Search results for " urinary diversion"
showing 7 items of 37 documents
The mainz-pouch (mixed augmentation ileum 'n zecum) for bladder augmentation and continent diversion
1985
The ideal urinary reservoir constructed from bowel material should be a low-pressure system with a high capacity, capable of preventing upper tract deterioration resulting from ureteral obstruction or reflux. It should achieve reliable control of continence and assure easy emptying of the reservoir. In the Mainz-pouch, the combination of cecum and ileum, the latter of which is able to absorb pressure waves created by the cecum, produces a low-pressure system with a high capacity immediately postoperatively. By incorporating large bowel in our pouch, ureteral implantation can be done using a simple and reliable standard antireflux technique with a submucosal tunnel. The Mainz-pouch has been …
Acid-Base Balance after Continent Urinary Diversion in Childhood – Risk of Imbalance Despite Medication
2010
Purpose Continent urinary-intestinal diversion can lead to alterations of the acid-base balance, acutely and chronically, the latter possibly causing bone demineralization. Annual check-ups have therefore been recommended for decades. Material and Methods At our institution, 89 children underwent continent urinary diversion by ileocecal pouch or bladder substitution between 1984 and 2006. In 58 of these patients (age 3-17 y., median 13.9 y.), we performed a minimum of 3 (range 3-23, median 6.2) consecutive annual blood-gas analyses over a follow-up period of up to 23 years (median 11.0) after surgery. At a base excess (BE) (as marker of the acid-base-balance) value below -2.5 mmol/l, treatm…
Vitamin B12 Deficiency in Children after Continent Urinary Diversion by Mainz Pouch Technique
2010
Purpose MAINZ pouch I urinary diversion provides a high-capacity, low-pressure reservoir. The use of terminal ileum can cause a decrease of vitamin B12 levels. Symptoms caused by vitamin B12 deficiency are rare, but some are irreversible, therefore annual check-ups are recommended. In this study the vitamin B12 levels in the above patients were analyzed in retrospect. Material and Methods The ileocecal segment was used for urinary tract reconstruction in > 80 children ≤17 years of age. B12 levels were determined at various time points within up to 21 years after surgery in 63 patients (8 with ileocecal bladder substitution, 55 continent cutaneous diversion). B12 values below 200pg/ml were c…
Mainz Pouch II technique: 10 years’ experience
2004
In this section, the use of the Mainz Pouch II is examined in some detail, from Mainz (where it originated), and from London. Both groups of authors found the procedure to be valuable and helpful, and critically assess the results and complications. OBJECTIVE To report the long-term results with the Mainz Pouch II procedure. PATIENTS AND METHODS Between 1990 and 2000 a Mainz Pouch II ureterosigmoidostomy was used in 123 patients (49 females and 74 males, mean age 43.6 years, range: 1–73). The indications for urinary diversion were cystectomy for bladder cancer in 92 patients, bladder exstrophy and/or incontinent epispadias in 26, irreparable traumatic loss of the sphincteric urethra in four…
Appendiceal continence mechanisms in continent urinary diversion.
1996
The creation of a safe, reliable, and easy-to-perform continence mechanism remains one of the most important problems during continent urinary diversion. The advent of the use of the appendix as an efferent segment brought through the umbilicus has greatly facilitated surgical procedures with very favorable results. Our experience with the insitu appendix as an efferent segment during continent cutaneous urinary diversion using the Mainz-pouch I technique over the past 6 years revealed a markedly decreased complication rate of 3.2% as compared with 7.2% in patients who received an ileocecal intussusception nipple. The routine use of the appendix as a continence mechanism during continent ur…
Applications of Ureterosigmoidostomy in Bladder Exstrophy
1999
Until 1994, 95 patients with bladder exstrophy and 20 with incontinent epispadias were operated upon at our department. During the last years more and more exstrophycripples were referred to our institution after primary treatment elsewhere. Thus a total of 56 of the 104 patients had a secondary treatment after failure or unsatisfactory treatment. In contrast to many other institutions, our standard procedure was primary ureterosigmoidostomy and, since 1990 it is completely replaced by a modification of it, the sigma rectum pouch (Mainz Pouch II). After failed primary bladder closure and in patients with short or pathological ureters or insufficient anal sphincter function, we prefer an ile…
Nastanak i liječenje gigantskih kamenaca ileocekalnog urinskog spremnika u pacijenta liječenog cistektomijom zbog intersticijskog cistitisa: prikaz s…
2021
Cilj: Cilj ovoga rada je prikazati pacijenta s intersticijskim cistitisom u kojega je došlo do stvaranja kamenaca u novoformiranom urinskom spremniku. Prikaz slučaja: Pacijent star 48 godina obrađivan je zbog recidivnih infekcija mokraćnog sustava. Prethodno mu je zbog intersticijskog cistitisa, koji je znatno utjecao na njegovu kvalitetu života, učinjena cistektomija uz oblikovanje urinskog spremnika (Mainz-pouch I). Urološkom obradom pronađena su u području urinskoga spremnika dva velika kamenca dimenzija 77 × 74 mm te 76 × 62 mm uz obostranu hidronefrozu. Kako bi se riješio uzrok rekurentnih urinarnih infekcija, učinjena mu je otvorenim pristupom ekstrakcija oba kamenca. Poslijeoperacijs…