Search results for "urinary diversion"

Kinder und Jugendliche mit neurogener Blasenfunktionsst�rung

2004

After the failure of conservative treatment in patients with neurogenic bladders, urinary diversion is a viable compromise between the urologist's concerns and the patient's desire, as the upper urinary tract can be protected in the long-term and high continence rates can be provided. This can be achieved with an acceptable complication rate. Our indications for orthotopic bladder augmentation or substitution involve patients with a good orthopedic condition and mobility, who find it easy to perform CISC through the urethra. A continent umbilical stoma offers a good alternative in obese, immobile or wheelchair bound patients. The serous lined extramural tunnel technique has proven to be sup…

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…

Sacral neuromodulation for treatment of lower urinary tract dysfunction

2000

Despite initial reservations, sacral neuromodulation has begun to develop as a new therapeutic tool for the treatment of lower urinary tract dysfunction. It bridges the gap between conservative treatment options and highly invasive procedures, such as urinary diversion. At present, there are no clinical variables that can reliably predict the efficacy of neuromodulation in an individual patient. All patients, regardless of indication, must therefore undergo a test stimulation before they can be offered chronic sacral neuromodulation with an implanted system. Evaluations in various clinical trials have confirmed that sacral neuromodulation, based on unilateral sacral foramen electrode implan…

Radical Surgery in Children and Adolescents with Rhabdomyosarcoma of the Lower Urinary Tract Using Orthotopic Bladder Substitution and Heterotopic Ur…

2008

Abstract Purpose Children with rhabdomyosarcoma(RMS)of the bladder/prostate can be treated by radical or organ sparing surgery both in combination with chemotherapy ± radiation therapy. In this retrospective study we analyzed the outcome with special attention to radical surgery and urinary diversion (UD). Material and Methods 24/32 patients with RMS of the genitourinary tract had RMS of the bladder (n=14) or prostate (n=10). 8 patients were stage II, 11 stage III and 5 stage IV. In 18/24 with RMS of the bladder/prostate, radical surgery and urinary diversion was performed. 3 had chemotherapy only, 2 in combination with radiotherapy. One patient underwent partial cystectomy. For UD: uretero…

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…

Nastanak i liječenje gigantskih kamenaca ileocekalnog urinskog spremnika u pacijenta liječenog cistektomijom zbog intersticijskog cistitisa: prikaz s…

2021

Cilj: Cilj ovoga rada je prikazati pacijenta s intersticijskim cistitisom u kojega je došlo do stvaranja kamenaca u novoformiranom urinskom spremniku. Prikaz slučaja: Pacijent star 48 godina obrađivan je zbog recidivnih infekcija mokraćnog sustava. Prethodno mu je zbog intersticijskog cistitisa, koji je znatno utjecao na njegovu kvalitetu života, učinjena cistektomija uz oblikovanje urinskog spremnika (Mainz-pouch I). Urološkom obradom pronađena su u području urinskoga spremnika dva velika kamenca dimenzija 77 × 74 mm te 76 × 62 mm uz obostranu hidronefrozu. Kako bi se riješio uzrok rekurentnih urinarnih infekcija, učinjena mu je otvorenim pristupom ekstrakcija oba kamenca. Poslijeoperacijs…

Re: End Cutaneous Ureterostomy for the Management of Severe Hydronephrosis

2007

Vaginal Reconstruction Using the Bladder and/or Rectal Walls in Patients with Radiation-Induced Fistulas

2000

Abstract Objective. In irreparable or recurrent vesicovaginal fistulas and cloacal defects following high-dose irradiation therapy for gynecological malignancies, urinary diversion is the last resort to achieve a socially acceptable solution. In a select group of young and tumor-free patients, additional vaginal reconstruction may be indicated. Multiple operative procedures are available, but the results are often disappointing in the previously irradiated area. Materials and methods. In six such patients with large radiogenic vesicovaginal defects ( n = 5) or a cloacal fistula ( n = 1), a continent reservoir using the transverse colon with an umbilical stoma was performed. At the end of th…

Urethral recurrence of transitional cell carcinoma in a female patient after cystectomy and orthotopic ileal neobladder.

2000

A 63-year-old woman presented elsewhere with a unifocal pT1, G3 transitional cell carcinoma at the bladder base in 1995. She underwent urethral sparing cystectomy and ileal neobladder. Intraoperative frozen section from the proximal urethra did not demonstrate tumor involvement. Final histological examination revealed pT1, pN2, G3 transitional cell carcinoma. Adjuvant chemotherapy was not given. In 1998 the patient had symptoms of obstructive voiding due to a 3 3 3 cm. solid mass at the neobladder-urethra anastomosis (see figure). After 6 cycles of methotrexate, vinblastine, doxorubicin and cisplatin and a transient tumor size reduction, the patient was referred to us for local tumor progre…