Search results for "Urinary diversion"
showing 10 items of 100 documents
Internal Urinary Diversion by a Percutaneous Ureteric Splint
1980
Treatment of Iatrogenic Functional or Morphologic Bladder Loss
1988
From 1984 to 1986, six children from 4 to 13 years of age, received a bladder augmentation by ileocecal cystoplasty (Mainz-pouch technique) because of an iatrogenic functional or morphologic bladder loss. Indications for operation were incontinence due to the low bladder capacity or threat to the upper urinary tract due to ureteral obstruction or vesicorenal reflux. Two of the children had already undergone supravesical urinary diversion by sigmoid conduit. After a follow-up period of 2 to 19 months, (mean 11 months), five of the six children are completely continent. One boy with a known weak sphincter still has slight, but decreasing, enuresis nocturna in periods of complete filling of th…
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…
Colon pouch (Mainz III) for continent urinary diversion
2007
OBJECTIVE To evaluate the use of a continent cutaneous pouch made exclusively of colon (Mainz pouch III), as excellent results with the Mainz pouch III in irradiated patients suggested that the indication for this type of urinary diversion could be extended. PATIENTS AND METHODS The outcome of 24 patients with continent cutaneous urinary diversions using colon segments (Mainz pouch III) was investigated retrospectively. Overall, 22 of the patients had a malignant disease and two a benign disease; 16 had a hysterectomy and pelvic exenteration for gynaecological tumours; two men with a rhabdomyosarcoma of the prostate had a radical cystoprostatectomy; one woman had pelvic exenteration for bla…
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.…
Retrograde endoureterotomy as a treatment option for impacted calculus in the ureterointestinal junction
2021
Introduction: In patients with a history of radical cystectomy and with intestinal diversion, urolithiasis in the upper urinary tract is a frequent event. Material and methods: We describe for the first time a case of retrograde endoureterotomy used to treat a calculus proximal to the ureterointestinal junction. Results: This technique is of interest when antegrade access is not possible. In our example, after passing the guidewire percutaneously, and externalize it through the stoma, the left meatus was reached with a resectoscope inserted through the ileal duct. After the use of a balloon to prevent migration of the calculus, a retrograde endoureterotomy was performed with a Collins knife…
Experience with palliative percutaneous nephrostomy in bladder cancer patients
1985
Minimal percutaneous nephrostomy as a palliative urinary diversion was performed in 50 patients with advanced bladder cancer disease. The average survival time was 6.6 months, with 38% of the patients alive after 6 months. Although 88% of the patients died within one year, 2 (5%) are still alive after more than 2 years. Each case of palliative diversion is an individual one, with many different factors influencing the decision. Prolonging life cannot be an indication for diversion. Percutaneous nephrostomy in combination with other percutaneous techniques provides the urologist with excellent therapeutic tools to avoid surgery in such emergency situations as uremia or local tumor symptoms. …
Orthotopic MAINZ pouch bladder substitution – long-term follow-up
2021
Introduction After radical cystectomy, orthotopic neobladder is one surgical strategy for urinary diversion. To assess the usefulness of an operation, long-term data are essential. We examined long-term complications and continence rates of orthotopic ileocecal (MAINZ pouch) bladder substitution. Material and methods Between 1986 and 2011, 193 patients underwent orthotopic MAINZ pouch bladder substitution. Until July 2000, ureter implantation was performed into the ascending colon through a submucosal tunnel technique (Goodwin-Hohenfellner). After July 2000, ureters were implanted into the terminal Ileum using the ileocecal valve to prevent reflux: the left spatulated ureter by an end-to-en…
Histological and histochemical changes in the colon mucosa after ureterosigmoidostomy or colonic conduit.
1988
A study was made of 22 patients previously subjected to urinary diversion, 12 with ureterosigmoidostomy and 10 with colon conduit. The histological and histochemical examination of biopsies of intestinal mucosa near to and far from the ureteral orifices showed transformations with considerable inflammatory infiltration, variations in the composition of the acid mucins with a prevalence of sialomucins, lengthening and branching of the glandular crypts, and sometimes dysplasias of the epithelium. These structural modifications are typical of transitional mucosa. Transitional mucosa might reflect an aspecific reaction of the intestinal mucosa or alternatively it might signify a precancerous co…
Quality of life in women undergoing urinary diversion for bladder cancer: results of a multicenter study among long-term disease-free survivors
2012
Purpose: Women undergoing radical cystectomy (RC) and urinary diversion for bladder cancer experience substantial limitations in health-related quality of life (HRQOL). However, the level of discomfort caused by different urinary diversion has been never evaluated in long term survivors. The aim of this multicenter study is to evaluate differences in HRQOL among recurrence-free women undergoing cutaneous ureterostomy (CUS), Bricker's ileal conduit (BK-IC) and Orthotopic neobladder VIP (ONB-VIP) in disease-free females treated with radical cystectomy (RC), with long-term follow up (mean 60.1 months; range 36-122 months). Materials and methods: All consecutively treated female patients from t…