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Indiana pouch

Michael A Bell, Edward J Wright, Sandy H Fang, Michael H Johnson, Nikolai A Sopko
Adenocarcinoma is a rare finding following urinary diversion with gastrointestinal segments. This report describes an 80-year-old woman with a history of bladder cancer who subsequently developed a pT4 adenocarcinoma 8 years following her radical cystectomy and Indiana Pouch continent urinary diversion. An en bloc resection of the pouch and affected small bowel was performed and the patient underwent conversion to an ileal conduit diversion. We use this case to highlight a mechanism for possible pathogenesis and the management of adenocarcinoma in urinary diversions including the need for regular surveillance and the surgical approach...
March 2018: Urology Case Reports
Kazuya Iwamoto, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
A 73-year-old man with lower abdominal pain was diagnosed at our hospital with sigmoid colon cancer. He had previously undergone radical cystectomy with Indiana pouch construction and gastrectomy to treat bladder cancer and gastric cancer, respectively. We performed a laparoscopic Hartmann's operation with Japanese D3 lymph node dissection. We observed severe adhesion in the abdominal cavity; adhesions between the urostomy and sigmoid colon were particularly severe. The tumor had invaded to the distal rectum, which had adhered to the pubic bone and the previously reconstructed urinary pouch...
November 2017: Asian Journal of Endoscopic Surgery
Paul T Gellhaus, Clint Cary, Hristos Z Kaimakliotis, Cynthia S Johnson, Michael Weiner, Michael O Koch, Richard Bihrle
OBJECTIVE: To evaluate the long-term (>5 years) health-related quality of life (HRQOL) outcomes following radical cystectomy, comparing Indiana pouch (IP), neobladder (NB), and ileal conduit (IC). MATERIALS AND METHODS: The departmental radical cystectomy database was queried to identify patients who underwent radical cystectomy and urinary diversion for bladder cancer between 1991 and 2009 and had not died. Three hundred patients were identified and sent the validated Bladder Cancer Index instrument...
August 2017: Urology
Mihir M Desai, Giuseppe Simone, Andre Luis de Castro Abreu, Sameer Chopra, Mariaconsiglia Ferriero, Salvatore Guaglianone, Francesco Minisola, Daniel Park, Rene Sotelo, Michele Gallucci, Inderbir S Gill, Monish Aron
PURPOSE: Robotic intracorporeal urinary diversion has mostly been done for ileal conduit or orthotopic neobladder diversion. We present what is to our knowledge the initial series, detailed technique and outcomes of the robotic intracorporeal Indiana pouch with a minimum 1-year followup. MATERIALS AND METHODS: Ten patients underwent robotic radical cystectomy, pelvic lymphadenectomy and intracorporeal Indiana pouch urinary diversion for cancer in 9 and benign disease in 1...
August 2017: Journal of Urology
Takuya Horio, Yosuke Oka, Ichitaro Shiratsuchi, Kouhei Saisho, Yuutarou Mihara, Reiichirou Kondo, Tetsushi Kinugusa, Jun Akiba, Yoshito Akagi
The transsacral approach is not routinely used for treating rectal tumors. We report the case of a 65-year-old man with a large adenoma at the posterior wall of the mid-rectum who was treated via the transsacral approach. The same lesion had been treated using transsacral endoscopic microsurgery 8 years previously. Moreover, 11 years previously he had undergone a laparotomy for bladder cancer, and an Indiana pouch had been constructed. Abdominal computed tomography showed that the pouch was adjacent to the rectum...
May 8, 2017: Kurume Medical Journal
Josemberg Marins Campos, Flávio Coelho Ferreira, André F Teixeira, Jones Silva Lima, Rena C Moon, Marco Aurélio D'Assunção, Manoel Galvão Neto
BACKGROUND: Chronic leaks after laparoscopic sleeve gastrectomy (LSG) are often difficult to treat by endoscopy metallic stent. Septotomy has been indicated as an effective procedure, but the technical aspects have not been detailed in previous publications (Campos JM, Siqueira LT, Ferraz AA, et al., J Am Coll Surg 204(4):711, 2007; Baretta G, Campos J, Correia S, et al., Surg Endosc 29(7):1714-20, 2015; Campos JM, Pereira EF, Evangelista LF, et al., Obes Surg 21(10):1520-9, 2011). We herein present a video (6 min) demonstrating the maneuver principles of this technique, showing it as a safe and feasible approach...
