[Report of experience in reconstruction of the lower urinary tract in the man and woman].
For some decades uretero(ileo) cutaneostomy and ureterosigmoidostomy were the methods of choice for urinary diversion in cystectomized patients. In recent years, lower urinary tract reconstruction with an anastomosis from an intestinal urinary reservoir to the urethra has established itself as an alternative for male patients undergoing cystectomy. We present the results obtained in 35 patients (32 men, 3 women) who chose to have a ureteroileal urethrostomy to the residual urethra after radical cystectomy for bladder cancer. These patients were followed up by clinical, serologic, radiographic, and urodynamic evaluation conducted at short intervals according to a strict protocol. There was no perioperative mortality, and the early postoperative complication rate was 17% (6/35 patients). For all patients, including those followed only for 3 months so far, the diurnal continence rate was 87% and the nocturnal continence rate was 78%. In every patient, male and female, the maximum urethral pressure (average value in the urethra pressure profile 50.8 cm H2O) was higher than the average resting intraluminal pressure in the pouch (average 12 cm H2O) with physiologic capacity (250-550 ml) of the urinary bladder. Patient acceptance, measured on a numerical self-rating scale, was high (average value 8.75 out of 10).
Stenzl
A
A
Urologische Universitätsklinik Innsbruck.
Janetschek
G
G
Bartsch
G
G
Hofer
C
C
Hartung
R
R
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002295:Carcinoma, Transitional Cell / Q000503:physiopathology / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology; D014521:Urethra / Q000503:physiopathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000601:surgery*; D016476:Urinary Reservoirs, Continent / Q000379:methods*; D014563:Urodynamics / Q000502:physiology; D014567:Urography
Erfahrungsbericht über die Rekonstruktion des unteren Harntrakts bei Mann und Frau.