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经脐横断回肠管状化膀胱术可控性尿流改道。

Transverse retubularized ileovesicostomy continent urinary diversion to the umbilicus.

作者信息

Van Savage J G, Chancellor M B, Slaughenhoupt B

机构信息

Department of Surgery, University of Louisville School of Medicine, Kentucky 40292, USA.

出版信息

Tech Urol. 2000 Mar;6(1):29-33.

Abstract

The transverse retubularized ileovesicostomy is useful as a continent urinary diversion when the appendix is unusable or unavailable for an appendicovesicostomy continent urinary diversion. Eight patients (mean age 29 years) with difficulty catheterizing their native urethras underwent creation of a transverse retubularized ileovesicostomy continent urinary diversion to the umbilicus. Diagnoses included myelomeningocele (3), multiple sclerosis (1), and spinal cord injury (4). Concomitant procedures included ileocystoplasty, antegrade continence enema procedure, and pubovaginal sling. All patients were able to catheterize their ileovesicostomy conduit and stoma easily with a 14F catheter. Six patients were completely dry, and two patients needed to catheterize every 3 to 4 hours to prevent urinary leakage. Mean follow-up was 3 years. Experience with the transverse retubularized ileovesicostomy continent urinary diversion to the umbilicus has been favorable. When the Mitrofanoff appendicovesicostomy continent urinary diversion is not an option, the transverse retubularized ileovesicostomy has several advantages as a second choice.

摘要

当阑尾无法用于阑尾膀胱造口可控性尿流改道术时,横断回肠管状化膀胱造口术作为一种可控性尿流改道术是有用的。8例(平均年龄29岁)经尿道插管困难的患者接受了横断回肠管状化膀胱造口术并将尿液可控性转流至脐部。诊断包括脊髓脊膜膨出(3例)、多发性硬化(1例)和脊髓损伤(4例)。同期手术包括回肠膀胱扩大术、顺行性可控灌肠术和耻骨后阴道吊带术。所有患者均能用14F导管轻松地经回肠膀胱造口导管和造口进行插管。6例患者完全无尿失禁,2例患者需要每3至4小时插管一次以防止尿液渗漏。平均随访时间为3年。将横断回肠管状化膀胱造口术用于脐部可控性尿流改道的经验是令人满意的。当米氏可控性阑尾膀胱造口尿流改道术不可行时,横断回肠管状化膀胱造口术作为第二选择有几个优点。

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