August 2016: Obesity Surgery
Jeremy B Myers, Sara M Lenherr
PURPOSE OF REVIEW: This article summarizes recent evidence describing perioperative and long-term surgical complications of the Indiana pouch and similar continent catheterizable urinary diversions. RECENT FINDINGS: The perioperative morbidity and long-term complications are better defined in recent literature describing the Indiana and similar pouches. Both perioperative and long-term surgical complications for the Indiana and similar pouches are extremely variable between studies, but ranges between 1-32% and 6-69%, respectively...
July 2016: Current Opinion in Urology
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No abstract text is available yet for this article.
April 2016: Oncology (Williston Park, NY)
Madeleine G Manka, Carlos Santoni, E James Wright, Susan L Gearhart
An increased risk of neoplasm has been noted when bowel segments are used for urinary diversion. Particularly true for ureterosigmoidostomy, colonic adenocarcinoma has rarely been reported following Indiana Pouch diversion. This report describes a 42-year-old woman with a history of bladder exstrophy who developed a polyp in her Indiana Pouch 24 years after its creation. The polyp, found incidentally, was a tubular adenoma with high-grade dysplasia. Due to its malignant potential, the polyp was resected with preservation of the Indiana Pouch...
September 2015: Urology Case Reports
Valary T Raup, Jairam R Eswara, Stephen D Marshall, Steven B Brandes
INTRODUCTION: Continent catheterizable diversions can exhibit long-term complications such as high pressures and involuntary unit contractions within the urinary reservoir, rendering them similar to neurogenic bladders. Given the similarity of these issues to neurogenic detrusor overactivity, the use of Botox injections is a logical treatment option to explore. TECHNICAL CONSIDERATIONS: A patient with a contracted Indiana pouch continent catheterizable diversion was treated with intra-pouch Botox injections after failing maximal doses of oral anticholinergic medications...
February 2016: Urology
Kristina Wittig, Nora Ruel, John Barlog, Laura Crocitto, Kevin Chan, Clayton Lau, Timothy Wilson, Bertram Yuh
OBJECTIVE: To examine the occurrence and cost burden of hospital readmission within 90 days of robot-assisted radical cystectomy (RARC). Subjects/Patients (or Materials) and Methods: From 2003 to 2012, 247 patients underwent RARC with extracorporeal urinary reconstruction at a single categorical cancer hospital. Continent diversions were performed in 67% of patients. All readmissions within 90 days were included. Readmissions were defined as early (<30 days) and late (31-90 days) with multiple readmissions captured as separate events...
January 2016: Journal of Endourology
Hiroaki Ishida, Jun-Ichi Teranishi, Yusuke Hattori, Takahiro Hanai, Mitsuyuki Koizumi, Kazumi Noguchi
Kidney transplantation with an Indiana pouch is very rare, and a case report about it has not been found. This is our report about a successful case of kidney transplantation in a patient with an Indiana pouch. A 32 year-old woman with end stage renal failure was referred to our hospital for living related kidney transplantation. She had undergone an Indiana pouch diversion, due to a neurogenic bladder with spina bifida and renal dysfunction, 11 years ago. However, her kidney function gradually deteriorated, and finally she was started on hemodialysis six months ago...
January 2015: Nihon Hinyōkika Gakkai Zasshi. the Japanese Journal of Urology
Andrew P Hawkins, Jonathan C Sum, Daniel Kirages, Erica Sigman, Soma Sahai-Srivastava
STUDY DESIGN: Resident's case problem. BACKGROUND: Groin pain represents a diagnostic challenge and requires a diagnostic process that rules out life-threatening illness or disease processes. Osteomyelitis is a potential fatal disease process that requires accurate diagnosis and medical management. Osteomyelitis presents a problem for the outpatient physical therapist, as the described physical findings for the diagnosis of osteomyelitis are nonspecific. DIAGNOSIS: A 67-year-old man with groin and bilateral medial thigh pain was referred for physical therapy care to address right adductor weakness and generalized deconditioning...
April 2015: Journal of Orthopaedic and Sports Physical Therapy
Alvin C Goh, Monty A Aghazadeh, Ross E Krasnow, Alexander W Pastuszak, Julie N Stewart, Brian J Miles
The purpose is to present the first report and describe our novel technique for intracorporeal continent cutaneous diversion after robotic cystectomy. After completion of robot-assisted cystectomy using a standard six-port transperitoneal technique, three additional ports are placed, and the robot is redocked laterally over the patient's right side in the modified lateral position. Our technique replicates step-by-step the principles of the open approach. Ileocolonic anastomosis, ureteroenteral anastomoses, and construction of a hand-sewn right colonic pouch are all performed intracorporeally...
