Search results for "urinary diversion"

Pediatric Urinary Diversion: Review and Own Experience

1992

New insights into the diseases of childhood, profound improvements and new developments in surgical techniques as well as the knowledge gained from long-term follow-up have altered the strategies and indications for urinary diversion in childhood. Continent urinary diversion is generally the method of choice. We are able to construct high capacity, low pressure reservoirs to protect the upper urinary tract and achieve continence. Nowadays, there is hardly any indication for permanent cutaneous urinary diversion. Temporary and intermediate cutaneous diversion are used only when serious conditions such as renal function deterioration occur. The possibility to convert any incontinent form of u…

Long Term Results of Bladder Exstrophy

1999

After primary bladder closure or urinary diversion, other factors apart from the reconstruction gain importance for individuals with the exstrophy-epispadias complex: social integration and, after reaching puberty, sexuality and fertility.

Urinary Diversion: How Experts Divert

2014

To determine the rates of the available urinary diversion options for patients treated with radical cystectomy for bladder cancer in different settings (pioneering institutions, leading urologic oncology centers, and population based).Population-based data from the literature included all patients (n = 7608) treated in Sweden during the period 1964-2008, from Germany (n = 14,200) for the years 2008 and 2011, US patients (identified from National Inpatient Sample during 1998-2005, 35,370 patients and 2001-2008, 55,187 patients), and from Medicare (n = 22,600) for the years 1992, 1995, 1998, and 2001. After the International Consultation on Urologic Diseases-European Association of Urology In…

Techniques for uretero-intestinal reimplantation.

2004

Purpose of review Uretero-intestinal reimplantation is a crucial component of urinary diversion. Several techniques for refluxing and nonrefluxing uretero-intestinal reimplantation have been established and modified to minimize anastomotic complications and preserve renal function. We review current experience with uretero-intestinal reimplantation in different types of urinary diversion. Recent findings The basic principles of uretero-intestinal reimplantation are still controversially discussed. Several studies have focused on complications of urinary reflux from direct end-to-side or end-to-end anastomosis, such as pyelonephritis and calculus formation. Strictures at the anastomotic site…

Idiopathic Retroperitoneal Fibrosis: What Is the Optimal Clinical Approach for Long-Term Preservation of Renal Function?

2022

<b><i>Background:</i></b> The aim of this study was to investigate the long-term effects of ureteral stenting and the exact timing of stent removal in favor of surgery in patients with idiopathic retroperitoneal fibrosis (IRF). <b><i>Summary:</i></b> Medline research terms of “idiopathic retroperitoneal fibrosis” AND “ medical therapy” OR “ureteral stenting” OR “surgical treatment” were done. Systematic reviews and observational and clinical studies were analyzed to obtain indication regarding the objective of the study for a narrative review. Ninety-two papers were analyzed. The treatment of IRF includes the monitoring of retroperitoneal fibr…

Long-term results of ileocecal continent urinary diversion in patients treated with or without previous pelvic irradiation

2003

Purpose: Patients who receive pelvic irradiation may require urinary diversion to manage complications resulting from progressive malignancy or radiotherapy. The choice of urinary diversion is an important issue and remains controversial. We characterized the long-term outcome of urinary diversion with a continent ileocecal reservoir in patients who received pelvic irradiation versus those who underwent urinary diversion without previous irradiation. Materials and Methods: Continent urinary diversion with an ileocecal reservoir (Mainz pouch 1) was performed in 36 irradiated patients in a 9-year period. Morbidity, mortality, the reoperative rate and parameters associated with the surgical pr…

Clinical Scenario: Unexpected Positive Nodes at Radical Cystectomy

2014

Positive lymph nodes are found in 20–30 % of patients undergoing radical cystectomy for bladder cancer. Their presence is associated with poor survival in the majority. Super-extended lymph node dissection is recommended in the presence of positive lymph nodes to possibly improve oncologic outcome. In patients with unsuspicious lymph nodes, dissection should be performed at least up to the common iliac vessels. Even in the presence of lymph node metastases cystectomy is indicated to reduce local tumor complications. The type of urinary diversion should not be altered by lymph node positivity unless the diversion would otherwise negatively influence the extent of the procedure.

What should be the patient's preference regarding the choice of hospital in the case of radical cystectomy? Evaluation of early complications…

2016

Jens Mani,1 Stefan Vallo,1 Maximilian P Brandt,1 Kilian M Gust,1 Claudia Bartsch,1 Johannes Daechert,1 Igor Tsaur,1 Georg Bartsch,2,* Axel Haferkamp1,* 1Department of Urology, Goethe University Hospital, Frankfurt am Main, 2Department of Urology, Johannes Gutenberg University Hospital Mainz, Mainz, Germany *These authors contributed equally to this work Purpose: This study compares early complications after cystectomy and urinary diversion (UD) stratified by the surgical focus and case load of two different department chairpersons in a single institution in two time periods. Creating clear data about complications that can affect the quality of life is an important tool for patient…

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…

Hyperammonemic encephalopathy after urinary diversion. Diet therapy

2016