The Experts below are selected from a list of 207 Experts worldwide ranked by ideXlab platform
Jacques Corcos - One of the best experts on this subject based on the ideXlab platform.
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Revisiting Ureterosigmoidostomy, a Useful Technique of Urinary Diversion in Functional Urology.
Urology, 2018Co-Authors: Mikolaj Przydacz, Jacques CorcosAbstract:Ureterosigmoidostomy has largely been disregarded in recent times but has now seen a resurgence of interest because of its potential applicability to newer, minimally invasive surgical techniques. The advantages of Ureterosigmoidostomy over intestinal conduits are urinary continence (obviating the need for stoma and external appliances), ease, and rapidity of performance as well as acceptance by patients. Ureterosigmoidostomy has been characterized by good continence outcomes and it offers good quality of life. Possible complications are anastomosis stenosis, coloureteral reflux, electrolyte imbalance, hydronephrosis, pyelonephritis, chronic renal failure, colorectal cancer, and others. Ureterosigmoidostomy is therefore only advisable for patients ready to accept long-term follow-up.
C.r.j. Woodhouse - One of the best experts on this subject based on the ideXlab platform.
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Modified Ureterosigmoidostomy (Mainz II): a long-term follow-up
BJU international, 2004Co-Authors: T. Nitkunan, R. Leaver, H.r.h. Patel, C.r.j. WoodhouseAbstract:To assess the long-term results in patients treated using a modified Ureterosigmoidostomy (Mainz II). Between 1994 and 1999, 17 patients had their lower urinary tract reconstructed by a Ureterosigmoidostomy, modified by reconfiguring the rectum to make a low-pressure reservoir (Mainz II). All patients were followed on a standard protocol. Data were extracted from the database and from a review of the case-notes. In 12 patients the procedure was with a radical cystectomy for carcinoma. Five had a failed conventional Ureterosigmoidostomy for bladder exstrophy and therefore proceeded to a Mainz II. The data on continence and complications were retrieved for a retrospective analysis; the mean (range) follow-up was 6.4 (4-8.6) years. Ten of those with bladder cancer and one in the revision group were continent. Two patients in the revision group had sufficiently severe nocturnal incontinence to require conversion to a colonic conduit. Seven of the 17 patients had hyperchloraemic acidosis, one had pyelonephritis and one had renal stones. There were no anastomotic neoplasms. The Mainz II has a good outcome if used as the primary procedure. In patients with an existing Ureterosigmoidostomy who are incontinent, detubularization of the rectosigmoid alone is unlikely to restore continence.
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modified Ureterosigmoidostomy mainz ii a long term follow up
BJUI, 2004Co-Authors: T. Nitkunan, R. Leaver, H.r.h. Patel, C.r.j. WoodhouseAbstract:OBJECTIVETo assess the long-term results in patients treated using a modified Ureterosigmoidostomy (Mainz II).PATIENTS AND METHODSBetween 1994 and 1999, 17 patients had their lower urinary tract reconstructed by a Ureterosigmoidostomy, modified by reconfiguring the rectum to make a low-pressure reservoir (Mainz II). All patients were followed on a standard protocol. Data were extracted from the database and from a review of the case-notes. In 12 patients the procedure was with a radical cystectomy for carcinoma. Five had a failed conventional Ureterosigmoidostomy for bladder exstrophy and therefore proceeded to a Mainz II. The data on continence and complications were retrieved for a retrospective analysis; the mean (range) follow-up was 6.4 (4-8.6) years.RESULTSTen of those with bladder cancer and one in the revision group were continent. Two patients in the revision group had sufficiently severe nocturnal incontinence to require conversion to a colonic conduit. Seven of the 17 patients had hyperchloraemic acidosis, one had pyelonephritis and one had renal stones. There were no anastomotic neoplasms.CONCLUSIONThe Mainz II has a good outcome if used as the primary procedure. In patients with an existing Ureterosigmoidostomy who are incontinent, detubularization of the rectosigmoid alone is unlikely to restore continence.
Peter W. De Leeuw - One of the best experts on this subject based on the ideXlab platform.
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Life-threatening hypokalaemia and quadriparesis in a patient with Ureterosigmoidostomy.
The Netherlands journal of medicine, 2002Co-Authors: J.w. Van Bekkum, Dirk Jan Bac, I.e. Nienhuis, A. Dees, Peter W. De LeeuwAbstract:We report quadriparesis as a result of severe hypokalaemia and acidosis in a 50-year-old man who had undergone Ureterosigmoidostomy for bladder extrophy 48 years earlier. Aggressive suppletion with intravenous potassium and bicarbonate combined with potassium-sparing diuretics and ACE inhibitors resulted in complete restoration of the serum potassium and resolution of the neurological symptoms. The underlying mechanism as well as the treatment of hypokalaemia and hyperchloraemic metabolic acidosis after Ureterosigmoidostomy are briefly discussed.
