sectional study ,Epidemiology ,Urology ,Bladder ,[SDV]Life Sciences [q-bio] ,Population ,030232 urology & nephrology ,MEDLINE ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,03 medical and health sciences ,0302 clinical medicine ,Cause of Death ,Medicine ,Humans ,Urinary ,Hospital Mortality ,Longitudinal Studies ,Mortality ,education ,Spina bifida ,Spinal Dysraphism ,Cause of death ,education.field_of_study ,business.industry ,medicine.disease ,Urological disorder ,[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,nervous system diseases ,3. Good health ,Hydrocephalus ,Death ,[SDV] Life Sciences [q-bio] ,Hospitalization ,Cross-Sectional Studies ,030220 oncology & carcinogenesis ,Needs assessment ,Observational study ,Female ,France ,business ,Needs Assessment - Abstract
International audience; Objective - To assess and analyze the contemporary causes of in-hospital deaths of spina bifida patients. Methods - It was a cross-sectional observational study of the longitudinal national cohort of all patients hospitalized in French public and private hospitals. We analyzed the data from the French hospital discharge database (Programme de Médicalisation des Systemes d'Information, PMSI) from 2009 to 2014. The number of in-hospital deaths was extracted using the combination of the ICD-10 codes "Q05" or "Q760" and a discharge code = 9. Results - There were 138 in-hospital deaths of spina bifida patients over the 6-year study period. The median age at death was 41 years (IQR: 25-52). The median age at death was significantly lower in patients with vs without hydrocephalus (26.6 vs 45.5 years; P
- Published
- 2019
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