The application of the modified rectal bladder in management of the compromized urethral damage.
Failure to repair the traumatic injuries of the lower urinary tract with loss of urethral sphincteric function usually puts forward the subject of urinary diversion. Ten males and five females presented with extensive urethral damage and with or without vesical fistulas. All attempts of repair were exhausted before the decision of diversion was planned. Continent urinary diversion using the modified rectal bladder (the augmented and valved rectum) was utilized. The procedure entailed functional isolation of the rectum without terminal colostomy and depended on colorectal intussuscepted valve. All the patients are currently evaluated with follow up periods ranging 10-56 months. Evidences proved the effectiveness of the colorectal valve in providing non impeded fecal stream to the functionally isolated rectal reservoir. Continent status is attributed to the ileal patching that produces a low pressure reservoir against the effective high anal resistance. The results support the distinct superiority of the modified rectal bladder to either the conventional methods of urinary diversion to the rectum or the abdominal reservoir with continent catheterizable stomas.
Mahran
M R
MR
Department of Urology, Urology & Nephrology Center, Mansoura, Egypt.
Ghoneim
M A
MA
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D013536:Suture Techniques; D014521:Urethra / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014522:Urethral Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D014525:Urethral Stricture / Q000000981:diagnostic imaging / Q000601:surgery*; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000601:surgery*; D016476:Urinary Reservoirs, Continent / Q000379:methods*; D014563:Urodynamics / Q000502:physiology; D014567:Urography; D014624:Vaginal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*