Selecting the appropriate urinary diversion procedure in the spinal cord injured: a poignant reminder.
Lower urinary tract reconstruction has been performed on the spinal injured population at our institution since 1988. Careful pre-operative evaluation including a detailed history, physical examination and radiographic and/or urodynamic studies are usually obtained to determine which type of procedure would be most beneficial for each individual patient. Typically, patients receive either a cutaneous (i.e., Kock or Indiana) diversion or undergo a form of bladder augmentation (usually ileocystoplasty). Pre-operative findings and the patient's history are carefully considered prior to choosing the appropriate procedure. Occasionally, a particular finding influences the decision. We describe a patient who received a hemi-Kock ileocystoplasty with a continent abdominal stoma who, in retrospect, would have benefitted from a supravesical diversion.
Razi
S S
SS
Division of Urology, Rancho Los Amigos Medical Center, Downey, CA 90242, USA.
Bennett
C J
CJ
D000328:Adult; D018934:Fournier Gangrene / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent / Q000379:methods*; D014563:Urodynamics / Q000502:physiology