CASE REPORTS Retroperitoneoscopic ureterocutaneostomy as a method of urinary diversion in case of complicated urinary fistula after radiotherapy

Słojewski, Marcin; Torbé, Bogdan

doi:10.5173/ceju.2011.03.art19

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…As the technology of ostomy pouches becomes more advanced, the compatibility of ostomy pouches with tissue is also improving, and the occurrence of skin irritation becomes increasingly less common and adverse effects are also becoming less frequent ( 15 ). The improved tubeless cutaneous ureterostomy procedure evaluated in this study had the following features ( 16 ): i) during ureter isolation, tissues on the periphery of the ureter were retained as much as possible to avoid damaging the supply vessels of the ureter; ii) ureter isolation spanned approximately 10 cm from the abdominal wall stoma, and the anastomotic stoma was enlarged; iii) the external coat of the ureter on the abdominal skin stoma side was fixed onto the abdominal wall to avoid placing excessive tension on the ureter; iv) a total of 2 single J tube stents were left in the ureter to avoid anastomotic stoma stenosis and urine leakage. The results of this study showed that the incidence of complications of the ‘improved’ group was significantly lower than that of other 2 groups.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in cases of invasive bladder cancer complicated by peritoneal metastasis

et al. 2015

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Radical cystectomy, as the most common surgical treatment for patients with invasive bladder cancer (IBC) complicated by peritoneal metastasis, is usually accompanied by a urinary diversion procedure. In this study, we evaluated the improved tubeless cutaneous ureterostomy technique by comparing the resulting clinical effects with either a traditional ureterostomy and an ileal conduit urinary diversion. Clinical data from 85 patients who underwent 1 of the 3 procedures between April 2012 and April 2015 were analyzed retrospectively. In total, 30 patients underwent improved tubeless cutaneous ureterostomy, 28 patients underwent a traditional cutaneous ureterostomy and 27 underwent an ileal conduit urinary diversion following radical cystectomy. The incidence of complications, including stoma infection, nipple atrophy, terminal necrosis, urine leakage, external orifice stenosis, uronephrosis and ureterectasia in the group of patients treated with the improved tubeless ureterostomy technique was significantly lower than that of the patients in the other 2 groups, and the difference was statistically significant (P<0.05). In addition, the duration of the surgery, intra-operative bleeding, the duration of the hospitalization period and the time to extubation in the patients treated with the improved tubeless ureterostomy technique were significantly decreased (P<0.05) compared with the patients in the other 2 groups. Finally, the health-related quality of life of the patients treated with the improved tubeless ureterostomy technique was significantly higher (P<0.05) than that of the patients in the other 2 groups. The findings of our study demonstrated that the use of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in patients with IBC complicated by peritoneal metastasis resulted in improved clinical effects. Thus, improved tubeless cutaneous ureterostomy may be a promising alternative for enhancing the quality of life of patients with IBC.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in cases of invasive bladder cancer complicated by peritoneal metastasis

et al. 2015

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“…Procedures are unsuccessful when URF occurs multiple times and increases the morbidity and mortality in patients [ 10 ]. Recurrent URF may require patients to be subjected to permanent urinary and fecal diversion [ 17 ]. Many authors have suggested that there is no ideal method of repair because of the rare occurrence of URF and the fact that a randomized clinical trial comparing the various methods has yet to be completed.…”

Section: Discussionmentioning

confidence: 99%

Treatment of urethrorectal fistulas caused by radical prostatectomy – two surgical techniques

Połom

Krajka

Fudalewski

et al. 2014

CEJU

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IntroductionThe repair of complex urethrorectal fistulas, which can be the result of treating prostate cancer with radical prostatectomy, is a big problem in urology and its final result is not always satisfactory. There are no universally accepted methods for repairing such fistulas. In our work we present a retrospective analysis of patients treated for urethrorectal fistulas after previous radical prostatectomy. The methods used were the initial excision and suture of the fistula, or a gracilis muscle flap interposition.Material and methodsIn the years 2000–2012, four patients were treated because of urethrorectal fistulas after radical prostatectomy. In two patients, open radical prostatectomy had been performed. Two other patients had been operated laparoscopically. Two patients had a primary fistula repair. They were operated using anterior perineal access. Two others were treated with the use of a gracilis muscle flap.ResultsDuring the follow up, there was no recurrence of fistulas. Medium follow up for the first two patients was 120 and 156 months, and follow up of two other patients was 16 and 23 months. Until now, there were no final postoperative complications.ConclusionsRepair of the fistulas requires an individual approach to each case. Excision and suturing of the fistula gives a very good final result, especially when the primary reconstruction is performed. Repair of urethrorectal fistula using a gracilis muscle flap appears to be an excellent option in cases of complex recurrent fistulas. It is also associated with low morbidity in patients and a high success rate.

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CASE REPORTS Retroperitoneoscopic ureterocutaneostomy as a method of urinary diversion in case of complicated urinary fistula after radiotherapy

Cited by 2 publications

References 7 publications

Evaluation of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in cases of invasive bladder cancer complicated by peritoneal metastasis

Evaluation of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in cases of invasive bladder cancer complicated by peritoneal metastasis

Treatment of urethrorectal fistulas caused by radical prostatectomy – two surgical techniques

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