Search results for "Urinary diversion"
showing 10 items of 100 documents
Continent Anal Urinary Diversion in Classic Bladder Exstrophy: 45-Year Experience
2017
Objective To evaluate the long-term outcomes in patients with classic bladder exstrophy and continent anal urinary diversion (CAD) for continence, upper urinary tract status, secondary malignancies, and sexual function. Patients and Methods The medical records of 82 exstrophy patients having undergone CAD in our department between 1970 and 2015 were reviewed. Patients were invited for follow-up examinations and asked to complete validated questionnaires relating to sexual function. Results Thirty-two of 57 eligible patients with a median follow-up of 23.9 years were included in the study. Ninety-seven percent of patients were fully continent during daytime. Upper urinary tract and renal fun…
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 …
Urinary diversion in children and young adults using the Mainz Pouch I technique
1997
Objectives To determine the late complications and consequences for renal function, vitamin and acid-base metabolism after application of the Mainz Pouch I (MZP-I) technique in children and young adults. Patients and methods To November 1994, the MZP-I procedure was carried out in 463 patients at our institution, 91 of whom were children and adolescents (≤20 years old) using bladder augmentation in 21 and a continent cutaneous stoma in 70. A minimum follow-up of 1 year was possible in 87 patients or 163 renal units (RUs) with a mean of 5.5 years (range 1–10.5). Results At the last examination, 23 of 55 (42%) pre-operatively dilated RUs had improved, 131 of the 163 RUs (80%) were stable and …
Sacral bladder denervation for treatment of detrusor hyperreflexia and autonomic dysreflexia
2001
Objectives. Detrusor hyperreflexia after spinal cord injury may cause urinary incontinence and chronic renal failure. In patients refractory to conservative treatment and not eligible for ventral sacral root stimulation for electrically induced micturition, we investigated the therapeutic value of sacral bladder denervation as a stand-alone procedure. Methods. Nine patients (8 men and 1 woman) between 21 and 58 years old (mean 30.2) with traumatic suprasacral spinal cord lesions underwent sacral bladder denervation for treatment of detrusor hyperreflexia and/or autonomic dysreflexia. Results. Detrusor hyperreflexia and autonomic dysreflexia were eliminated in all cases. Bladder capacity inc…
Long-term metabolic effects in patients with urinary diversion
1998
The use of intestinal segments in genitourinary reconstruction could influence vitamin metabolism and affect the skeletal bone and its mineral content in the long term. In 137 patients, serum levels of the vitamins A, B1, B2, B6, B12, D, and E and of folic acid, bile acid, and ammonia as well as levels of intracorpuscular vitamin B12 and folic acid were examined and a red blood cell count was performed. The patients were divided into three groups (or = 2 years,2 toor = 4 years, and4 years after surgery) as well as into children and adults. In addition, bone mineral density (dual-photon absorptiometry) was measured in 25 patients. Of these, 16 patients were approximately 16.8 years s/p recta…
CONVERSION FROM COLONIC OR ILEAL CONDUIT TO CONTINENT CUTANEOUS URINARY DIVERSION
2004
ABSTRACT Purpose: After ileal or colonic conduit diversion some patients, particularly adolescents, desire conversion to a continent diversion to improve quality of life. We report our long-term results on conversion from conduit diversion to continent cutaneous diversion. Materials and Methods: Between 1986 and 2001, 39 patients (mean age 24 years, range 6 to 49) underwent conversion from a colonic (21) or ileal conduit (18) to an ileocecal pouch (Mainz pouch I) with a mean followup of 102 months (range 18 to 192). Conversion was performed after a mean of 11 years (range 1 to 36) of conduit urinary diversion by incorporating the preexisting colonic/ ileal conduit and the ileocecal pouch. R…
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…
Refinements in buccal mucosal graft urethroplasty for hypospadias repair
1998
We evaluated our experience with buccal mucosa in urethral reconstruction for complex hypospadias repair in a total of 62 children operated on at our institution since 1990 at a mean follow-up of 23 months. After the graft had been taken from the lower lip, with possible extension to the inner cheek, complete thinning of the graft was performed. The graft was then sutured in an onlay fashion to the urethral plate, and suprapubic urinary diversion was carried out for 3 weeks. The overall complication rate in this rather complex series of patients, including 26 "hypospadias cripples," was 13%; the complications involved 4 fistulas, 3 cases of graft necrosis, and only 1 meatal stenosis during …
Long-term followup of the intussuscepted ileal nipple and the in situ, submucosally embedded appendix as continence mechanisms of continent urinary d…
2006
We analyzed stoma related complications and continence rates in patients who underwent continent urinary diversion with the cutaneous ileocecal pouch (Mainz pouch I). We compared the intussuscepted ileal nipple and in situ, submucosally embedded appendix as continence mechanisms.A total of 401 patients were included in a retrospective followup study. Continence mechanisms were the intussuscepted ileal nipple in 205 patients and the in situ, submucosally embedded appendix in 196.A total of 144 patients (36%) required intervention for a stomal complication. Of patients who received an intussuscepted ileal nipple 34 (17%) had stomal stenosis at a mean time to first stenosis of 43.8 months, 41 …
Conversion from colonic conduit into recto-sigmoid pouch (Mainz pouch II)
2005
The Mainz Pouch II has now been used widely and found to be a valuable addition to the various types of urinary diversion. The authors from Mainz describe how a colonic conduit can be converted into a Mainz Pouch II, and the expected outcome from such a procedure. OBJECTIVE To report our long-term results of conversion from conduit conversion into a continent anal urinary diversion, as after conduit urinary diversion in childhood, some patients wish to have a later conversion to a continent diversion to avoid external appliances and to improve their quality of life. PATIENTS AND METHODS Between 1992 and 2003, 139 patients had a urinary diversion with a recto-sigmoid pouch (Mainz pouch II), …