-
International Braz J Urol : Official... 2022A systematic review of the literature with available published literature to compare ileal conduit (IC) and cutaneous ureterostomy (CU) urinary diversions (UD) in terms... (Review)
Review
PURPOSE
A systematic review of the literature with available published literature to compare ileal conduit (IC) and cutaneous ureterostomy (CU) urinary diversions (UD) in terms of perioperative, functional, and oncological outcomes of high-risk elderly patients treated with radical cystectomy (RC). Protocol Registration: PROSPERO ID CRD42020168851.
MATERIALS AND METHODS
A systematic review, according to the PRISMA Statement, was performed. Search through the Medline, Embase, Scopus, Scielo, Lilacs, and Cochrane Database until July 2020.
RESULTS
The literature search yielded 2,883 citations and were selected eight studies, including 1096 patients. A total of 707 patients underwent IC and 389 CU. Surgical procedures and outcomes, complications, mortality, and quality of life were analyzed.
CONCLUSIONS
CU seems to be a safe alternative for the elderly and more frail patients. It is associated with faster surgery, less blood loss, lower transfusion rates, a lower necessity of intensive care, and shorter hospital stay. According to most studies, complications are less frequent after CU, even though mortality rates are similar. Studies with long-term follow up are awaited.
Topics: Aged; Cystectomy; Humans; Quality of Life; Ureterostomy; Urinary Bladder Neoplasms; Urinary Diversion
PubMed: 33861058
DOI: 10.1590/S1677-5538.IBJU.2020.0892 -
Archivos Espanoles de Urologia Sep 2018To report a new case of prostatic carcinosarcoma, an uncommon and locally and distance aggressive tumor.
OBJECTIVE
To report a new case of prostatic carcinosarcoma, an uncommon and locally and distance aggressive tumor.
METHOD
We analyzed one case diagnosed in our Center, from clinical and pathological diagnosis to death, describing the treatments received.
RESULT
Patient presented a huge pelvic mass and a pulmonary metastasis that was treated with cystoprostatectomy and bilateral cutaneous ureterostomy with the diagnosis of carcinosarcoma of the prostate. He received 8 cycles of Docetaxel with bone progression and then 3 cycles of doxorubicin, suspending treatment due to progression. The survival was 18 months.
CONCLUSIONS
Prostate carcinosarcoma is a very aggressive neoplasia that does not respond to the usual treatments of prostate cancer.
Topics: Aged; Carcinosarcoma; Humans; Male; Prostatic Neoplasms
PubMed: 30198853
DOI: No ID Found -
Frontiers in Pediatrics 2019Robot-assisted laparoscopic (RAL) surgery is a safe, minimally invasive technique that has become more widely used in pediatric urology over recent decades. With several... (Review)
Review
Robot-assisted laparoscopic (RAL) surgery is a safe, minimally invasive technique that has become more widely used in pediatric urology over recent decades. With several advantages over standard laparoscopy, robotic surgery is particularly well-suited to reconstructive surgery involving delicate structures like the ureter. A robotic approach provides excellent access to and visualization of the ureter at all levels. Common applications include upper ureteral reconstruction (e.g., pyeloplasty, ureteropelvic junction polypectomy, ureterocalicostomy, and high uretero-ureterostomy in duplex systems), mid-ureteral reconstruction (e.g., mid uretero-ureterostomy for stricture or polyp), and lower ureteral reconstruction (e.g., ureteral reimplantation and lower ureter-ureterostomy in duplex systems). Herein, we describe each of these robotic procedures in detail.
PubMed: 30968006
DOI: 10.3389/fped.2019.00085 -
BMC Surgery Nov 2022Seventy percent of ureteric injuries result from iatrogenic causes with about 75% of these diagnosed in the postoperative period. It may have fatal complications such as... (Review)
Review
BACKGROUND
Seventy percent of ureteric injuries result from iatrogenic causes with about 75% of these diagnosed in the postoperative period. It may have fatal complications such as sepsis and or renal functional damage increasing morbidity and treatment cost.
OBJECTIVE
The study aimed to identify the risk factors for iatrogenic ureteric injuries from open surgical procedures and the intervention outcome in a resource-poor setting.
