Search results for "Urinary system"

Bladder augmentation and urinary diversion in patients with neurogenic bladder: Non-surgical considerations

2011

Segments from almost all parts of the bowel have been used for urinary diversion. As a result, the available absorptive surface area of the bowel is reduced, and the incorporation of bowel segments into the urinary tract may have metabolic consequences. This is an area somewhat neglected in the literature. Metabolic complications are rare, but sub-clinical metabolic disturbances are quite common. Several studies have demonstrated that some of the absorbent and secreting properties of the bowel tissue are preserved after incorporation into the urinary tract. Hyperchloraemic metabolic acidosis can occur if ileal and/or colon segments are used, as well as malabsorption of vitamin B(12) and bil…

PATHOPHYSIOLOGY AND CLINICAL ASPECTS OF URINARY LITHIASIS

2007

Urine is a complex balanced solution containing dissociated and non-dissociated solutes. Any variation in urine saturation grade (number of crystals dissolved in a volume of urine), urinary pH and the concentration of crystallization inhibitors can break the normal existing balance and lead to urolithiasis. In the present article we analyze the principal mechanisms (absorptive, renal, resorptive) of hypercalciuria. It will be also shown how heredity directly influences the clinical aspects of cystine, xanthine and oxalate lithiasis and how diet, in association with metabolic disorders, interferes in uric acid and oxalate stone formation. Finally, we report on the roles of urinary tract malf…

Operative Reconstruction of the External and Internal Genitalia in Female Patients with Bladder Exstrophy or Incontinent Epispadias

1995

AbstractPurpose: Urologists and gynecologists rarely encounter questions on cohabitation and pregnancy in female patients with bladder exstrophy or incontinent epispadias.Materials and Methods: Until 1994, 41 female patients underwent surgery at our institution (vaginal cutback or vaginoplasty in 23, correction of the external genitalia in 25 and uterus fixation to correct or prevent prolapse in 13).Results: Followup was available in 37 patients (mean 16.8 years, with followup of 18 years or longer in 19). Of the patients 94 percent are satisfied with the cosmetic results. All adults engage in sexual intercourse, 4 delivered 6 children by cesarean section and 5 presently desire children.Con…

Is intraoperative neuromonitoring associated with better functional outcome in patients undergoing open TME?

2013

Aims: Intraoperative neuromonitoring (IONM) aims to control nerve-sparing total mesorectal excision (TME) for rectal cancer in order to improve patients’ functional outcome. This study was designed to compare the urogenital and anorectal functional outcome of TME with and without IONM of innervation to the bladder and the internal anal sphincter. Methods: A consecutive series of 150 patients with primary rectal cancer were analysed. Fifteen match pairs with open TME and combined urogenital and anorectal functional assessment at follow up were established identical regarding gender, tumour site, tumour stage, neoadjuvant radiotherapy and type of surgery. Urogenital and anorectal function was…

Pathophysiology orientated therapy of the aging bladder

2004

Aging is associated with changes of organ systems including skin, bone metabolism and the muscoloskeletal, endocrine, cardiovascular, and genitourinary systems . Concerning age-related changes in lower urinary tract function, the incidence of nocturia and general neurological or vascular diseases with impact on detrusor function are comparable for men and women. However, there are also sex related differences in lower urinary tract symptoms [LUTS) such as bladder outlet obstruction in men (due to agerelated prostate growth) and gonadal insufficiency, multiparity, cystocele or enterocele in women. In addition to the common occurrence of LUTS in elderly people, comorbidity increases with age,…

Local Treatment of Urogenital Atrophy with an Estradiol-Releasing Vaginal Ring: A Comparative and a Placebo-Controlled Multicenter Study

1999

Local estrogen substitution has been shown to be more appropriate than any systemic application for the treatment of urogenital symptoms of hormone defiency. The efficacy, safety and acceptability of a new low-dose drug delivery system consisting of an estradiol-releasing silicone vaginal ring was studied in two multicenter trials. In an open-label comparative trial a total of 219 postmenopausal women were randomized to the estradiol-releasing vaginal ring or to estriol suppositories. In terms of efficacy both treatment arms were shown to be equivalent; however, significantly higher rates of acceptability were found for the vaginal ring. In a double-blinded placebo-controlled study a total …

MP-07.06

2006

Continent urinary diversion and bladder augmentation in children: the Mainz pouch procedure.

1989

The formation of a bowel reservoir of large capacity at low pressure by using small and large bowel (ileocaecal segment) has proved reliable for achieving continent urinary diversion (n = 80), for bladder augmentation (n = 42) as well as for total bladder replacement (n = 24). Encouraged by the results we obtained in our adult patients, we have used this technique during the last 3.5 years in 29 children. Indications for urinary diversions in children have been: neurogenic bladder with diplegia (n = 8), bladder exstrophy (n = 2), traumatic loss of the bladder (n = 1), urogenital sinus (n = 1) and rhabdomyosarcoma of the prostate or bladder (n = 2). Bladder augmentation was indicated in 6 ch…

Italian version of qualiveen-30: Cultural adaptation of a neurogenic urinary disorder-specific instrument

2011

Purpose Qualiveen-30 is a neurological urinary disorder (UD)-specific health-related quality of life (HRQL) instrument, recommended in the European Association of Urology guideline 2008. The objective is to complete the cultural adaptation of Qualiveen-30 into Italian. Materials and Methods One hundred and twenty eight Italian-speaking spinal cord injury (SCI) patients completed Qualiveen-30 and the SF-12 physical and mental component (PC and MC) at enrolment and 4 weeks later. At follow-up, patients also made global ratings of change (GRC) in urinary HRQL (GRC). Results Qualiveen-30 proved reliable (intraclass correlation coefficients of four domains: 0.77–0.90). Correlations with SF-12 an…

Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Pe…

2017

Purpose: To analyze perioperative complications and postoperative explantation rates for selected readjustable male sling systems and the perineal single-cuff artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort. Methods: Two hundred eighty-two male patients who underwent implantation between 2010 and 2012 in 13 participating institutions were included in the study (n = 127 adjustable male sling [n = 95 Argus classic, n = 32 Argus T], n = 155 AUS). Perioperative characteristics and postoperative complications were analyzed. The explantation rates of the respective devices were assessed using the Fisher exact test and the Mann-Whitney U-test. A Kapl…