A New Extra-Abdominal Channel Alternative to the Mitrofanoff Principle: Experimental and Preliminary Clinical Experience

Size: px

Start display at page:

Download "A New Extra-Abdominal Channel Alternative to the Mitrofanoff Principle: Experimental and Preliminary Clinical Experience"

Loraine Booth
5 years ago
Views:

1 Pediatric Urology Channel Alternative to the Mitrofanoff Principle International Braz J Urol Vol. 35 (2): , March - April, 2009 A New Extra-Abdominal Channel Alternative to the Mitrofanoff Principle: Experimental and Preliminary Clinical Experience Antonio Macedo Jr., Tiago Rosito, Jesus A. S. Pires, Riberto Liguori, Valdemar Ortiz Department of Urology, Federal University of Sao Paulo, Unifesp, Sao Paulo, SP, Brazil ABSTRACT Introduction: The appendix is the gold-standard channel for the Mitrofanoff principle in pediatric urology, but the search Material and Methods: - th Result: Conclusion: Key words: bladder; children; urinary diversion; Mitrofanoff principle; surgery Int Braz J Urol. 2009; 35: INTRODUCTION - - appendix is the gold-standard channel for urinary res- 205

2 although this latter condition has not yet been proved - - MATERIALS AND METHODS - - operated on under sterile conditions and under opti- - - for subsequently evaluating continence through the - 206

3 A B C D Figure 1 an onlay to create a tube to be connected to the bladder dome. parents about potential advantages of the technique, one had posterior urethral valve and a third boy had and additional surgical procedures are described in - RESULTS

4 A B C D Figure 2 Table 1 Animal UD per Urethra UD per stoma DLPP Maximal Pressure Cistometry DLPP Cistometry No loss No loss No loss No loss No loss No loss No loss DLPP = detrusor leak-point pressure. 208

5 - - A B C D Figure 3 209

6 A B C D Figure 4 COMMENTS The ureter has also been used to construct a - 210

7 tions due to the need for associated ureteral recon- garded as a valuable alternative for continent urinary - - A B D C Figure 5 211

8 Table 2 Clinical status of patients. Case Age Diagnosis Follow-up in Months Additional Procedure Present Status obstruction none and bilateral orchiopexy repair that suggests that onlay repair is superior to have a drop of urine deposited along the channel but tion, although there are not objective data currently caution should be observed in reoperations, although it

9 - procedures and aesthetic aspect is also very favorable A B C D Figure 6 Histological analysis of the specimen showed good integration of the skin tube with the bladder, in some areas with loss of epithelium however without ulceration. 213

10 Figure 7 Urodynamic evaluation of detrusor leak-point pressure through the urethra (20 cm H 2 2 our approach are the easy of the technique, applying nary results are very favorable and technical feasibil- CONFLICT OF INTEREST REFERENCES

11 - - - Accepted after revision: January 20, 2009 Correspondence address: EDITORIAL COMMENT

12 be of clinical relevance, such as those related to the - The authors are to be congratulated on fol- - - out to be true, but there is paucity of data to categori- to establish prospective clinical research protocols - - can enjoy the expansion of our surgical options based REFERENCE Dr. Armando J. Lorenzo Pediatric Urology Hospital for Sick Children ajlmd@aol.com 216

Robotic Appendicovesicostomy

Robotic Appendicovesicostomy Cheryl Baxter, MSN,RN,CPNP Daniel DaJusta, MD Kristina Booth, MSN,RN,FNP Roadmap for Presentation Part 1 Pre-surgical/historical neurogenic bladder- Baxter Part 2 Robotic appendicovesicostomy/