Macedo Antonio, Cruz Marcela Leal da
Centro de Apoio à Criança com Anomalia Urológica, São Paulo, SP, Brazil.
Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2018 Nov 8;16(4):eRC3887. doi: 10.31744/einstein_journal/2018RC3887.
We report a case of secondary urinary reconstruction of previously separated conjoined twins with exstrophic bladder and urinary incontinence. Patients were male and aged 13-year-old. Twin one had a history of failed enterocystoplasty that extruded and was visible like an exstrophic neobladder. He underwent a procedure to close bladder neck and reconfigure abdominal wall. After the procedure the patient developed a fistula that was treated, but it persisted and, for this reason, a catheterizable pouch was constructed and native bladder was discarded. Twin two required the immediately construction of catheterizable pouch using the Macedo's technique. Currently, both patients are continent at 4 hour intervals. The mean follow-up was 8 months. Modern continent urinary diversion techniques offer new perspectives and hope for such complex population.
我们报告了一例先前分离的联体双胎伴膀胱外翻和尿失禁患者进行二次尿路重建的病例。患者为男性，13岁。双胞胎之一曾有肠膀胱扩大术失败的病史，肠膀胱扩大术挤出后像外翻的新膀胱一样可见。他接受了关闭膀胱颈和重新构建腹壁的手术。术后患者出现了瘘管，虽经治疗，但瘘管持续存在，因此构建了可导尿袋并废弃了原膀胱。双胞胎之二需要立即使用马塞多技术构建可导尿袋。目前，两名患者均能每4小时自主排尿一次。平均随访时间为8个月。现代可控性尿流改道技术为这类复杂患者群体提供了新的前景和希望。
