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Harshjeet Singh Bal, Sudipta Sen, Cenita Sam, Jacob Chacko, John Mathai, S R Regunandan
INTRODUCTION: In the management of cloaca, there is concern that dissection of the urogenital sinus in early childhood with the aim of total anatomical correction is hazardous. Avoiding such mobilization and providing mitrofanoff channel, when needed, till peripubertal period reduces complications and is technically easier. MATERIALS AND METHODS: Forty-three cases of cloaca were managed in the period 2004-2016. Case records and radiology were reviewed retrospectively...
April 2017: Journal of Indian Association of Pediatric Surgeons
Vasilis Stavrinides, Paul Charlesworth, Dan Wood, Divyesh Desai, Abraham Cherian, Imran Mushtaq, Peter Cuckow, Naima Smeulders
INTRODUCTION: Isolated bilateral simplex ectopic ureters (BSEUs) are rare but pose a therapeutic challenge: ureteric reimplantation alone does not accomplish continence in all. Identifying the patients needing additional procedures for continence early could prevent multiple operations. OBJECTIVE: Potential preoperative indicators for postoperative continence are explored in eight BSEU girls without cloacal, anorectal, or spinal anomalies. STUDY DESIGN: With institutional approval, all patients with BSEU between 1985 and 2012 were retrospectively reviewed...
March 6, 2017: Journal of Pediatric Urology
Deborah L Jacobson, John C Thomas, John Pope, Stacy T Tanaka, Douglass B Clayton, John W Brock, Mark C Adams
PURPOSE: We previously reported catheterizable channel associated outcomes and concluded that the incidence of postoperative complications was greatest in the first 2 years after surgery. At that time our followup was short. In this series we sought to determine whether complications continued to accumulate with longer followup in an updated cohort of patients. MATERIALS AND METHODS: We comprehensively reviewed the outcomes in 81 consecutive patients who underwent construction of a MACE (Malone antegrade continence enema) and/or a Mitrofanoff channel in association with complex genitourinary reconstruction...
December 16, 2016: Journal of Urology
Joana Lopes, Andy Robb, Liam McCarthy
BACKGROUND/PURPOSE: Reconstruction of microbladders is a difficult surgical challenge: How can a neobladder be recreated when >90% of the new bladder is augmented patch, and how can a Mitrofanoff conduit be anastomosed when the native bladder is so tiny? This series describes microbladders secondary to anuria and/or diversion that required augmentation. This was done using a de-tubularized ileal segment, and because of the small size of the native bladder, Mitrofanoff anastomosis was performed to the bowel patch (using a novel "Keel Procedure")...
February 2017: Journal of Pediatric Surgery
Jörg Fuchs, Frank Paulsen, Martin Bleif, Ulf Lamprecht, Nicola Weidner, Daniel Zips, Felix Neunhoeffer, Guido Seitz
BACKGROUND AND PURPOSE: Outcome of patients with genitourinary rhabdomyosarcoma has been improved in the past, but organ preservation rates are too low. Conservative surgery with LDR-brachytherapy has been advocated, but LDR-brachytherapy is often not available. We wanted to establish a novel treatment modality combining HDR-brachytherapy and conservative surgery. MATERIAL AND METHODS: We performed an organ preserving tumor resection with intraoperative placement of brachytherapy tubes...
November 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Takuro Sunada, Satoshi Kamido, Akihiro Hamada, Keiji Kato, Hirotsugu Uetsuki, Hiroaki Kawanishi, Kazuhiro Okumura
A 55-year-old woman was referred to our hospital with dysuria. We were unable to catheterize her using a nelaton catheter because of a urethral stricture, resulting in a large residual urine volume on ultrasonography. The circumference of the periurethral tissue was also thickened and the entire length of the urethra was stenotic, without apparent cause, on magnetic resonance imaging. Biopsy did not reveal malignancy. The pathological diagnosis of the periurethral tissue was simply fibrosis, and there was no definitive diagnosis...
September 2016: Hinyokika Kiyo. Acta Urologica Japonica
C Vuichoud, M-A Perrouin-Verbe, V Phe, M-O Bitker, J Parra, E Chartier-Kastler
INTRODUCTION: Among available urinary diversion, continent cutaneous urinary diversion (CCUD) is not frequently used after cystectomy for malignancy. The aim of our work was to assess mid-term oncological and functional outcomes of CCUD in case of malignancies. PATIENTS AND METHODS: We retrospectively included all patients who underwent CCUD after radical cystectomy for cancer (according Mitrofanoff or Monti's principle) between July 2001 and November 2015 in our department...
