PD11-10 AUGMENTATION ENTEROCYSTOPLASTY WITH CONTINENT ILEAL CONDUIT. SURGICAL TECHNIQUE AND OUTCOMES

You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion II1 Apr 2015PD11-10 AUGMENTATION ENTEROCYSTOPLASTY WITH CONTINENT ILEAL CONDUIT. SURGICAL TECHNIQUE AND OUTCOMES Matias I Gonzalez, Gabriel A Favre, Maria E Zubieta, Lucas Britez, Oscar H Damia, and Juan C Tejerizo Matias I GonzalezMatias I Gonzalez More articles by this author , Gabriel A FavreGabriel A Favre More articles by this author , Maria E ZubietaMaria E Zubieta More articles by this author , Lucas BritezLucas Britez More articles by this author , Oscar H DamiaOscar H Damia More articles by this author , and Juan C TejerizoJuan C Tejerizo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1099AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The bladder augmentation is used in the treatment of both structural and functional lower urinary tract disorders, creating a reservoir that allows a low pressure filling of the bladder. The purpose of this paper is to describe an augmentation enterocistoplasty with continent ileal conduit surgical technique and its outcomes. METHODS Between May 2008 and May 2012, 16 patients underwent augmentation enterocystoplasties with continent illeal conduit. All patients had at least 1 year follow-up. Among the diseases causing bladder dysfunction: 6 (37.5%) were neurogenic bladders due to spinal cord injury, 4 (25%) microbladders due to myelomeningocele, 4 (25%) microbladders secondary to radiotherapy, 1 (6.25%) tuberculous microbladder and 1 (6.25%) idiopathic bladder. All patients mentioned urinary incontinence (UI) and urinary tract infection as the reason for consultation, 5 (31.25%) of them also had renal failure with aggregate uronephrosis and 4 (25%) used indwelling urinary catheter. Surgical technique:Section of 45 cm of vascularized ileum, 15 cm from the ileocecal valve, detubularizing 30 cm of the proximal portion and respecting 15 cm of distal ileum that will form the ileal conduit. The open intestinal portion is folded in a “U” shape, joining the adjacent edges. Refinement and intussusception of the ileal conduit, forming an anti-reflux valve. The bladder is opened in the sagittal plane, the intestinal patch and bladder edges are sutured together. Umbilical resection and umbilical duct externalization. RESULTS The mean follow-up was 30.18 months (13-48). Mean age was 37 years old (23-71). Intermittent catheterization was performed from postoperative day 21. Immediate complications occurred, 1 (6.25%) urinary fistula, paralytic ileus in 2 (12.5%) patients, urosepsis in 2 (12.5%) patients. Late complications were urinary tract infection in 4 patients (25%), urinary incontinence in 4 (25%), bladder stones in 2 patients (12.5%), and 1 patient (6.25%) decided to continue with permanent bladder catheter in the ileal conduit. The mean preoperative and post-operative bladder pressures was 87 cm of H2O and 17 cm of H2O respectively. The average preoperative and post-operative bladder capacity after one year was 112.5 cc (40-230 cc) and 426.25 cc (250-660 cc) respectively. CONCLUSIONS The surgical technique for augmentation enterocistoplasty with continent ileal conduit is a feasible and safe approach for the management of urinary incontinence and renal failure in patients with neurogenic bladder and/or microbladder refractory to other treatments. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e254-e255 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matias I Gonzalez More articles by this author Gabriel A Favre More articles by this author Maria E Zubieta More articles by this author Lucas Britez More articles by this author Oscar H Damia More articles by this author Juan C Tejerizo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...