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• W2414016705 abstract "No AccessJournal of Urology1 Aug 1994Urinary Undiversion in Adults with Myelodysplasia: Long-Term Followup Sender Herschorn, Satish Rangaswamy, and Sidney B. Radomski Sender HerschornSender Herschorn More articles by this author , Satish RangaswamySatish Rangaswamy More articles by this author , and Sidney B. RadomskiSidney B. Radomski More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)32732-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail A total of 14 women and 6 men 19 to 39 years old (mean age 27 years) with myelodysplasia underwent undiversion 8 to 29 years (mean 16) after ileal conduit diversion. The main reasons for diversion were incontinence in 17 patients and failed ureteral reimplants in 3, and those for undiversion were a desire for an improved quality of life in 16, increasing hydronephrosis in 4 and stomal problems in 3. Preoperative assessment included upper and lower tract imaging, and video urodynamics. Operations on the ureters included reimplantation into an intussuscepted nipple valve in 8 patients, tunneled reimplants into a sigmoid augmentation in 3 and the ureters joined to either the bladder or lower ureter without interposing bowel in 9. All reimplantations were done with nonrefluxing techniques. A total of 18 patients underwent bladder augmentation and 2 women in whom cystectomy was performed for pyocystis underwent substitutions. Simultaneous continence procedures in 18 patients included trigonal tubularization in 2, artificial sphincter implantation in 2, a bladder neck sling in 5 or bladder neck tapering and a sling in 9. The patients were followed for a mean of 69 months (range 21 to 133). Eight patients required reintervention within 1 year for problems, such as anastomotic leak in 1, bladder neck obstruction in 1, incontinence in 1, artificial urinary sphincter revisions in 1 and bladder stones in 1. One patient had a recurrent renal calculus 10 years after undiversion. All patients experienced either persistence of normal upper tract appearance or improvement and/or stabilization of hydronephrosis. Mean bladder capacity was 77cc preoperatively and 480cc postoperatively, while mean pressure at capacity decreased from 50 to 14cm. water with detubularized augmentation. Of the patients 17 are completely dry, 2 wear 1 pad per day and 1 has enuresis. All but 1 patient who voids with straining are on intermittent self-catheterization. All patients, on followup interviews, reported an improved quality of life without a stoma. We conclude that undiversion provides an improved quality of life and an acceptable morbidity rate. The choice of operation depends on the anatomy of the patient. We prefer a nonprosthetic type of incontinence procedure when intermittent self-catheterization is to be done. No long-term morbidity has yet been noted. © 1994 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByAHLERING T, GHOLDOIAN G, SKARECKY D, WEINBERG A and WILSON T (2018) SIMPLIFIED TECHNIQUE WITH SHORT AND LONG-TERM FOLLOWUP OF CONVERSION OF AN ILEAL CONDUIT TO AN INDIANA POUCHJournal of Urology, VOL. 163, NO. 5, (1428-1431), Online publication date: 1-May-2000.STEIN R, FISCH M, ERMERT A, SCHWARZ M, BLACK P, FILIPAS D and HOHENFELLNER R (2018) URINARY DIVERSION AND ORTHOTOPIC BLADDER SUBSTITUTION IN CHILDREN AND YOUNG ADULTS WITH NEUROGENIC BLADDER: A SAFE OPTION FOR TREATMENT?Journal of Urology, VOL. 163, NO. 2, (568-573), Online publication date: 1-Feb-2000.Gosalbez R and Gousse A (2018) RECONSTRUCTION AND UNDIVERSION OF THE SHORT OR SEVERELY DILATED URETER: THE ANTIREFLUX ILEAL NIPPLE REVISITEDJournal of Urology, VOL. 159, NO. 2, (530-534), Online publication date: 1-Feb-1998. Volume 152Issue 2 Part 1August 1994Page: 329-333 Advertisement Copyright & Permissions© 1994 by The American Urological Association Education and Research, Inc.Keywordsurinary diversionbladder, neurogenicneural tube defectsMetricsAuthor Information Sender Herschorn More articles by this author Satish Rangaswamy More articles by this author Sidney B. Radomski More articles by this author Expand All Advertisement Loading ..." @default.
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• W2414016705 title "Urinary Undiversion in Adults with Myelodysplasia: Long-Term Followup" @default.
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