Topic
Continent Catheterizable Diversion
About: Continent Catheterizable Diversion is a research topic. Over the lifetime, 7 publications have been published within this topic receiving 29 citations.
Papers
TL;DR: Study Type – Therapy (case series) Level of Evidence 4
Abstract: Study Type – Therapy (case series) Level of Evidence 4
OBJECTIVE
To evaluate our experience with urethral recurrences in patients treated by radical cystectomy(RC) and orthotopic neobladder urinary diversion for carcinoma of the bladder.
PATIENTS AND METHODS
We retrospectively reviewed the records of patients treated with RC and orthotopic urinary diversion between January 1980 and July 2004.
RESULTS
In all, 260 patients underwent RC with a Studer or Hautmann orthotopic urinary diversion; the median (range) follow-up was 5.1 (0–15.6) years. Six patients (2.3%) developed local recurrence of urothelial cancer (UC) within the urethra after this treatment. The median (range) time to presentation with recurrence after RC was 2.4 (0.7–3.6) years for pT1-4 UC. Recurrences were treated with various methods, including transurethral resection, urethrectomy with conversion of neobladder to continent catheterizable diversion, and chemotherapy. At the last follow-up, four of these six patients were alive without disease, one was alive with disease, and one had died from disease.
CONCLUSIONS
In our experience, local recurrences involving the urethra are infrequent. Complete surgical excision can provide a good outcome. Neoadjuvant chemotherapy should be considered for recurrences with adverse clinicopathological features.
29 citations
TL;DR: Botox injections may be an excellent long-term treatment option for contracted continent catheterizable diversions, or at least used as a temporizing measure before surgical augmentation.
3 citations
TL;DR: This work discusses short-term and long-term complications for CCD with attention to specific complications related to the efferent limb and continent pouch and comparison to the orthotopic neobladder and conduit diversion.
Abstract: Techniques for continent cutaneous urinary diversion (CCD) have evolved considerably over the last 65 years. The Indiana pouch (IP) was initially described in the 1980s and has gained wide acceptance among urologists. For patients who desire continent urinary diversion, many clinical scenarios and individual preferences continue to make the IP an excellent option for appropriately selected patients. Continence rates for the IP are generally satisfactory and compare favorably with orthotopic neobladder. Unfortunately, radical cystectomy with urinary diversion is associated with a high complication rate. We discuss short-term (<90 days) and long-term complications for CCD with attention to specific complications related to the efferent limb and continent pouch. Finally, we discuss health-related quality of life (HRQOL) after IP urinary diversion with comparison to the orthotopic neobladder and conduit diversion.
1 citations
TL;DR: In this paper, the authors describe a method of using a bladder flap to partially span the distance between the bladder and abdominal wall when creating a concealed catheterizable channel, which improves ease of catheterization in addition to providing a surface where a tunneled, nonrefluxing anastomosis between the proximal limb and bladder can be easily performed.
1 citations
TL;DR: Patients may benefit greatly from a continent urinary diversion, however, selection must include patients who are able to maintain their pouch and follow-up with their providers to avoid major complications that may occur up to years following...
Abstract: Background: Continent diversions have since been performed with increasing frequency since the 1950s, with some providers espousing the use of orthotopic diversions as being the new gold standard. However, patients must be counseled to take great care in the maintenance of their diversions because of complications such as metabolic abnormalities, pouch stones, and mucus retention. Case Report: A 21-year-old male with a history of posterior urethral valves underwent a continent catheterizable diversion as a child. He is undocumented and without health insurance and as a result unable to follow-up with an urologist for >10 years. He subsequently develops pyocystis with cutaneous fistulization and pouch stones necessitating percutaneous management. Conclusion: Patients may benefit greatly from a continent urinary diversion, however, selection must include patients who are able to maintain their pouch and follow-up with their providers to avoid major complications that may occur up to years following...
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2017 | 1 |
| 2016 | 1 |
| 2015 | 2 |
| 2014 | 1 |
| 2009 | 1 |
| 1992 | 1 |