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• W2005561162 abstract "No AccessJournal of UrologyPediatric Urology1 Sep 2004THE URETER AS A PEDICLE FOR CONSTRUCTION OF A URETERAL URETHRA: THE DOUBLE TUNNEL WALDO C. FENG, PASQUALE CASALE, RICHARD W. GRADY, BYRON D. JOYNER, and MICHAEL E. MITCHELL WALDO C. FENGWALDO C. FENG More articles by this author , PASQUALE CASALEPASQUALE CASALE More articles by this author , RICHARD W. GRADYRICHARD W. GRADY More articles by this author , BYRON D. JOYNERBYRON D. JOYNER More articles by this author , and MICHAEL E. MITCHELLMICHAEL E. MITCHELL More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000135531.51765.f3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Clean intermittent self-catheterization has been shown to be an effective method for the prevention of upper tract urinary disease in patients who are unable to void efficiently. When the urethra is not available for catheterization surgeons can construct a catheterizable channel from the appendix or retubularized bowel. However, for patients without an appendix and limited bowel segments we have reimplanted the ureter to prevent reflux and tunneled the distal portion of the same ureter to construct a catheterizable stoma, the “double tunnel.” Materials and Methods: We retrospectively reviewed our 10-year experience with the double tunnel ureteral pedicle. A total of 10 patients (8 girls and 2 boys) were included in this study. The left ureter was used in 7 cases and the right ureter was used in 3. Mean followup for these patients was 4.1 years, with a range of 0.5 to 8.5 years. Outcome measures included intraoperative complications, reoperation rates, postoperative complications and upper urinary tract deterioration. Results: There were no intraoperative complications. Furthermore, there were no cases of stomal stenosis or strictures that required reoperation or excision of the ureteral pedicle in the followup period. In our cohort the renal function associated with the ipsilateral double tunnel ureteral pedicle remained stable or improved. All patients reported that their catheterizable stoma is still functional. Conclusions: The double tunnel ureteral pedicle provides another option in the urological armamentarium when there are minimal resources with which to construct a catheterizable stoma. References 1 : Continent urinary diversion in childhood. J Urol1990; 143: 981. Link, Google Scholar 2 : The use of the Mitrofanoff principle in achieving clean intermittent catheterisation and urinary continence in children. J Pediatr Surg1991; 26: 535. Google Scholar 3 : Strategies in urological reconstruction in myelomeningocele. Curr Opin Urol2002; 12: 485. Google Scholar 4 : Transappendicular continent cystostomy in the management of the neurogenic bladder. Chir Pediatr1980; 21: 297. Google Scholar 5 : The Mitrofanoff principle in continent urinary reconstruction. Urol Clin North Am1997; 24: 795. Google Scholar 6 : The Mitrofanoff procedure in paediatric urinary tract reconstruction. Aust N Z J Surg1998; 68: 199. Google Scholar 7 : The Yang-Monti ileovesicostomy: a problematic channel?. BJU Int2001; 87: 861. Google Scholar 8 : Results of the Mitrofanoff procedure in urinary tract reconstruction in children. Br J Urol1997; 79: 279. Google Scholar 9 : New techniques for construction of efferent conduits based on the Mitrofanoff principle. Urology1997; 49: 112. Google Scholar 10 : Yang needle tunneling technique in creating antireflux and continent mechanisms. J Urol1993; 150: 830. Link, Google Scholar 11 : The role of ureter in the creation of Mitrofanoff channels in children. J Urol1997; 157: 635. Link, Google Scholar 12 : Appendicovesicostomy and newer alternatives for the Mitrofanoff procedure: results in the last 100 patients at Riley Children’s Hospital. J Urol1999; 162: 1749. Link, Google Scholar 13 : Refashioned short bowel segments for the construction of catheterizable channels (the Monti procedure): early clinical experience. J Urol1998; 160: 1099. Link, Google Scholar 14 : Urethral replacement with ureter. J Urol1988; 139: 1282. Link, Google Scholar 15 : A continence procedure using a single ureter as a nonrefluxing ureter and catheterizable neourethra. J Urol1997; 157: 968. Link, Google Scholar 16 : Pediatric urology: the Mitrofanoff catheterizable channel: patient acceptance. J Urol1995; 153: 771. Link, Google Scholar 17 : Continent urinary diversion: the Children’s Hospital experience. J Urol1997; 157: 1394. Link, Google Scholar 18 : Transverse retubularized ileum: early clinical experience with a new second line Mitrofanoff tube. J Urol1998; 159: 525. Link, Google Scholar From the Division of Pediatric Urology, Children’s Hospital and Regional Medical Center, University of Washington, Seattle, Washington© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySOYGUR T, ARIKAN N, ZUMRUTBAS A and GULPINAR O (2018) SEROSAL LINED EXTRAMURAL TUNNEL (GHONEIM) PRINCIPLE IN THE CREATION OF A CATHETERIZABLE CHANNEL IN BLADDER AUGMENTATIONJournal of Urology, VOL. 174, NO. 2, (696-699), Online publication date: 1-Aug-2005. Volume 172Issue 3September 2004Page: 1089-1091 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsbladder surgeryurinary reservoirs, continentcloacaurinary diversionureterMetricsAuthor Information WALDO C. FENG More articles by this author PASQUALE CASALE More articles by this author RICHARD W. GRADY More articles by this author BYRON D. JOYNER More articles by this author MICHAEL E. MITCHELL More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2005561162 title "THE URETER AS A PEDICLE FOR CONSTRUCTION OF A URETERAL URETHRA: THE DOUBLE TUNNEL" @default.
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