Document Detail


Gastrocystoplasty: an alternative solution to the problem of urological reconstruction in the severely compromised patient.
MedLine Citation:
PMID:  3184289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An isolated segment of stomach was used for bladder augmentation in 10 patients or construction of a continent urinary reservoir in 3. Diagnosis in these 13 patients included cloacal exstrophy (5), myelodysplasia (4), posterior urethral valves (2), radiation cystitis (1) and neurogenic bladder secondary to a rectal pull-through procedure (1). Indications for the use of stomach in bladder reconstruction were decreased renal function and acidosis (6 patients), insufficient large and small bowel (6) and decreased mucus production (1). Postoperative followup averaged 13 months (range 6 to 23 months). All patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 10 require intermittent clean catheterization to empty and 11 are completely continent. Nine patients have remained free of infection, while 4 had asymptomatic bacteriuria. Mucus production is reduced relative to other intestinal segments and 10 patients require no bladder irrigations. Postoperative urodynamic evaluation is similar to that of ileocystoplasty or colocystoplasty. Use of stomach has protected these patients from the development of new or worsened hyperchloremic acidosis. Serum chloride values have decreased and serum total carbon dioxide values have increased after bladder reconstruction, particularly in patients with impaired renal function. Stomach should be considered when lower urinary tract reconstruction is necessary in such compromised patients.
Authors:
M C Adams; M E Mitchell; R C Rink
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  140     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  1988 Nov 
Date Detail:
Created Date:  1988-11-28     Completed Date:  1988-11-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1152-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Urology, James Whitcomb Riley Hospital for Children, Indianapolis, Indiana.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Chemical Analysis
Child
Child, Preschool
Female
Humans
Hydrogen-Ion Concentration
Infant
Kidney Concentrating Ability
Male
Postoperative Complications
Replantation
Stomach / transplantation*
Ureteral Obstruction / etiology,  surgery
Urinary Bladder / surgery*
Urine / metabolism,  microbiology
Urodynamics
Urologic Diseases / blood,  physiopathology,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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