Marshall L. Stoller - One of the best experts on this subject based on the ideXlab platform.
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endoscopic management of obstructive complications in Ureterosigmoidostomy
Urology, 2007Co-Authors: Michael L. Eisenberg, Keith L. Lee, Marshall L. StollerAbstract:OBJECTIVES Although rarely used today for supravesical urinary diversion, Ureterosigmoidostomy remains useful in patients with bladder exstrophy. However, management of ureteral stricture and ureteral urolithiasis is challenging because of the lack of anatomic landmarks. METHODS We reviewed our prospectively collected database from 1994 to 2006 for all patients requiring surgical treatment for obstructive complications associated with Ureterosigmoidostomy. RESULTS Our analysis revealed 3 patients (mean age 46 years; 2 men and 1 woman). All 3 patients had undergone Ureterosigmoidostomy as a component of bladder exstrophy management. All patients presented with renal failure due to obstruction and required antegrade endoscopic management. Two patients had anastomotic strictures and one had obstructive urolithiasis. One patient in whom the stricture was judged to be chronic was treated with an endoureterotomy and Acucise balloon. The second patient, who had an acute obstruction after colonoscopic biopsy of his anastomosis, was treated with antegrade balloon dilation. Both patients had stents placed across the anastomosis for 6 weeks postoperatively. Despite reflux of stool into the collecting system, neither patient manifested with local or systemic signs of infection. The patient with urolithiasis required antegrade basket stone extraction. CONCLUSIONS Obstructive complications after Ureterosigmoidostomy should be managed using antegrade endoscopic techniques.
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Endoscopic management of obstructive complications in Ureterosigmoidostomy.
Urology, 2007Co-Authors: Michael L. Eisenberg, Keith L. Lee, Marshall L. StollerAbstract:Although rarely used today for supravesical urinary diversion, Ureterosigmoidostomy remains useful in patients with bladder exstrophy. However, management of ureteral stricture and ureteral urolithiasis is challenging because of the lack of anatomic landmarks. We reviewed our prospectively collected database from 1994 to 2006 for all patients requiring surgical treatment for obstructive complications associated with Ureterosigmoidostomy. Our analysis revealed 3 patients (mean age 46 years; 2 men and 1 woman). All 3 patients had undergone Ureterosigmoidostomy as a component of bladder exstrophy management. All patients presented with renal failure due to obstruction and required antegrade endoscopic management. Two patients had anastomotic strictures and one had obstructive urolithiasis. One patient in whom the stricture was judged to be chronic was treated with an endoureterotomy and Acucise balloon. The second patient, who had an acute obstruction after colonoscopic biopsy of his anastomosis, was treated with antegrade balloon dilation. Both patients had stents placed across the anastomosis for 6 weeks postoperatively. Despite reflux of stool into the collecting system, neither patient manifested with local or systemic signs of infection. The patient with urolithiasis required antegrade basket stone extraction. Obstructive complications after Ureterosigmoidostomy should be managed using antegrade endoscopic techniques.
John W. Duckett - One of the best experts on this subject based on the ideXlab platform.
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Long-Term Results of Ureterosigmoidostomy in Children With Bladder Exstrophy
The Journal of urology, 1996Co-Authors: Harry P. Koo, Luigi Avolio, John W. DuckettAbstract:AbstractPurpose: We evaluated long-term results of patients with bladder exstrophy who underwent Ureterosigmoidostomy.Materials and Methods: Of 4 women and 23 men monitored at our institution 16 (59 percent) underwent primary diversion by Ureterosigmoidostomy, while 11 (41 percent) underwent primary bladder closure or an ileal conduit procedure before conversion to Ureterosigmoidostomy. Average followup after Ureterosigmoidostomy was 17 years.Results: Significant upper urinary tract changes developed in 18 percent of the patients. Metabolic acidosis was well compensated in most patients but 2 had problems with urinary retention leading to hyperammonemia and acidosis. Of the 19 patients monitored with biennial colonoscopy benign polyps were removed in 4. Daytime continence was achieved in 92 percent of cases and nighttime continence in 58 percent.Conclusions: Our experience with Ureterosigmoidostomy in children with bladder exstrophy has been favorable through long-term followup. With proper imaging, metab...
