Applications of the Serous Lined Extramural Tunnel for Antireflux Ureteroileal Reimplan- tation and Refashioned Short Bowel Seg- ments for the Construction of Catheterizable Stoma in Cutaneous Continent Urinary Diver- sion: Early Clinical Experience
Keywords:
Serous Lined Extramural Tunnel, Antireflux Ureteroileal Reimplan- tation, Short Bowel Segments, Catheterizable Stoma, Cutaneous Continent Urinary DiversionAbstract
Purpose: To report the early results of a new surgical procedure for cutaneous continent urinary diversion by using serous lined extramural tunnel for antireflux ureteroileal reimplantation and double Monti ileal tube with flap valve mechanism to construct a continent catheterizable stoma.
Materials and Methods: Three female patients with a mean age of 44 years have undergone cutaneous continent urinary diversion by using serous lined extramural tunnel for antireflux ureteroileal reimplantation and double Monti ileal tube with flap valve metchanism to construct a continent catheterizable stoma. Anterior pelvic exenteration was done in 1 patient with urethral carcinoma, 2 patients from bladder carcinoma. This report described surgical procedure and followed the result by observe and questionnaire about the problems with self clean intermittent catheterize stoma or any leakage of urine from stoma. Ultrasound and cystogram was done 3 months postoperatively and every 6 months thereafter to evaluate the configuration of the upper tract and to assess the reflux.
Results: All three patients had no problem with self clean intermittent catheterization nor leakage of urine from stoma. Ultrasound evaluated upper tract showed no hydronephrosis and no reflux to upper urinary tract by cystography, after follow up from 8 to 21 months with a mean follow up of 10 months.
Conclusions: After anterior pelvic exenteration and bladder was removed, the patient must be undergone urinary diversion with ileal or colonic conduit which need urostomy bag. Some patients un- dergo orthotopic neobladder if healthy urethral was available, but for the patients who had no healthy urethral and did not want urostomy bag, so another choice of operation was cutaneous continent urinary diversion which needed for self clean intermittent catheterization. This report presented the good result of surgical techniques for antireflux ureteroileal reimplantation and continent catheterizable stoma with pa- tients satisfaction after operations.
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