Sacral neuromodulation seems to constitute a serious therapeutic option for patients with neurogenic lower urinary tract dysfunction. However, its results depend on the type of the underlying neurologic disease and in particular, whether it may progress or not.

Chaabane W, Praddaude F, Buleon M, Jaafar A, Vallet M, Rischmann P, Galarreta CI, Chevalier RL, Tack I. Renal functional decline and glomerulotubular injury are arrested but not restored by release of unilateral ureteral obstruction (UUO). Am J Physiol Renal Physiol 304: F432-F439, 2013. First published December 5, 2012; doi:10.1152/ajprenal.00425.2012.-Murine unilateral ureteral obstruction (UUO), a major model of progressive kidney disease, causes loss of proximal tubular mass and formation of atubular glomeruli. Adult C57BL/6 mice underwent a sham operation or reversible UUO under anesthesia. In group 1, kidneys were harvested after 7 days. In group 2, the obstruction was released after 7 days, and a physiological study of both kidneys was performed 30 days later. Renal blood flow (RBF), glomerular filtration rate (GFR), urine protein, and albumin excretion were measured after ligation of either the left or right ureter. Glomerular volume (periodic acidSchiff), glomerulotubular integrity and proximal tubular mass (Lotus tetragonolobus lectin), and interstitial collagen (Sirius red) were measured by histomorphometry. Obstructed kidney weight was reduced by 15% at 7 days but was not different from sham after a 30-day recovery. Glomerular volume and proximal tubular area of the obstructed kidney were reduced by 55% at 7 days, but normalized after 30 days. Interstitial collagen deposition increased 2.4-fold after 7 days of UUO and normalized after release. However, GFR and RBF were reduced by 40% and urine albumin/protein ratio was increased 2.8-fold 30 days after release of UUO. This was associated with a 50% reduction in glomerulotubular integrity despite a 30-day recovery (P Ͻ 0.05 for all data). We conclude that release of 7-day UUO can arrest progression but does not restore normal function of the postobstructed kidney. Although the remaining intact nephrons have hypertrophied, glomerular injury is revealed by albuminuria. These results suggest that glomerulotubular injury should become the primary target of slowing progressive kidney disease. glomerular filtration rate; albuminuria; renal hypertrophy; atubular glomeruli; proximal tubule; fibrosis PARENCHYMAL LOSS AND PROGRESSIVE interstitial fibrosis are common features of chronic kidney disease (23). Unilateral ureteral obstruction (UUO) is the animal model most widely used to study the development of tissue damage and fibrosis. In addition, release of obstruction permits examination of renal repair (for a review, see Ref. 5). The renal impact of UUO varies with animal species, and until the past decade rabbits, dogs, and rats have been mostly used (21). However, most studies are currently performed in mice, which offer a variety of genetically engineered animals (9, 12, 16). Because of its technical difficulty, the use of reversible models of UUO in mice remains limited and little information is available regarding the renal functional impact of UUO and its relief. As in humans, most species exhibit a compensatory renal growth of the nonobstructed kidney ...

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Objectif : Le but de cette étude était de comparer les résultats de la débitmétrie et de la mesure du résidu postmictionnel (RPM) par échographie sus-pubienne au ressenti du patient évalué à l'aide d'une échelle visuelle analogique (EVA). Matériel et méthodes : Une étude prospective a été menée auprès de 31 patients (26 hommes et cinq femmes) âgés en moyenne de 63,74 ± 12,37 ans ayant consulté en urologie pour des troubles urinaires du bas appareil. Tous les patients ont eu une débitmétrie ainsi qu'une mesure par échographie du RPM. Les données étudiées étaient : l'âge, la présence d'une maladie neurologique, les antécédents chirurgicaux, le débit maximum (Q max ), le volume uriné, le RPM mesuré par échographie, les données de l'EVA concernant la force du jet urinaire (EVA Q max ) et le RPM (EVArpm). Résultats : Les résultats de l'EVA du jet urinaire maximal n'étaient pas statistiquement corrélés au débit maximum (Q max /EVA Q max : r2 = 0,005993 ; IC 95 % : -0,2911 à 0,4259 ; p = 0,6843). Une sensation de mauvaise vidange vésicale était exprimée chez dix parmi les 31 patients. Le résultat de l'autoévaluation par EVA était statistiquement corrélé au volume du RPM (r2 = 0,1485 ; IC 95 % : 0,02184 à 0,6589 ; p = 0,039). Aucune corrélation n'a été trouvée entre la dysurie (Q max < 15 ml/s) et la sensation de mauvaise vidange vésicale. Il n'y avait pas de lien statistique entre l'autoévaluation de la force du jet urinaire et celle de la vidange vésicale. Conclusion : L'intensité du trouble mictionnel tel qu'il est vécu par le patient est très différente de la réalité urodynamique. Une évaluation plus fine des symptômes, combinée éventuellement à des moyens de mesures non invasifs, pourrait améliorer la prise en charge de ces patients. Pour citer cette revue : Pelvi-Périnéologie 6 (2011). Mots clés Échelle visuelle analogique (EVA) · Débitmétrie · Résidu postmictionnelAbstract Objective: The purpose of this study was to compare uroflowmetry and ultrasound postvoid residue measurement results of data collected with patient feelings recorded through a visual analogue scale (VAS). Material and methods: Thirty-one patients, 26 men and five women, mean age 63.74 ± 12.37 years, consulting in urology for lower urinary tract symptoms were enrolled in a prospective study. All patients had an uroflowmetry and an ultrasound postvoid residue (PVR) measurement. Selfassessment by VAS of the strength of urinary stream and the feeling of complete bladder voiding were performed in all patients. Data collected were age, presence of a neurological disease, previous surgery, maximum flow rate (Q max ), voided volume, postvoid residue, VAS results of the strength of the urinary stream (VAS Q max ), and postvoid residue (VASrpm). Results: Maximum flow rate VAS results were not correlated to the maximum flow rate (Q max /VAS Q max : r2 = 0.005993; W. Chaabane (*) Service de chirurgie générale et d'urologie, centre hospitalier Montauban, 100, rue Léon-Cladel,