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Purpose: At the time of castration resistance, it is recommended to realize hormonal manipulations before chemotherapy. We evaluated the impact of a switch from GnRH agonist to antagonist in patients with castration-resistant prostate cancer on PSA and testosterone levels at 3 months., Methods: Retrospectively, 17 patients from 5 different centers undergoing androgen deprivation therapy and presenting rising PSA confirmed on 3 blood samples 2 weeks apart and despite a castrate testosterone level (<0.5 ng/ml) were reviewed. Antiandrogen withdrawal syndrome had been tested before the switch. Degarelix was administered as followed: 240 mg for the first injection and then 80 mg every month, subcutaneously. We evaluated the PSA and testosterone level variation 3 months after the switch. Patients who experienced a variation in PSA of less than 10% compared to the baseline or who had a more than 10% PSA decrease were defined as responders., Results: Mean PSA level at the switch was 34.3 ± 50.3 ng/ml, with a mean testosterone level of 0.21 ± 0.13 ng/ml. Three months after the switch, mean PSA level was 59.9 ± 81.6 ng/ml (P = 0.061), with a mean testosterone level of 0.19 ± 0.08 ng/ml (P = 0.086). At 3 months, 4 patients (23%) responded to therapy. Thirteen patients (77%) experienced a rise in PSA of more than 10% compared to baseline; 41% of patients decreased their testosterone level. The limitations of this study are its retrospective nature and the limited number of patients., Conclusion: Switch from an agonist to an antagonist of GnRH has a limited impact on PSA at 3 months in castration-resistant prostate cancer patients.

Aim: The objective of the study was to analyse the results of a transurethral resection of the prostate (TURP) or a transurethral incision of the prostate (TUIP) performed immediately after kidney transplantation., Material: For the patients who had undergone a transurethral surgical procedure immediately following a renal transplantation, their files were systematically reviewed. Depending on prostate volume, TURP or TUIP was performed. The preoperative assessment included past medical history, clinical examination, retrograde cystography and PSA., Results: Among the 256 patients having had a renal transplantation between 2001 and 2006, 12 TURP and eight TUIP were done. The procedure was performed 15.2 days (10-30) after the transplantation. The average day of urethral catheter removal was 3.1 days (2-15) after the transurethral procedure. Mean postoperative maximum flow rate was 22.1 ml/s (18-33) and postvoiding residual urine volume was not significant. One patient suffered from two acute urinary retentions that were treated by temporary intermittent self-catherization. Four patients were diagnosed with acute prostatitis. The procedure for benign prostatic hyperplasia did not alter renal function. With a follow-up of 34.2 months (12-73), 18 patients had no urologic symptoms with a mean IPSS score of 4 (3-6)., Conclusion: TURP or TUIP gives good results immediately following a renal transplantation.

Ureterohydronephrosis of the lower segment in a context of ureteric duplication is a rare entity and is usually associated with vesicoureteric reflux. The authors report the case of a 35-year-old woman with giant ureterohydronephrosis of the lower segment secondary to partial ureteric duplication due to primary megaureter discovered in a context of infection. After primary percutaneous drainage of the collection, treatment consisted of partial nephrectomy with preservation of the good quality upper segment.