[Children and youths with neurogenic disturbances of bladder function. Bladder augmentation, substitution and the diversion of urine].
After the failure of conservative treatment in patients with neurogenic bladders, urinary diversion is a viable compromise between the urologist's concerns and the patient's desire, as the upper urinary tract can be protected in the long-term and high continence rates can be provided. This can be achieved with an acceptable complication rate. Our indications for orthotopic bladder augmentation or substitution involve patients with a good orthopedic condition and mobility, who find it easy to perform CISC through the urethra. A continent umbilical stoma offers a good alternative in obese, immobile or wheelchair bound patients. The serous lined extramural tunnel technique has proven to be superior to submucosal implantation in patients with fibrotic and dilated ureters.
Stein
R
R
Urologische Klinik und Poliklinik im Klinikum der Johannes-Gutenberg-Universität Mainz. Stein@urologie.klinik.uni-mainz.de
Beetz
R
R
Thüroff
J W
JW
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent; D013520:Urologic Surgical Procedures / Q000379:methods