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Bladder augmentation and continent urinary diversion in boys with posterior urethral valves.

Baka-Ostrowska M - Cent European J Urol (2011)

Bottom Line: Poor compliance/small bladder could be treated with anticholinergics, but bladder augmentation will probably be indicated.Although bladder reconstruction with gastrointestinal segments can be associated with multiple complications, including metabolic disorders, calculus formation, mucus production, enteric fistulas, and malignancy formation, enterocystoplasty is still the gold standard.In contrast to a neuropathic or exstrophic bladder, augmentation of the valve bladder allows spontaneous voiding without significant residual urine in the majority of cases, but some require CIC (clean intermittent cathterization).

View Article: PubMed Central - PubMed

Affiliation: Pediatric Urology Department Children's Memorial Health Institute, Warsaw, Poland.

ABSTRACT
Posterior urethral valve (PUV) is a condition that leads to characteristic changes in the bladder and upper urinary tract. Dysfunction of the bladder such as a hyperreflective, hypertonic, and small capacity bladder as well as sphincter incompetence and/or myogenic failure should be adequately treated. Poor compliance/small bladder could be treated with anticholinergics, but bladder augmentation will probably be indicated. Although bladder reconstruction with gastrointestinal segments can be associated with multiple complications, including metabolic disorders, calculus formation, mucus production, enteric fistulas, and malignancy formation, enterocystoplasty is still the gold standard. In contrast to a neuropathic or exstrophic bladder, augmentation of the valve bladder allows spontaneous voiding without significant residual urine in the majority of cases, but some require CIC (clean intermittent cathterization). Augmentation cystoplasty is also an efficient approach in those children who will require kidney transplantation in the future.

No MeSH data available.


Related in: MedlinePlus

Reservoir is continent with adequate capacity.
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Figure 0004: Reservoir is continent with adequate capacity.

Mentions: To create a continent reservoir, we used 15 cm of demucosalized sigmoid segment (Fig. 1). The bowel is folded in a W-shape to obtain the largest possible capacity (Figs. 2, 3, 4). Appendicocutaneostomy is created according to Mitrofanoff and Y-V plasty is done to prevent obstruction of the stoma. After appendix implantation, the bladder is cut out of the urethra. The dissection is done in two steps and the urethra is closed [15].


Bladder augmentation and continent urinary diversion in boys with posterior urethral valves.

Baka-Ostrowska M - Cent European J Urol (2011)

Reservoir is continent with adequate capacity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921740&req=5

Figure 0004: Reservoir is continent with adequate capacity.
Mentions: To create a continent reservoir, we used 15 cm of demucosalized sigmoid segment (Fig. 1). The bowel is folded in a W-shape to obtain the largest possible capacity (Figs. 2, 3, 4). Appendicocutaneostomy is created according to Mitrofanoff and Y-V plasty is done to prevent obstruction of the stoma. After appendix implantation, the bladder is cut out of the urethra. The dissection is done in two steps and the urethra is closed [15].

Bottom Line: Poor compliance/small bladder could be treated with anticholinergics, but bladder augmentation will probably be indicated.Although bladder reconstruction with gastrointestinal segments can be associated with multiple complications, including metabolic disorders, calculus formation, mucus production, enteric fistulas, and malignancy formation, enterocystoplasty is still the gold standard.In contrast to a neuropathic or exstrophic bladder, augmentation of the valve bladder allows spontaneous voiding without significant residual urine in the majority of cases, but some require CIC (clean intermittent cathterization).

View Article: PubMed Central - PubMed

Affiliation: Pediatric Urology Department Children's Memorial Health Institute, Warsaw, Poland.

ABSTRACT
Posterior urethral valve (PUV) is a condition that leads to characteristic changes in the bladder and upper urinary tract. Dysfunction of the bladder such as a hyperreflective, hypertonic, and small capacity bladder as well as sphincter incompetence and/or myogenic failure should be adequately treated. Poor compliance/small bladder could be treated with anticholinergics, but bladder augmentation will probably be indicated. Although bladder reconstruction with gastrointestinal segments can be associated with multiple complications, including metabolic disorders, calculus formation, mucus production, enteric fistulas, and malignancy formation, enterocystoplasty is still the gold standard. In contrast to a neuropathic or exstrophic bladder, augmentation of the valve bladder allows spontaneous voiding without significant residual urine in the majority of cases, but some require CIC (clean intermittent cathterization). Augmentation cystoplasty is also an efficient approach in those children who will require kidney transplantation in the future.

No MeSH data available.


Related in: MedlinePlus