A technique for total substitution of the lower urinary tract without the use of a prosthesis.
A technique is described for total replacement of the lower urinary tract in women in which a pedicled labial skin tube is created and anastomosed to a substitution cystoplasty with a submucosal tunnelled type of "anti-reflux" anastomosis which provides a continence mechanism. The patients thereafter void by intermittent self-catheterisation. This technique has been used in 6 women as part of total pelvic reconstruction for vesico-vagino-rectal fistula following radical radiotherapy, with or without a Wertheim's hysterectomy, for carcinoma of the cervix. A similar technique using a pedicled preputial/penile skin tube has been used in 2 men following a cystoprostato-urethrectomy for transitional cell carcinoma of the bladder.
Mundy
A R
AR
Department of Surgery, Guy's Hospital, London.
D000714:Anastomosis, Surgical; D003106:Colon; D005260:Female; D006801:Humans; D008722:Methods; D011878:Radiotherapy / Q000009:adverse effects; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy; D014719:Vesicovaginal Fistula / Q000209:etiology / Q000601:surgery