September 2016: Progrès en Urologie
Alice Faure, Rebecca Cooksey, Aurore Bouty, Alan Woodward, John Hutson, Mike O'Brien, Yves Heloury
BACKGROUND: Effective bladder emptying by clean intermittent catheterization for children with severe bladder dysfunction is critical for renal preservation and social integration. Use of a continent catheterizable conduit (CCC) as urethral alternative procedure provides effective bladder drainage. However, it brings a substantive maintenance. METHODS: Retrospective review of the indications and long-term outcomes of 54 patients with a Mitrofanoff procedure in a single center over a 20-year period (1995-2015)...
March 2017: Journal of Pediatric Surgery
Ariella A Friedman, Paul F Zelkovic, Edward F Reda, Israel Franco, Lane S Palmer
INTRODUCTION: Aphallia is exceedingly rare (1/30 million births). Previous reports have provided limited detail on associated urinary tract findings. OBJECTIVE: We reviewed urinary tract anomalies in two boys with aphallia (patients 1 and 2) and a girl with urinary tract dysplasia, a similar external appearance and lack of corporal tissue (patient 3), also consistent with aphallia. CASE REPORTS (FIGURE): Patients 1 and 2 both had a 46XY karyotype, bilateral descended testes in well-formed scrotums, and posterior skin tags containing rudimentary urethras...
August 2016: Journal of Pediatric Urology
Sarah Giutronich, Aurélien Scalabre, Thomas Blanc, Peter Borzi, Yves Aigrain, Mike O'Brien, Pierre D E Mouriquand, Yves Heloury
OBJECTIVE: Bladder perforation is not commonly described in bladder exstrophy patients without bladder augmentation. The goal of this study was to identify the risk factors of spontaneous perforation in non-augmented exstrophy bladders. METHODS: The study was a retrospective multi-institutional review of bladder perforation in seven male and two female patients with classic bladder exstrophy-epispadias (E-E). RESULTS: Correction of E-E was performed using Kelly repair in two and staged repair in seven (Table)...
December 2016: Journal of Pediatric Urology
Mohan S Gundeti, Michael E Petravick, Joseph J Pariser, Shane M Pearce, Blake B Anderson, Gwen M Grimsby, Ardavan Akhavan, Pankaj P Dangle, Aseem R Shukla, Thomas S Lendvay, Glenn M Cannon, Patricio C Gargollo
BACKGROUND: Robotic techniques are increasingly being used for reconstructive procedures in the pediatric population. OBJECTIVE: The present study reported the functional and perioperative outcomes of a multi-institutional cohort of pediatric patients who underwent robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy (RALMA). STUDY DESIGN: Pediatric patients who underwent RALMA at five different centers were included. Positioning is shown (Summary Figure)...
December 2016: Journal of Pediatric Urology
Balaji N Reddy, Madanika Subhash, Monika Pilichowska, George T Klauber
Squamous cell carcinoma arising from a urinary stoma is exceedingly rare, and none so far is reported from a cutaneous ureterovesical stoma. Squamous cell carcinoma usually occurs as a late complication of urinary diversion, and we report the first such case in a cutaneous ureterovesical stoma with a review of published literature.
January 2017: Urology
Jeffrey A Cadeddu
No abstract text is available yet for this article.
June 2016: Journal of Urology
Carlos Augusto Fernandes Molina, Gilson José de Lima, Marcelo Ferreira Cassini, Murilo Ferreira de Andrade, Inalda Facincani, Silvio Tucci Júnior
PURPOSE: Bladder augmentation is an effective surgical procedure for increasing bladder capacity and reducing pressure on the urinary system. It is indicated for patients with anomalies such as spina bifida, myelomeningocele, urethral valve and bladder exstrophy, who progress with low tolerance of medication. CASES: This was a retrospective study conducted on pediatric patients submitted to bladder augmentation from 2000 to 2011. RESULTS: 34 patients aged 4 to 17 years were submitted to bladder augmentation, 30 of them with an ileal loop and 4 with a ureter...
