BJU international · 2000
The transverse colonic reservoir: the Unicamp technique.
СтатьяНазвание и аннотация: Перевод в очереди
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Ferreira U, Rodrigues Netto N, Lucena R
Аннотация
OBJECTIVE: To present the results of a continent and nonrefluxing transverse colonic urinary reservoir technique.
PATIENTS AND METHODS: Twenty patients who had received high doses of irradiation underwent construction of transverse colonic reservoir as a primary form of urinary diversion. Fourteen patients had a vesicovaginal fistula after definitive radiation therapy for gynaecological tumours and six had radiation therapy for invasive bladder cancer as a definitive treatment. They were followed for a median (range) of 4.5(1-8) years. Intravenous pyelography before diversion showed mild hydronephrosis in 10 patients.
RESULTS: After diversion, hydronephrosis improved in four patients and no upper tract deteriorated. All but one of the pouchograms showed no ureteric reflux. All the patients required clean intermittent self-catheterization every 3-4 h. Persistent asymptomatic bacteriuria was present in 14 patients, although clinical urinary tract infections were not reported. A moderate metabolic acidosis was present in 12 patients, but none required treatment. The urodynamic evaluation revealed a median (range) reservoir capacity of 450 (350-600) mL, with no contractions or contractions of <35 cm H2O.
CONCLUSION: These results suggest that the Unicamp technique for constructing a transverse colonic reservoir is a safe and effective diversion, and is recommended as an alternative method for patients treated by pelvic irradiation.
PATIENTS AND METHODS: Twenty patients who had received high doses of irradiation underwent construction of transverse colonic reservoir as a primary form of urinary diversion. Fourteen patients had a vesicovaginal fistula after definitive radiation therapy for gynaecological tumours and six had radiation therapy for invasive bladder cancer as a definitive treatment. They were followed for a median (range) of 4.5(1-8) years. Intravenous pyelography before diversion showed mild hydronephrosis in 10 patients.
RESULTS: After diversion, hydronephrosis improved in four patients and no upper tract deteriorated. All but one of the pouchograms showed no ureteric reflux. All the patients required clean intermittent self-catheterization every 3-4 h. Persistent asymptomatic bacteriuria was present in 14 patients, although clinical urinary tract infections were not reported. A moderate metabolic acidosis was present in 12 patients, but none required treatment. The urodynamic evaluation revealed a median (range) reservoir capacity of 450 (350-600) mL, with no contractions or contractions of <35 cm H2O.
CONCLUSION: These results suggest that the Unicamp technique for constructing a transverse colonic reservoir is a safe and effective diversion, and is recommended as an alternative method for patients treated by pelvic irradiation.