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To report the multi-institutional outcomes of Microperc for nephrolithiasis and to assess its feasibility in outpatient care.We retrospectively identified all adult patients who underwent Microperc for renal stones at three centres between May 2015 and March 2021. Interventions were performed by three Surgeons. One Surgeon adopted a "one-way" strategy and all Microperc were performed on an outpatient basis, while the other two Surgeons provided inpatient monitoring for at least one day after surgery. The primary endpoint was same-day discharge after Microperc without emergency department visits or unplanned readmission within 30 days of the procedure. The secondary endpoints included treatment outcomes and the 30-day complication rate.Out of 72 consecutive patients included, 32 patients (44.4%) had same-day discharge. Median Charlson score (1 [0-2]) and cumulative stone size (15 [12-20] mm) were comparable between both groups. At one month post procedure, 32 patients (44.4%) were stone free and 23 patients (32%) had residual micro-fragments3mm, conferring an overall success rate of 76.4% (inpatient Microperc group: 77.5% vs outpatient Microperc group: 75%, P=1). Analysis of the 30-day complication rate showed similar results between the two groups (Clavien I-II: 18.1%, Clavien≥III: 4.1%). After outpatient care, the rate of immediate admission and unplanned readmission was 12.5% (n=4), mainly due to urinary tract infection.In this multi-institutional study, we report that outpatient Microperc is feasible in selected patients with no significant impact on postoperative outcome.

Resumen Introduccion Nuestro objetivo ha sido informar de los resultados oncologicos de pacientes con ERET y antecedentes de neoplasias urologicas que fueron sometidos posteriormente a un trasplante renal (TR). Material y metodo Estudio retrospectivo llevado a cabo en el registro de la Fundacion Puigvert (Barcelona) con 1.200 TR realizados entre 1988 y 2018. Se identificaron 85 neoplasias urologicas que recibieron tratamiento previo al TR en 81 pacientes: 15 (18%) canceres de prostata, 49 (58%) carcinoma de celulas renales (CCR), 19 (22%) carcinomas uroteliales y 2 (2%) canceres de testiculo. Se registraron datos de las caracteristicas basales, la estadificacion del cancer, el tratamiento y el seguimiento, y sobre la cronologia del inicio de dialisis, la inscripcion en la lista de espera y el TR. Los criterios de valoracion fueron la recidiva del cancer, la progresion metastasica, la muerte especifica por cancer y la supervivencia global. Resultados En una mediana de seguimiento de 13,1 anos (2,2-32), se registraron 16/85 (19%) recidivas del cancer, con 3 (4%) progresiones a metastasis y muerte por cancer. La mediana de supervivencia global tras el tratamiento del cancer fue de 25,3 anos y la supervivencia por cancer especifica fue del 95% a los 25 anos. La mediana de tiempo desde el tratamiento del cancer hasta el trasplante de rinon fue de 4,8 anos: 3,7 anos en el cancer de prostata, 3,9 anos en el CCR y 8,8 anos en el cancer vesical. La mediana de tiempo desde el inicio de dialisis hasta el TR fue de 1,8 anos en los pacientes con antecedentes de neoplasia urologica, frente a 0,5 anos en la cohorte total de 1.200 trasplantes renales durante el mismo periodo. Conclusiones Los pacientes con antecedentes de neoplasias urologicas bien seleccionados se pueden beneficiar enormemente del trasplante de rinon con una recidiva del cancer tardia y poco frecuente. Para el cancer de prostata de bajo riesgo y el CCR, podria optimizarse el tiempo de espera, pero se necesitan datos mas solidos en este contexto.

INTRODUCTION Among trauma emergencies, kidney damage is uncommon. The urologist is frequently on the second line in the management of patients with multiple traumatic lesions. Knowledge of treatment is necessary to be able to integrate the different teams involved in an approach that is both vital in the context of damage control and functional with a concern for parenchymal preservation. METHODS A systematic review of the literature was carried out using the Medline database in order to identify the most relevant articles in English and French. RESULTS Kidney trauma occurs either by direct shock or by a deceleration mechanism. They are classified by severity according to the AAST classification. Management is mostly conservative by avoiding surgery and controlling bleeding by arterial embolization. Surveillance checks for complications occurrence in high-grade trauma. Traumatic dissection of the renal artery, with a poor functional prognosis requires a short delay before treatment. CONCLUSION The prognosis for trauma to the kidney, regardless of the grade, is currently good, with improvements of effective resuscitation and embolization in the event of bleeding.

