Prog Urol
-
To define vulvodynia and to describe the main approaches to treatment. ⋯ Many unknowns persist especially concerning the aetiology of vulvodynia. Evaluation of symptoms and treatment have not been clearly defined. However, symptomatic management provide satisfactory long-term results.
-
Chronic postoperative pain has been defined as pain arising after a surgical operation, present for at least 2 months, with no organic (active cancer or chronic infection) or preexisting cause. The purpose of this article is to review the risk factors and prevention of chronic postoperative pelvic and perineal pain. ⋯ A good knowledge of the risk factors and appropriate prevention can decrease the incidence and consequences of chronic postoperative pain.
-
Chronic pelvic and perineal pain can be related to a nerve lesion caused by direct or indirect trauma or by an entrapment syndrome, which must then be demonstrated by a test block. The purpose of this article is to review the techniques and modalities of somatic nerve block in the management of chronic pelvic and perineal pain. ⋯ Somatic nerve blocks are an integral part of the management of chronic pelvic and perineal pain and are predominantly performed under CT guidance in order to be as selective as possible. Once the diagnosis and the level of the nerve lesion have been defined, more specific therapeutic procedures can then be proposed.
-
The use of immediate postoperative and salvage radiotherapy in high-risk patients after radical prostatectomy for prostate cancer remains controversial. Immediate postoperative radiotherapy improves biochemical and clinical progression-free survival in randomised trials. ⋯ The adjunction of androgen deprivation therapy to immediate postoperative or salvage radiotherapy is only supported by retrospective data. The results of the ongoing, prospective, randomized trials will hopefully enable accurate comparison of immediate postoperative radiotherapy with salvage radiotherapy and assessment of the value of androgen deprivation therapy.
-
Open surgery for stones of the upper urinary tract has very few indications, failures or complications of other techniques, greater than 2cm stones, hard stones, anatomical abnormalities and complex stones. Open surgery for stone may be difficult and need specific tools. ⋯ The stone-free rate of open surgery is over 90%. The main complications are stenosis, fistula and infections.