Search results for "urinary diversion"
showing 10 items of 100 documents
Ileocecal valve reconstruction during continent urinary diversion.
1994
During construction of an ileocecal reservoir, such as the Mainz or Indiana pouch, the ileocecal valve is lost. Subsequently, the intestinal transit time is shortened and malabsorption as well as diarrhea may result. Patients having undergone previous bowel resection as well as children with myelomeningocele who often already have frequent defecations will be heavily affected by the loss of the ileocecal valve. We have functionally reconstructed the ileocecal valve by embedding ileum into the ascending colon via a submucosal tunnel in analogy to the technique used when creating the continence mechanism during the Mainz pouch procedure using the appendix. Experimental results in 15 dogs demo…
The Mainz Pouch (Mixed Augmentation Ileum and Cecum) for Bladder Augmentation and Continent Diversion
1986
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 …
URINARY DIVERSION AND ORTHOTOPIC BLADDER SUBSTITUTION IN CHILDREN AND YOUNG ADULTS WITH NEUROGENIC BLADDER: A SAFE OPTION FOR TREATMENT?
2000
Combined pharmacotherapy, clean intermittent catheterization and infection prophylaxis is currently the gold standard of treatment for neurogenic bladder. However, as the adolescent gains independence from parental supervision, the intervals of clean intermittent catheterization compliance with medical treatment and regularity of followup examinations may decrease, and neurological and/or orthopedic status may change. This situation sometimes leads to failure of conservative treatment, resulting in incontinence and/or deterioration of the upper urinary tract. A multidisciplinary team was established at our institution 30 years ago to assess all aspects of care for patients with neurogenic b…
Radical surgery and different types of urinary diversion in patients with rhabdomyosarcoma of bladder or prostate--a single institution experience.
2013
Abstract Purpose In a retrospective study we analyzed the outcome of patients treated for rhabdomyosarcoma (RMS) of the bladder/prostate with special attention to radical surgery. Methods In 25 patients with genitourinary RMS (15 bladder/10 prostate) the median age at diagnosis was 4 years [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , and 8 patients had a stage II RMS, 12 stage III and 5 stage IV. In 19/25 (12 bladder/7 prostate), radical surgery and urinary diversion were performed. Urinary diversion comprised 2 continent anal diversions, 11 continent cutaneous diversions, 4 colon conduits and 2 urethral diversions (2 +…
Long-term follow-up of submucosal tunnel and serosa-lined extramural tunnel ureter implantation in ileocaecal continent cutaneous urinary diversion (…
2007
Authors from Mainz, Germany present the long-term follow-up of submucosal tunnel and serosa-lined extramural tunnel ureter implantation in the ileocaecal continent cutaneous urinary diversion first described in that department, called the Mainz-Pouch I. OBJECTIVE To assess upper urinary tract complications and renal function in patients with a submucosal tunnel and serosa-lined extramural tunnel ureter implantation during the long-term follow-up of ileocaecal continent cutaneous urinary diversion (Mainz pouch I). PATIENTS AND METHODS In all, 458 patients who had diversion with the ileocaecal pouch were analysed in a retrospective follow-up study. Uretero-intestinal implantation was done usi…
The Fate Of The Adult Exstrophy Patient
1994
Between 1968 and 1993, 101 patients with bladder exstrophy or incontinent epispadias underwent surgery at our hospital. The standard procedure was ureterosigmoidostomy and additional genital reconstruction. Of the 56 patients who have reached adulthood 45 could be interviewed regarding social integration, sexuality and fertility. All patients have a functioning urinary diversion. Of the 45 patients questioned 41 have completed vocational training or are currently in training, 3 are unemployed and 1 lives at a therapeutic center. Among the patients 29 are married or have a steady partner. All women engage in sexual intercourse and 2 have delivered 3 children by cesarean section. All men achi…
Dislodgement in Long-Term Patients with Nephrostomy Tube: Risk Factors and Comparative Analysis Between Two Catheter Designs
2020
Objective: To determine possible risk factors for accidental nephrostomy tube dislodgement and compare two different tube types in this context in patients with chronic catheters. Materials and Met...
Pyelotransverse pyelocolostomy: an alternative method for high urinary diversion in patients with extended bilateral ureter damage.
1991
After previous radiation due to pelvic malignoma or after multiple operations, the ileal conduit as well as sigmoid conduit are associated with an increased rate of complications. In these patients, the middle and distal ureter often cannot be considered for reimplantation due to fibrosis. High anastomosis to a bowel segment which is undamaged proves favorable. The transverse colon, conveniently situated in the cranial abdomen, is close enough to the kidneys for such a high anastomosis and is mostly spared from irradiation. In cases where severely damaged ureters forbid connection to a normal transverse conduit, we performed a pyelotransverse pyelocolostomy with high anastomosis of the bowe…
Social integration, sexual behavior and fertility in patients with bladder exstrophy--a long-term follow up.
1996
After primary bladder closure or urinary diversion, other factors apart from the reconstruction itself gain importance for individuals with the exstrophy-epispadias complex: social integration and, after reaching puberty, sexuality and fertility. Between 1968 and July 1994 115 patients with bladder exstrophy or incontinent epispadias underwent surgery at our institution. A total of 104 patients could be followed, 2 of whom died in the meantime. Of the remaining 102 patients 48 attend school, 4 are in college, 40 have completed or are currently undergoing vocational training, 3 are unemployed, 1 lives in a therapeutic centre and 6 are younger than 6 years of age. A total of 95% of the patien…
Sexual Function, Social Integration and Paternity of Males with Classic Bladder Exstrophy following Urinary Diversion.
2015
We evaluated patients with classic bladder exstrophy and a history of urinary diversion for sexual function, social integration and paternity.We reviewed the medical records of males older than 18 years with exstrophy who had undergone urinary diversion at our department between 1969 and 2014. Patients were invited for structured followup examinations and were asked to complete questionnaires relating to sexual function, social integration and paternity.Of 79 eligible patients 39 (49%) with a mean followup of 23.8 years (range 2 to 45) were included in the study. Of the patients 41% had undergone primary urinary diversion and 59% had undergone secondary urinary diversion after failed recons…