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A case of venous extension de renal angiomyolipoma is reported. The diagnosis was established preoperatively by ultrasonography and renal CT. This tumour was treated conservatively by partial nephrectomy after selective embolization because of the presence of complete duplication.

We report the case of a young female patient who underwent dual segmentary pancreatic and renal transplantation in May 1990. The immediate post-operative course was marked by the peri pancreatic collections normally noted with this technique. However, a peculiarity was a long-lasting pseudocyst of the grafted tissue which could not be drained externally despite several attempts. This was compressing the splenic vein of the tissue, thereby causing a reflux. Fear of losing tissue functionality led us four and a half years later to perform an internal cysto-ileal derivation on a bowel loop. In this way, normal endocrine function of the pancreatic graft tissue has now been maintained for over a year.

When ureteral rupture is suspected after trauma with fracture of the pelvis, insertion of a suprapubic catheter is required as an emergency measure. Ureteral lesions must be repaired early by the 5th to 10th day after trauma. Pyelography or retrograde ureterography is required to determine whether there is total or partial rupture and the degree of damage is identified endoscopically. We operated 73 total ruptures in deferred emergency situations (58 transpubic, 14 perineal approaches) and achieved good results in 80%. There were also 41 partial ruptures treated with an indwelling catheter in which 21 developed strictures requiring secondary uretrotomy. In three particular situations (anorectal damage, infected perineal wound, polytrauma with head trauma), in 8 patients were managed with suprapubic drainage alone before repair 3 months later. Different complications, including stricture and impotency were observed.

A series of 136 bladder replacements using colon tissue was performed after total prostacystectomy for cancer of the bladder. Sixty-four Bordeaux-type ileocecal replacements were performed. The first bladder Bordeaux-type was created in March 1985. The technique involves detubulization of an ileocecal segment using 15 cm of the right colonic segment submucally according to the Goodwin technique. Uretral anastomosis uses the lower most portion of the cecum. Ileocecal anastomosis is performed manually or using a biofragmenting ring with terminoterminal junction as in the last 12 patients. After a follow-up of 1 to 8 years, 39 patients were evaluated for long-term results. The notion of need was obvious. Daytime continence was achieved in all patients. Night-time continence was achieved in 75% including several patients who had nocturnal mictions. Bladder filling occurred at low pressure with peaks from 5 to 20 cm H2O. Bladder capacity varied from 300 to 400 cc. Mean urinary flow was 21 ml/s. No cases of diarrhea were observed. Radiotransparent and asymptomatic bladder stones were seen in two cases. Mean corpuscular volume, vitamin B12 and folic acid levels were normal in 3/4 patients. No cases of elevated chloride were observed and no cases of oxaliuria occurred. Bladder Bordeaux-type construction offers a functional volume similar to the normal bladder with good metabolic tolerance, remarkable good stability over time and no deterioration of the upper urinary system.