Resume Introduction Les complications emaillant un traumatisme du rein et de l’uretere sont directement dans le domaine de l’urologue. Si celles-ci viennent au second plan dans le pronostic vital, une bonne connaissance de ces pathologies est essentielle. Methodes Une revue systematique de la litterature a ete effectuee en utilisant la base Medline afin de degager les articles les plus pertinents en langue anglaise et francaise. Resultats L’extravasation urinaire dans le cadre des traumatismes fermes du rein a un bon pronostic fonctionnel. L’alteration de la fonction du rein traumatise est liee aux lesions vasculaires associees au grade IV. La surveillance est le traitement de choix avec une prise en charge differee en cas de degradation septique ou douloureuse. Les lesions de l’uretere sont majoritairement iatrogenes. Si les lesions incompletes peuvent etre traitees par endoscopie, les lesions completes (stenose ou plaie) requierent une intervention chirurgicale. Les lesions de l’uretere distal, les plus frequentes sont facilement traitees par reimplantation uretero-vesicale. Les larges pertes de substance peuvent necessiter un remplacement ileal. Conclusion Les traumatismes fermes du rein occasionnant une extravasation urinaire, d’excellent pronostic sont traites de maniere conservatrice. A l’inverse, les lesions de l’uretere necessitent dans la majorite des cas une intervention de remise en continuite.

To evaluate the feasibility, efficiency, and predictive factors of therapeutic success of Vibration, Diuresis and Inversion (VDI) therapy for the removal of upper urinary tract stones.It is a retrospective, single-center study at the CHU - La Conception, Marseille, France including all patients treated with VDI from 2013 to 2018. VDI was indicated for stones6mm in first-line treatment or for residual fragments6mm after ureteroscopy, PCNL, microPCNL. The protocol included 4 sessions in outpatient care from 2013 to 2015 then 6 sessions from 2015 to 2018 and a final radiological evaluation.In total, 109 patients or 489 sessions are reported: median age was 55 years [14-84], median BMI 25kg/mVDI is a simple, non invasive and well tolerated technique for the elimination of small renal lithiasis after SWL, ureteroscopy, PCNL or as a first-line treatment.

International audience; Objective: To report the nature, diagnosis and therapeutic strategy of infectious emergencies in urology.Material and methods: Bibliographic research from Pubmed, Embase, and Google scholar in July 2021. A synthesis of the guidelines of national infectious diseases societies.Results: Urosepsis and complicated urinary tract infection have a standardized definition. Diagnosis and therapeutic strategy are presented for upper tract urinary infection, male urinary infection, healthcare associated urinary infection, symptomatic canduria and urinary infections of the elderly. Appropriate antibiotherapy should be tailored to the degree of severity, bacterial ecosystem, patient characteristics et localization of the infection.Conclusion: Urinary infections can be critical and require immediate care. Knowledge of the guidelines and of appropriate diagnosis and therapeutics strategy improve care which should be rapidly applied, and collegial.; ObjectifRapporter la nature, les stratégies diagnostiques et thérapeutiques des urgences infectieuses en urologie.Matériel et méthodeRecherche bibliographique à partir de Pubmed, Embase et Google Scholar en juillet 2021. Synthèse des recommandations nationales du comité d’infectiologie de l’AFU (CIAFU) et de la Société de Pathologies Infectieuses de Langue Française (SPILF).RésultatsL’urosepsis et sepsis urinaire grave répondent à des critères diagnostiques stricts. La prise en charge infectieuse diagnostique et thérapeutique des pyélonéphrites graves, infections urinaires masculines graves, infections urinaires associées aux soins, candiduries symptomatiques et infections urinaires chez la personne âgée sont décrites. L’antibiothérapie doit être adaptée à la gravité, l’écologie bactérienne, aux particularités du patient et au site d’infection.ConclusionLes infections urinaires peuvent être graves et nécessitent une prise en charge en urgence. La connaissance des recommandations et des stratégies diagnostiques et thérapeutiques adaptées aux diverses présentations permet une optimisation de la prise en charge qui doit être la plus rapide possible, et collégiale.