Risk of Bowel Dysfunction with Diarrhea After Continent Urinary Diversion with Ileal and Ileocecal Segments

Roth, Stephan; Semjonow, Axel; Waldner, Michael; Hertle, L.

doi:10.1097/00005392-199511000-00025

Cited by 10 publications

(11 citation statements)

References 14 publications

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“…There are only a few reports in the literature concerning bowel dysfunction after urinary diversion. Increased faecal frequency was reported to develop after ileal or colonic conduit diversion in 11%-33% of patients, after bladder augmentation/substitution in 22%-27%, and after continent cutaneous diversion in 20%-23% [31,32,33,34]. In the 65 patients of our series who underwent resection of the ileocaecal segment, the ileocaecal valve was reconstructed in 37 patients.…”

Section: Discussionmentioning

confidence: 77%

Urinary diversion in children and adolescents with neurogenic bladder: the Mainz experience

Stein¹,

Wiesner²,

Beetz³

et al. 2005

Pediatr Nephrol

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After failure of conservative treatment of neurogenic bladders (deterioration of the upper urinary tract/incontinence) continent cutaneous diversion has to be considered in those patients with irreparable urethral sphincter defects or those who are unable to perform trans-urethral self-catheterization. In this second part of the study we investigated the long-term safety of using the Mainz pouch I with regard to protecting the upper urinary tracts and to provide urine continence. Between 1985 and 2002, operations to form an ileocaecal pouch with umbilical stoma (Mainz pouch I) were performed on 70 children and adolescents of median age 15.3 years (range 5.7-20 years). During the follow-up period five patients died 2.4-14 years postoperatively of causes not related to urinary diversion. A follow-up period of 8.7 years (0.9-18) was achieved in 65 patients with 118 renal units (RUs). As compared to preoperatively, the upper urinary tracts had remained stable or improved in 113/118 RUs (95.8%) at the latest follow-up. Complete continence was achieved in 97% of patients with a continent cutaneous diversion. Surgical revisions were required for: incontinence of the outlet mechanism in 9%, stoma prolapse in 2%, stoma stenosis in 23%, pouch calculi in 15%, symptomatic reflux in 1%, ureter stenosis in 16% of the RUs with submucosal tunnel and in 3% of the RUs with an extramural tunnel. We conclude that, in patients with irreparable sphincter defect and those who are unable to perform urethral self-catheterization, continent cutaneous urinary diversion with the Mainz pouch I provides a high continence rate with preservation of the upper urinary tracts in the long run. In patients with dilated ureters, the extramural tunnel technique results in a lower complication rate.

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Section: Discussionmentioning

confidence: 77%

Urinary diversion in children and adolescents with neurogenic bladder: the Mainz experience

Stein¹,

Wiesner²,

Beetz³

et al. 2005

Pediatr Nephrol

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“…Diarrhea was a minor problem for about half of patients and a major one for 1 patient. Symptomatic drug therapy (16) and diet regulation is the optimal treatment, but alternatively surgical therapy (e.g. colostomy) has to be considered in resistant cases.…”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life after 5-12 Years of Continent Ileal Urostomy (Kock Reservoir) in Children and Adolescents

Abd-el-Gawad

Abrahamsson

Al³

et al. 2002

Scandinavian Journal of Urology and Nephrology

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“…L'utilisation d'un segment intestinal de moins de 50 cm semble expliquer qu'il n'y ait pas de retentissement plus important [147,148]. L'existence de diarrhées est possible après agrandissement vésical, avec une fréquence allant de 0 à 30 % des cas [59,[149][150][151]. La non-conservation de la valve iléo-caecale est un facteur majorant le risque de diarrhée.…”

Section: En Résuméunclassified

Suivi des vessies neurologiques du blessé médullaire et du patient porteur d'une myéloméningocèle Revue de la littérature et recommandations pratiques de suivi

Ruffion¹,

Sèze

Denys

et al. 2006

Pelv Perineol

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L'évolution des patients blessés médullaires (BM) ou porteurs d'une myéloméningocèle (MM) s'est profondément transformée au cours des soixante derniè-res années. Leur espérance de vie s'est considérablement accrue, jusqu'à approcher celle de la population générale. La pathologie urologique reste cependant une des plus grandes pourvoyeuses de morbi-mortalité dans cette population de patients. Dans un premier temps, nous avons souhaité, à travers une revue de la littérature, réactualiser les données épidémiologiques concernant les différentes facettes des pathologies urinaires susceptibles d'être observées chez ces patients. Ce travail s'est accompagné d'une réflexion sur la validité et la pertinence des examens complémentaires proposés dans le diagnostic de ces pathologies. À partir de ces données, nous avons dressé un cahier des charges du suivi neurourologique de ces patients.Mots clés : Vessie neurologique -Blessé médullaire -Myéloméningocèle -Pronostic uronéphrologique Care of neurogenic bladder in spinal cord injured patients and patients with myelomeningocele: Review of the literature and therapeutic recommendationsAbstract: The clinical course of spinal cord injured patients and those with myelomeningocele (MM) has radically changed over the last 60 years. Life expectancy has been significantly extended and is approaching that of the general population. Urologic disease remains, nonetheless, one of the most predictive factors of morbidity and mortality in this patient population. As a first step, we carried out a literature review in an effort to update the epidemiological data concerning the various aspects of urinary disorders observed in these patients. This paper also discusses the validity and appropriateness of additional diagnostic screening procedures for these disorders. Based on this data, we have created clinical guidelines for the neurological and urologic care of these patients.

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Risk of Bowel Dysfunction with Diarrhea After Continent Urinary Diversion with Ileal and Ileocecal Segments

Abstract: The risk of diarrhea after ileocecal resection seems to be twice as high as after ileal resection. Most patients responded to symptomatic drug therapy. Alternative surgical therapies should be considered when risk factors are present.

Cited by 10 publications

References 14 publications

Urinary diversion in children and adolescents with neurogenic bladder: the Mainz experience

Urinary diversion in children and adolescents with neurogenic bladder: the Mainz experience

Health-Related Quality of Life after 5-12 Years of Continent Ileal Urostomy (Kock Reservoir) in Children and Adolescents

Suivi des vessies neurologiques du blessé médullaire et du patient porteur d'une myéloméningocèle Revue de la littérature et recommandations pratiques de suivi

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