November 2015: Journal of Endourology
Scott Tobis, Jonathan E Heinlen, Nora Ruel, Clayton Lau, Mark Kawachi, Timothy Wilson, Kevin Chan
INTRODUCTION: Alvimopan has been shown to improve time to return of bowel function in patients undergoing bowel resection. The objective of this study is to determine if alvimopan has similar benefits for patients undergoing robot-assisted radical cystectomy (RARC). MATERIALS AND METHODS: All RARC cases were reviewed from January 2008 to March 2012. All patients during this time were administered alvimopan unless they had been receiving narcotics preoperatively...
October 2014: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Bashir Al Hussein Al Awamlh, Lily C Wang, Daniel P Nguyen, Malte Rieken, Richard K Lee, Daniel J Lee, Thomas Flynn, James Chrystal, Shahrokh F Shariat, Douglas S Scherr
OBJECTIVE: To evaluate functional outcomes of continent cutaneous urinary diversion (CCUD) after radical cystectomy (RC) and to compare diversion-related complications and long-term renal function in a contemporary cohort of patients undergoing urinary diversion with CCUD, orthotopic bladder substitute (OBS) and ileal conduit (IC). PATIENTS AND METHODS: In all, 322 patients underwent RC and CCUD, OBS or IC from January 2002 to June 2013. CCUD was performed using either a modified Indiana pouch or an appendiceal stoma...
November 2015: BJU International
Sujit K Chowdhary, Katargadda L N Rao, Deepak K Kandpal, Anupam Sibal, Rajendra N Srivastava
OBJECTIVE: We report our experience with the Indiana pouch (continent urinary reservoir) in 12 consecutive children over the last 15 years and report their follow-up. MATERIAL AND METHODS: Twelve consecutive children, who underwent the continent urinary reservoir procedure in the form of an Indiana pouch, were prospectively enrolled in the study. All consecutive children who were referred to our service with multiple failed surgeries for exstrophy-epispadias repair, cloacal exstrophy, genitourinary rhabdomyosarcoma with residual disease in the trigonal area not amenable to partial cystectomy, and neuropathic bladder with nephrogenic metaplasia were included over the period 1997-2012...
October 2014: Journal of Pediatric Urology
M Francesca Monn, Hristos Z Kaimakliotis, K Clint Cary, Jose A Pedrosa, Chandra K Flack, Michael O Koch, Richard Bihrle
PURPOSE: Literature surrounding Indiana pouch (IP) urinary diversion suggests a higher incidence of complications and longer operative time compared with ileal conduit (IC) and neobladder (NB). We sought to assess short-term complications of IP diversions compared with other diversions at our institution. MATERIALS AND METHODS: Using institutional National Surgical Quality Improvement Program data, we identified radical cystectomy cases performed for bladder cancer at Indiana University from January 2011 until June 2013...
November 2014: Urologic Oncology
O A Castillo, G Aranguren, F Campos-Juanatey
INTRODUCTION: Radical pelvic surgery requires continent or incontinent urinary diversion. There are many techniques, but the orthotopic neobladder is the most used. A continent catheterizable urinary reservoir is sometimes a good alternative when this derivation is not possible or not indicated. This paper has aimed to present our experience with the Indiana pouch continent urinary reservoir. MATERIAL AND METHODS: The series is made up of 85 patients, 66 women and 19 men, with a mean age of 56 years (31-77 years)...
July 2014: Actas Urologicas Españolas
John Kinahan, Howard Pai, Mildred Martens, Jason Gray, Darren Biberdorf, Alex Mihailovic, Iain McAuley
Radiation therapy is a well-recognized treatment for unfavourable risk localized prostate cancer. Radiation induced recto-urethral fistulae are known rare complications particularly from brachytherapy. We report a case of a recto-urethral fistula 7 years post-external beam radiation and I-125 brachytherapy, which was complicated by a severe polymicrobial soft tissue infection. This infection required penectomy and pelvic exenteration with diverting colostomy, Indiana pouch urinary diversion and gracilis myo-cutaneuos flap closure of the perineum...
January 2014: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
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