PATIENTS AND METHODS
This was a multi-centre study. The clinical records of patients with iatrogenic ureteric injuries seen between 2015-2021 who were managed at the urology units of the Margaret Marquart Catholic Hospital, and the Ho Teaching Hospital, in the Volta region of Ghana, were retrieved. The data extracted included patients' demographic factors, the clinical presentation, the primary surgery details, the time from surgery to presentation, the intervention offered, and the outcomes. The data were analysed using the Statistical Package for Social Scientists (SPSS) version 24.0.
RESULTS
Twelve patients aged between 24-54 years with a total of 19 ureteric injuries were managed. The injuries resulted from a hysterectomy in 10 cases (83.3%), and one each from emergency caesarean section and inguinal hernia repair with traction and transection injuries respectively (16.7%). Seven out of 12 cases were diagnosed 48 h after surgery. Bilateral injuries occurred in 7 cases (14/19 injuries). Intraoperative recognition was common in unilateral injuries and surgeries performed by specialist surgeons. Ureteroneocystostomy (14/19), uretero-ureterostomy (1/19), and open suture release were the management procedures performed as in the intervention.
CONCLUSION
Open hysterectomy (83.7%) was the most common procedure leading to iatrogenic ureteric injuries in this study. Intra-operative recognition occurred when trained specialist surgeons performed the surgery. Late presentation with more severe morbidity was found amongst non-specialist surgeons. Thus, improvement in training to allow intra-operative diagnosis should be encouraged in general practitioners to reduce morbidity and improve outcomes.
Topics: Humans; Pregnancy; Female; Young Adult; Adult; Middle Aged; Retrospective Studies; Cesarean Section; Ureter; Hysterectomy; Abdominal Injuries; Iatrogenic Disease; Multicenter Studies as Topic
PubMed: 36335342
DOI: 10.1186/s12893-022-01817-3 -
Journal of Minimal Access Surgery Oct 2005Laparoscopic reconstructive urology is undergoing rapid change. We review the current status of laparoscopic reconstructive urology, with particular respect to...
OBJECTIVE
Laparoscopic reconstructive urology is undergoing rapid change. We review the current status of laparoscopic reconstructive urology, with particular respect to pyeloplasty and reconstructive ureteric surgery.
METHODS
An extensive Medline search of reconstructive laparoscopic procedures was undertaken. The initial reports and large series reports of a range of procedures was examined and summarised. The most commonly practised procedure within this remit is laparoscopic pyeloplasty. Several series of over 100 patients have been published. Success rates average over 90% for laparoscopic pyeloplasty with a low complication rate. Much less common laparoscopic reconstructive urological procedures include ureteric re-implantation, Boari flap, urinary diversion and transuretero-ureterostomy. The results of these are encouraging.
CONCLUSIONS
Laparoscopic pyeloplasty may be safely performed by either the transperitoneal or retroperitoneal routes with excellent results. It should be considered the "gold standard" for the management of UPJ obstruction, especially in those patients with significant hydronephrosis, renal impairment or a crossing vessel. Laparoscopic ureteric reimplantation, Boari flap, urinary diversion and transuretero-ureterostomy have been performed by experienced laparoscopic urologists with encouraging results.
