Search results for "Continent"
showing 10 items of 598 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 …
Continent diversion with the Mainz pouch.
1996
From 1983 until July 1994, 561 patients in 2 urology departments (Mainz and Wuppertal) underwent a Mainz pouch 1 procedure. The Mainz pouch 1 was used for bladder augmentation in 60 patients, for orthotopic bladder substitution in 61 patients, and for continent cutaneous urinary diversion in 440 patients. In the group of continent cutaneous urinary diversion, the continence mechanism applied was an ileal intussusception nipple in 270 patients, an appendix stoma in 146 patients, a submucosal seromuscular bowel-flap tube in 14 patients, and a submucosal full-thickness bowel-flap tube in 10 patients. Indications for urinary diversion were bladder cancer in 339 patients, anatomical or functiona…
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…
Orthotopic bladder augmentation and substitution.
1999
Orthotopic bladder augmentation or substitution using intestinal segments has become a standard procedure for many disorders that cause a loss of functional or anatomical bladder capacity. From the technical point of view, reservoir configuration by detubularizing the intestinal segments is the general practice. Various techniques exist, depending which types of segments and which techniques of ureteral implantation are used. Common problems include urinary incontinence, retention, metabolic disorders, and the possibility of secondary malignancies. As a result, research has been conducted into utilizing tissues other than intestine for bladder augmentation or substitution.
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…
Urinary diversion and reconstruction.
2000
Orthotopic bladder augmentation and substitution has been established as the standard procedure for urinary diversion in many institutions, with current studies reporting mainly on continence rates and procedure-associated complications, such as the risk of impairment of neobladder function by local tumor recurrences in the small pelvis. Similarly, in other types of continent diversion, such as continent cutaneous diversion and rectal reservoirs, current interest is primarily directed towards minimization of surgery-associated complications.
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…
Contribución al conocimiento de los moluscos del Pleistoceno Inferior del yacimiento de Barranco León (Cuenca de Guadix-Baza)
2020
Se exponen los resultados obtenidos en el análisis de la asociación malacológica de dos muestras pertenecientes a la capa D del yacimiento del pleistoceno inferior de Barranco León (Cuenca de Guadix-Baza). Los principales resultados obtenidos son la relación de especies que componen la asociación malacológica y su abundancia relativa, que indican su marcado carácter acuático. Por otra parte, pese a las limitaciones impuestas por la escasez de información tafonómica y la cautela que sugieren ciertos indicadores, se aporta, a partir del análisis de las exigencias ecológicas de cada taxón, una interpretación paleoambiental sobre las condiciones existentes en el momento del depósito. Éstas corr…