Search results for "Continent Urinary Diversion"

Long-term results of ileocecal continent urinary diversion in patients treated with or without previous pelvic irradiation

2003

Purpose: Patients who receive pelvic irradiation may require urinary diversion to manage complications resulting from progressive malignancy or radiotherapy. The choice of urinary diversion is an important issue and remains controversial. We characterized the long-term outcome of urinary diversion with a continent ileocecal reservoir in patients who received pelvic irradiation versus those who underwent urinary diversion without previous irradiation. Materials and Methods: Continent urinary diversion with an ileocecal reservoir (Mainz pouch 1) was performed in 36 irradiated patients in a 9-year period. Morbidity, mortality, the reoperative rate and parameters associated with the surgical pr…

Metabolic Evaluation of 94 Patients 5 to 16 Years After Ileocecal Pouch (Mainz Pouch 1) Continent Urinary Diversion

2003

PURPOSE In continent urinary diversion metabolic disturbances may be encountered in long-term followup. We evaluated metabolic consequences in patients with a minimum followup of 5 years after Mainz pouch 1 urinary diversion.At our institution continent urinary diversion using the ileocecal segment was performed between 1983 and 1995 in 458 patients. A total of 94 patients with an ileocecal pouch for a minimum of 5 years were reevaluated for metabolic changes. Median followup was 9.0 years. Routine laboratory parameters, blood gas analysis, vitamin B12, vitamin D25, cross-laps, bone specific alkaline phosphatase, osteocalcin and propeptide of type I collagen were obtained. Bone density was …

Rhabdomyosarcoma of the bladder, prostate or vagina: the role of surgery

2003

Rhabdomyosarcoma of pelvic organs is not common enough for many people to develop large series. However, the authors from Mainz retrospectively analysed 107 children with this condition, and suggest that primary chemotherapy followed by radical surgery yields excellent cure rates. OBJECTIVE To retrospectively analyse the outcome of children with rhabdomyosarcoma (RMS) of the bladder, prostate or vagina who were treated with chemotherapy, with or without radical surgery or additional radiotherapy, at our institution since 1968. PATIENTS AND METHODS From a total of 107 children with RMS seen between 1968 and December 2001, 22 (mean age 5.9, range 0.5–18) had RMS of bladder/prostate or vagina.…

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…

Mainz Pouch for Augmentation Bladder Substitution or Continent Urinary Diversion

1988

Kontinente Harnableitung und Schwangerschaft

1995

We report on our experience with 7 pregnancies in 6 women who previously underwent reconstruction of the urinary tract with a continent urinary diversion using an ileo caecal segment (Mainz-Pouch I), ureterosigmoidostomy or bladder augmentation. Urinary tract infection and upper tract dilatation were the only complications during pregnancy which required bilateral nephrostomies in one case. All other sequelae were handled conservatively. The continence mechanisms were not compromised during pregnancy or delivery. Deliveries were vaginal in two cases and by Caesarean section in five. All seven newborn were healthy. Pregnancy is not contraindicated after any type of urinary diversion includin…

Quality of Life and Health in Patients with Urinary Diversion: A Comparison of Incontinent versus Continent Urinary Diversion

1997

Objective: To compare the quality of life and health in patients with incontinent and continent urinary diversions, in correlation with the initial diagnosis, diversion-related symptoms, psychological status and employment status. Materials and Methods: 81 patients (64% male and 36% female) with a mean age of 55 years (18-65 years) were included in this retrospective study. A total of 27 had an incontinent urinary diversion (group A) and 54 a continent diversion (group B). The initial diagnosis was malignant tumor in 75% (n = 61) and nontumor disease in 25% (n = 20). A structured interview and psychometric instrument assessment of the quality of life as well as somatic and psychological sym…

100 cases of Mainz pouch: continuing experience and evolution.

1988

The surgical technique for creation of the Mainz pouch uses 10 to 15 cm. of cecum and ascending colon and 2 ileal loops of the same length for construction of a urinary reservoir. Initial applications of the Mainz pouch were for bladder augmentation after subtotal cystectomy and for continent urinary diversion. Current indications have been extended to complete bladder substitution after radical cystoprostatectomy with anastomosis of the pouch to the membranous urethra. For cosmetic reasons the umbilicus is used as a stomal site for continent urinary diversion, and the technique of intussuscepting the continence nipple has been modified accordingly. A total of 100 patients underwent a Mainz…

Extent of Surgery in Rhabdomyosarcoma of Urogenital Structures

1989

After high inguinal semicastration in group-1 paratesticular rhabdomyosarcoma (RMS), the patient having undergone chemotherapy can be followed closely by CT scanning without retroperitoneal lymphadenectomy. In contrast, retroperitoneal RMS should be operated on as radically as possible after downstaging the tumor mass. In RMS of the female genitalia locally limited organ-preserving surgery is the method of choice. The prognosis is excellent with adjuvant chemotherapy. Only 20% of all bladder RMS arise from the bladder dome or the movable part of the bladder, where primary partial resection including a safety margin of 3 cm of healthy tissue is possible. The majority, however, arising from t…

Social integration, sexual behavior and fertility in patients with bladder exstrophy--a long-term follow up.

1996

After primary bladder closure or urinary diversion, other factors apart from the reconstruction itself gain importance for individuals with the exstrophy-epispadias complex: social integration and, after reaching puberty, sexuality and fertility. Between 1968 and July 1994 115 patients with bladder exstrophy or incontinent epispadias underwent surgery at our institution. A total of 104 patients could be followed, 2 of whom died in the meantime. Of the remaining 102 patients 48 attend school, 4 are in college, 40 have completed or are currently undergoing vocational training, 3 are unemployed, 1 lives in a therapeutic centre and 6 are younger than 6 years of age. A total of 95% of the patien…