PubMed: 21206661
DOI: 10.4103/0972-9941.19265 -
Actas Dermo-sifiliograficas May 2017
Topics: Biopsy; Cystectomy; Dermatitis; Diagnosis, Differential; Humans; Hydrogen-Ion Concentration; Ileostomy; Male; Middle Aged; Postoperative Complications; Prostatectomy; Prostatic Neoplasms; Proteus Infections; Skin Diseases, Papulosquamous; Surgical Stomas; Ureterostomy; Urinary Tract Infections; Urine; Warts
PubMed: 27393457
DOI: 10.1016/j.ad.2016.02.018 -
Korean Journal of Urology Jan 2014The incidence of ureteral strictures has increased worldwide owing to the widespread use of laparoscopic and endourologic procedures. Midureteral strictures can be... (Review)
Review
The incidence of ureteral strictures has increased worldwide owing to the widespread use of laparoscopic and endourologic procedures. Midureteral strictures can be managed by either an endoscopic approach or surgical reconstruction, including open or minimally invasive (laparoscopic/robotic) techniques. Minimally invasive surgical ureteral reconstruction is gaining in popularity in the management of midureteral strictures. However, only a few studies have been published so far regarding the safety and efficacy of laparoscopic and robotic ureteral reconstruction procedures. Nevertheless, most of the studies have reported at least equivalent outcomes with the open approach. In general, strictures more than 2 cm, injury strictures, and strictures associated either with radiation or with reduced renal function of less than 25% may be managed more appropriately by minimally invasive surgical reconstruction, although the evidence to establish these recommendations is not yet adequate. Defects of 2 to 3 cm in length may be treated with laparoscopic or robot-assisted uretero-ureterostomy, whereas defects of 12 to 15 cm may be managed either via ureteral reimplantation with a Boari flap or via transuretero-ureterostomy in case of low bladder capacity. Cases with more extended defects can be reconstructed with the incorporation of the ileum in ureteral repair.
PubMed: 24466390
DOI: 10.4111/kju.2014.55.1.2 -
International Journal of Urology :... Mar 2000A new method was developed in order to create a single stoma cutaneous ureterostomy in which both ureters traverse the abdominal cavity and yet are buttressed by the... (Clinical Trial)
Clinical Trial
BACKGROUND
A new method was developed in order to create a single stoma cutaneous ureterostomy in which both ureters traverse the abdominal cavity and yet are buttressed by the mesosigmoid and covered by its visceral peritoneum.
METHODS
The long mesenterium which is attached to the most mobile part of the sigmoid colon was used for the bilateral ureteral pathway. Tunnels for the ureteral path were made just underneath the visceral peritoneum on the bilateral side of the mesosigmoid. Through the tunnels both ureteral ends were brought from the retroperitoneal space to the mesenterocolonic junction (MCJ) and the MCJ is then approximated and sutured to the inside of the ureteral tract through the abdominal wall. The ureters brought outside the skin, are conjoined and sutured to the V skin flap. Eight patients who carried a high risk for operation and/or had a bladder tumor judged to be incurable underwent this cutaneous ureterostomy.
RESULTS
All cases except one with low urinary output could be managed without catheter indwelling during the follow-up period. Three patients suffered from paralytic ileus and one required laparotomy for mechanical ileus during the short postoperative period. Postoperative excretory urography evaluated 14 kidneys during the follow-up period from 2 to 61 months and showed normal upper urinary tract in 11 and a mildly hydronephrotic tract in three.
CONCLUSIONS
Transmesosigmoid cutaneous ureterostomy provides a single catheterless stoma even when the available ureters are relatively short. It appears to be a good method for supravesical urinary diversion when indicated.
Topics: Aged; Colon, Sigmoid; Female; Humans; Male; Ureterostomy; Urinary Bladder Neoplasms
PubMed: 10750889
DOI: 10.1046/j.1442-2042.2000.00148.x -
Asian Pacific Journal of Cancer... 2015Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and... (Review)
Review
Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and chemical cystitis. Radiation proctitis and cystitis are major complications following radiotherapy. Prevention of radiation-induced haemorrhagic cystitis has been investigated using various oral agents with minimal benefit. Bladder irrigation remains the most frequently adopted modality followed by intra-vesical instillation of alum or formalin. In intractable cases, surgical intervention is required in the form of diversion ureterostomy or cystectomy. Proctitis is more common in even low dose ranges but is self-limiting and improves on treatment interruption. However, treatment of radiation proctitis is broadly non-invasive or invasive. Non-invasive treatment consists of non-steroid anti-inflammatory drugs (NSAIDs), anti-oxidants, sucralfate, short chain fatty acids and hyperbaric oxygen. Invasive treatment consists of ablative procedures like formalin application, endoscopic YAG laser coagulation or argon plasma coagulation and surgery as a last resort.
Topics: Cystitis; Disease Management; Humans; Proctitis; Radiation Injuries; Radiotherapy; Rectum; Urinary Bladder
PubMed: 26320421
DOI: 10.7314/apjcp.2015.16.14.5589