2016: Acta Cirúrgica Brasileira
Aureen Ruby D'Cunha, Jujju Jacob Kurian, Tarun John K Jacob
Female hypospadias is a rare anomaly of the female urethra where it opens on the anterior vaginal wall anywhere between the introitus and the fornix. It is often associated with other genitourinary anomalies such as Cloacal malformation, female pseudohermaphroditism, nonneurogenic neurogenic bladder and urethral duplication. Idiopathic female pseudohermaphroditism is extremely rare, and most cases occur secondary to adrenogenital syndrome or maternal androgen exposure. We report a unique case of a 1-year and 4-month-old girl who presented with ambiguous genitalia and renal failure secondary to a non-neurogenic neurogenic bladder...
March 10, 2016: BMJ Case Reports
Yuka Kono, Naoki Terada, Yasushi Takashima, Kensuke Hikami, Takuya Hida, Shuhei Goto, Takuro Sunada, Yoshiyuki Okada, Noboru Shibasaki, Hiromitsu Negoro, Takashi Kobayashi, Toshinari Yamasaki, Yoshiyuki Matsui, Takahiro Inoue, Tomomi Kamba, Osamu Ogawa
A 29-year-old woman had undergone gastrocystoplasty with Mitrofanoff appendicovesicostomy for urethral trauma at 9 years of age. Since then, she was being followed up for performing clean intermittent self-catheterization at regular intervals. Twenty years after the surgery, she presented with gross hematuria. Ultrasonographic findings revealed bilateral hydronephrosis. Cystoscopy and computed tomography (CT) revealed invasive bladder cancer with pelvic lymph node metastases. A biopsy confirmed the diagnosis of adenocarcinoma with signet ring cell carcinoma...
January 2016: Hinyokika Kiyo. Acta Urologica Japonica
Caleb E Cooper, Alfred P Kennedy, D Preston Smith
We present a rare complication of abdominal compartment syndrome (ACS) in a child undergoing complex urologic reconstruction. A 10-year-old female born with the abdominal wall defect cloacal exstrophy who had previously undergone multiple abdominal procedures then developed findings consistent with ACS following a complex Mitrofanoff procedure. Although intravesical pressures were not documented because of the nature of her reconstruction, her ACS-type findings were (1) abdominal pain, (2) melena, (3) pulmonary hypoinflation, (4) renal insufficiency, (5) tachycardia, and (6) segmental ischemic small bowel...
July 2016: Urology
Mya E Levy, Sean P Elliott
Cutaneous catheterizable channels allow for continent bladder emptying when an alternate route is desired. The goals of channel creation in the neurogenic bladder population are successful urine elimination, renal preservation, continence and lastly cosmesis. In addition to a particular surgeon's comfort and experience with a given procedure, individual patient factors such as medical comorbidities, anatomic factors, and occupational function should be central to the selection of a surgical approach. An ideal channel is one that is short, straight, and well supported by associated blood supply and surrounding adventitia, so as to minimize difficulty with catheterization...
February 2016: Translational Andrology and Urology
M Bouassida, W Smaoui, M Fourati, M A Mseddi, K Chabchoub, A Chaabouni, S Rekik, N Rebai, J Masmoudi, M Hadjslimen, M N Mhiri
OBJECTIVE: To evaluate the influence of continent external urinary diversion type Mitrofanoff on male sexuality. MATERIAL AND METHODS: Between 1992 and 2011, 140 patients underwent continent urinary diversion type Mitrofanoff at an academic hospital. Among 76 men, 46 were interviewed about their sexuality after this operation. This study was performed using a set of validated questionnaires (IIEF, DAN PSS and Urolife), grouped by the model of the CTMH. Patients were divided according to their marital status: group 1: patients married before surgery (15 cases), group 2: patients married after surgery (7 cases) and group 3: singles (24 cases)...
February 2016: Progrès en Urologie
M Davari, B W Lamb, S Chowdhury, C Jameson, J D Kelly, T Greenwell
Aggressive angiomyxoma is a rare mesenchymal tumour predominantly affecting the female pelvis and perineum but has also been described in males. This tumour can often present a diagnostic challenge and has a propensity for local recurrence after surgical excision. We present an unusual case of aggressive angiomyxoma arising from the bladder of a female patient which required local excision and Mitrofanoff formation.
2015: Case Reports in Urology
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