The study findings showed no adverse impact from previous infliximab therapy on the laparoscopic IPAA postoperative course.

Aphallia is a rare genital anomaly poorly reported in literature. The authors describe an atypical case of aphallia characterized by ultrasound and magnetic resonance imaging findings of atrophic cavernous corpus associated with anterior urethral opening. Aphallia is a complex malformation, featuring various anomalies which should be assessed before electing a specific treatment.

Urodynamic parameters and satisfaction were recorded after micturition in the seated position versus the standing position with a single-use device (P-Mate) in healthy women. Healthy adult women were recruited. Eligibility criteria were: no past urological history and no urological symptoms. Volunteers were given four P-Mates to use during a week and a satisfaction questionnaire to fill. After this trial week, they were invited to perform four flowmetries, two in the seated position and two standing up, with the P-Mate. Seated and standing flowmetry parameters were compared (by paired t-test). Twenty women completed the study. There was no difference in the maximum flow rate (Qmax), voided volume and post-void residual (PVR) in the standing versus the seated position. In terms of Qmax and PVR in healthy women, urinating standing up was as efficient as in the seated position. A majority of participants were satisfied with the device.

A 27-year-old patient was investigated after an upper gastro-intestinal tract obstruction. Computed tomography and endoscopy showed a large gastric trichobezoar with a duodenojejunal tail. Conservative treatments failed to remove the bezoar. We performed a short laparotomy which allowed the removal of the bezoar through a longitudinal gastrotomy. Postoperative course was uneventful.

First, I thank Professors Hanisch and Zioga for their interesting comments on our work. The multifactorial etiology of inflammatory bowel diseases implies that before long, their treatments will not be purely pharmacologic. Indeed, even if anti-tumor necrosis factor-a (anti-TNFa) drugs are of major interest for their management, to date they have not proven their efficiency in reducing the restorative proctocolectomy rate in the course of ulcerative colitis [1].Surgical treatment then is meant to be part of the therapeutic options for a long time to come. In addition, surgery also allows prevention of the most serious long-term complication of ulcerative colitis, which is neoplasia. However, it is a complex procedure, requiring a large experience in colorectal surgery and laparoscopy. It brings major consequences to patients' quality of life, including incontinence and low fertility for women [2].As mentioned by Professors Hanisch and Zioga, our study aimed to assess the consequences of pharmacologic and surgical treatments used on the same patient. This occurrence still is frequent, given the complementarities of these treatments. Anti-TNFa drugs interact with inflammatory processes, interfering with immunity and wound-healing mechanisms. Questions about their safety in a possible surgical context were legitimate. Our study, taking its statistical weakness into account, seems to confirm it. Still, it seemed important to underscore the need for precautions in this multimodal strategy, sometimes using means with theoretical antagonisms. Disclosures B. Coquet-Reinier and S. V. Berdah have no conflicts of interest or financial ties to disclose.References 1. Aratari A, Papi C, Clemente V, Moretti A, Luchetti R, Loch M, Capurso L, Caprilli R (2008) Colectomy rate in acute severe ulcerative colitis in the infliximab era. Dig Liver Dis 40:821-826 2. Cornish JA, Tan E, Teare J, Teoh TG, Rai R, Darzi AW, Paraskevas P, Clark SK, Tekkis PP (2007) The effect of restorative proctocolectomy on sexual function, urinary function, fertility, pregnancy, and delivery: a systematic review.