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From 1974 to 1993, the authors admitted 212 patients with renal trauma to their department. A large proportion of these cases were due to skiing accidents. Based on a retrospective study of 78 patients admitted to the Grenoble urology department, the authors describe the features of this trauma. 91% of patients were males with a mean age of 27.5 years, with 9% of type III trauma. Treatment was surgical in 55% of cases. Total nephrectomy was performed in 21% of patients. Partial nephrectomy was performed in 25.5% of cases, with a morbidity of 45%, predominantly consisting of fistulas.

Xanthogranulomatous pyelonephritis is a rare disease that may mimic various renal lesions, especially renal tumors, in its focal form. We report a case of pseudoneoplastic xanthogranulomatous pyelonephritis in a young woman. This case is unusual, because it was diagnosed by a percutaneous renal puncture and furthermore total renal recovery was achieved by antibiotic treatment alone.

Surgical complications of renal transplantation, rejection and infectious diseases are factors contributing to poor renal graft survival. Factors directly concerning the donor can be involved in graft failure: age, medical history, causes of donor brain death. Urologic or arterial anatomic variations are often the source of difficult surgical conditions during renal transplantation. Technical errors during graft procurement must be avoided such as excess of traction or coagulation. Failure in perfusion preservation. As few renal grafts are available, it is thus essential to obtain optimal conditions to avoid failure in cadaver donor graft linked to technical errors during organ procurement.

Nephrectomy of a non-functioning renal transplant after renal transplantation is a delicate operation which the authors evaluate on the basis of a retrospective analysis of 62 patients. A review of the literature helps to more clearly define the indications, optimal time of the operation and the operative technique. A subcapsular approach, by simplifying the operation, constitutes an important factor in reducing the operative morbidity in the late forms. "Early" transplantectomies are often more serious because of the recently operated patient's fragile status and immunosuppression, responsible for frequent infectious complications. Transplantectomy should therefore not be delayed once the permanent loss of transplant function has been confirmed.

The emergency treatment of Fournier's and perineal gangrene is now well defined and is based on excision of the necrotic tissues and broad spectrum antibiotics combined with hyperbarid oxygen therapy and symptomatic resuscitation measures. However, several procedures have been described for the reconstruction of the excised zones. In the light of one case of Fournier's gangrene, the authors evaluate reconstruction of the penile skin by means of a helical split-skin graft. With a follow-up of one year, the morphological and functional result was excellent. The patient has normal erection and the suture line does not contain any retractile adhesions. The authors therefore consider that this simple, but little known procedure should be part of the urologist's therapeutic arsenal for reconstruction of the penile skin.

between 1982 and 1990, 73 children were operated for pyeloureteric junction syndrome (76 pyeloplasties). The authors distinguish between a group of 45 infants operated before the age of 2 years and a group of 35 children operated after the age of 2 years. 40% of these cases had been detected antenatally, which modified the management and treatment of these infants, operated at about the age of 6 months (mean: 6.6 months). Treatment was conservative (one nephrectomy out of the 41 infants operated: 2.4%). Pyeloplasty was performed according to the Anderson-Hynes-Küss resection-anastomosis technique under an operating magnifying glass. Early surgery offers the best chance of recovery. Urinary tract drainage was not systematic in these infants (50% of cases) and did not affect the long term results. Early complications and surgical revisions (3.9%) were not more frequent in the infants operated earlier. The definitive results were good in 88.5% of cases, while 7.2% of cases required further surveillance. Renal parenchymal lesions (4.3%) were related more to pyelonephritis than to failure of surgery. Overall, a conservative surgical approach is recommended, except in minor syndromes which require rigorous surveillance.

Piezo-electric shock wave lithotripsy was successfully performed in 20 patients out of 25 presenting with distal ureteral stones. Echographic adjustment of the stone remains the very most important point of the technique. The treatment is non invasive, doesn't require any in-hospital stay and displays good tolerance.

Between 1985 and 1988, 156 organs were harvested using a multiorgan procurement technique (MPO) in the Urology Dept of Grenoble University Hospital (50 MOP). All the organs transplanted either in Grenoble or in other centers have been followed up after transplantation to try to appreciate their value and function. The surgical procedure is described, and results, organ by organ, are given. The conclusion is that the MOP technique is perfectly usable and reliable without jeopardizing any of the transplanted organs.

We present here four cases of adult prostatic utricules, and discuss the endoscopic or surgical treatment. A brief embryological and clinical summary allows a better understanding of this malformation. Therapeutic indications are reviewed and transtrigonal approach is described. We think that this surgical procedure gives better results and less morbidity.