Sarin Yogesh K
Department of Paediatric Surgery, Maulana Azad Medical College New Delhi, India.
APSP J Case Rep. 2011 May;2(2):15. Epub 2011 Jul 30.
Mitrofanoff appendicovesicostomy has been the method of choice for dealing with urinary incontinence. However, there may be some cases where some alternate conduits have to be used. Yang-Monti ileovesicostomy is an alternative to Mitrofanoff appendicovesicostomy. Three boys who underwent successful Yang-Monti continent ileovesicostomy are reported in this manuscript. In the first case, Mitrofanoff procedure was done for traumatic anorectal and urethral disruption after attempting ureterosigmoidostomy. Later on, on the request of the patient the appendicovesicostomy was excised. The patient presented later with chronic renal failure and bilateral hydroureteronephrosis thus an ileovesicostomy was fashioned. The patient could not be survived due to chronic renal failure related complications. In the second patient with exstrophy of bladder, the ileocecal junction along with appendix had to be resected on account of strangulated inguinal hernia; later on, an ileovesicostomy was performed for small capacity bladder and major degree of vesicoureteric reflux. The third patient with exstrophy of bladder, in whom Mitrofanoff procedure had been performed, presented with stenosis of the appendicovesicostomy. On re-operation the entire channel had disappeared thus necessitated ileovesicostomy. Both of these patients were doing well on follow-up.
米氏阑尾膀胱造瘘术一直是处理尿失禁的首选方法。然而，在某些情况下可能不得不使用一些替代导管。杨-蒙蒂回肠膀胱造瘘术是米氏阑尾膀胱造瘘术的一种替代方法。本文报告了3例成功接受杨-蒙蒂可控性回肠膀胱造瘘术的男孩。第一例患者，在尝试输尿管乙状结肠吻合术后因创伤性肛门直肠和尿道断裂而进行了米氏手术。后来，应患者要求切除了阑尾膀胱造瘘术。该患者后来出现慢性肾衰竭和双侧肾盂输尿管积水，因此进行了回肠膀胱造瘘术。患者因慢性肾衰竭相关并发症未能存活。第二例膀胱外翻患者，由于绞窄性腹股沟疝不得不切除回盲部及阑尾；后来，因膀胱容量小和严重的膀胱输尿管反流进行了回肠膀胱造瘘术。第三例膀胱外翻患者，曾接受米氏手术，出现阑尾膀胱造瘘口狭窄。再次手术时整个通道已消失，因此需要进行回肠膀胱造瘘术。这两名患者随访情况良好。
