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At least 37 records · Page 2Linked to original sources
PubMed1998

Endoscopy of mandibular cysts after cystostomy: a preliminary report.

PURPOSE: This study evaluated the use of endoscopy to explore mandibular cysts after cystostomy. MATERIALS AND METHODS: Six mandibular cysts were explored with a fiber endoscope immediately after cystostomy, allowing evaluation of the appearance of the cyst lining and biopsies to be performed. RESULTS: The lining of the cyst wall had a pearly appearance. It was easy to visualize the interior of large cysts extending from the body into the ramus, as well as to explore lobes and recesses. In no case did biopsies of the cyst lining indicate a neoplasm. CONCLUSIONS: Fiber endoscopy is a useful technique for the exploration and monitoring of mandibular cysts after cystostomy, particularly in cases in which the cyst extends from the body into the ramus.

Biopsy↗
PubMed1998

The Lyell sound: a new instrument for suprapubic cystostomy.

To describe a new instrument for use in suprapubic cystostomy. Forty-one patients underwent suprapubic cystostomy from March 1993 to October 1996 using the Lyell Sound. Operative time was not appreciably increased over methods of placement using a trochar. No complications attributable to the technique were noted. This technique allows placement of larger suprapubic catheters with ease and without any increase in time or complications.

Cystostomy↗
PubMed2000

Cystotomy, partial cystectomy, and tube cystostomy.

Knowledge of the regional anatomy and healing characteristics of the urinary bladder are crucial to successful surgical intervention in common disorders of the bladder. Innervation and blood supply enter the neck region of the bladder on the dorsal surface. Surgical approach to the bladder is via a ventral midline incision. Cystotomy is most commonly performed on the ventral surface of the bladder and the incision is closed using absorbable suture material in a single-layer, appositional closure. Removal of urinary calculi is the most common indication for cystotomy and should be accompanied by mucosal biopsy and culture. After cystotomy for removal of calculi, a lateral radiograph should be made to confirm removal of all calculi. Partial cystectomy is indicated for bladder trauma, neoplasia, patent urachus, and urachal diverticula. A large percentage of the bladder wall can be excised with gradual return to near normal function when the trigone region is preserved. Complete cystectomy is not recommended because of the patient morbidity and client dissatisfaction with these procedures. Tube cystostomy is performed routinely for temporary or permanent urinary diversion. Temporary diversion may be performed concurrently with surgical repair of urethral trauma or to relieve acute urethral obstructions. Permanent cystostomy may be performed in cases of neurogenic bladder atony or bladder cancer.

Animals↗
PubMed1999

Voiding and sexual dysfunctions after pelvic fracture urethral injuries treated with either initial cystostomy and delayed urethroplasty or immediate primary urethral realignment.

OBJECTIVE: The aim of this study is to evaluate the effects of the different immediate treatment modalities on the sexual and voiding functions in pelvic fracture urethral injuries. METHODS: The records of 38 male patients with traumatic posterior urethral injuries were reviewed, 18 of whom were treated by initial suprapubic cystostomy and delayed repair (Group 1), and 20 by primary urethral realignment (Group 2). Types of pelvic fractures and urethral injuries were classified according to surgical and radiological findings. Long-term voiding functions were determined by the patient questionnaire, residual urine and uroflow. Sexual functions were also determined by the patient questionnaire and a penile duplex ultrasound study. RESULTS: Mean follow-ups of Groups 1 and 2 were 37 and 39 months, respectively. Membranous urethral disruption extending to the urogenital diaphragm was the most frequent urethral injury (type 3), with incidences of 66.7% and 77.7%, respectively. There were no statistically significant differences in mean age, incidence of pelvic fracture types and urethral injury types between groups (p > 0.05). After the immediate treatments, 16.7% and 55% of the patients regained normal urination, and stricture developed in 83.3% and 45% of the patients, respectively. In 44.4% of the patients in Group 1 and 10% in Group 2, urethral strictures required open urethroplasty (p < 0.05). Erectile impotence before urethroplasty in 17.6% and 20%, anejaculation after urethroplasty in 17.6% and 15% and incontinence in 5.6% and 10% of the patients were found in Groups 1 and 2, respectively (p > 0.05). However, 88.8% and 90% of patients eventually achieved normal urination with complete continence. CONCLUSION: Sexual and voiding dysfunction after pelvic fracture posterior urethral injury seem to be the result of the injury itself, not of the immediate treatment modalities. In urethral disruption injuries, primary urethral realignment seems more favourable than suprapubic cystostomy and delayed repair.

Adolescent↗
PubMed1994

The invaginated sleeve technique for a continent cystostomy--five years' clinical experience.

OBJECTIVE: To evaluate the invaginated sleeve technique for continent cystostomy in humans. PATIENTS AND METHODS: Over the past 5 years six patients have undergone this operative procedure. An essential principle utilized in the technique is the property of partial thickness bladder grafts to stretch longitudinally, so that each tubularized pedicle graft could be directed transmurally and extended extravesically to reach the skin of the lower abdominal wall. As a consequence a urothelial-lined tract, both extravesically and through the bladder wall, was provided for intermittent self-catheterization. RESULTS: Apart from one woman, whose cystostomy tract was disrupted by inappropriate catheterization in the immediate post-operative period to attempt to stop leakage through exposed fenestrations in the suprapubic stent, this procedure provided robust, continent catheterizing routes for all patients for periods of 63, 52, 12, 7 and 1.5 months respectively. Two patients developed discrete stenoses at their mucocutaneous junctions at 3 and 5 months which were corrected easily. CONCLUSION: This simple, minimally morbid technique, which avoids the use of non-urinary tract epithelial structures and maintains bladder capacity, is strongly recommended for patients who need to practise clean intermittent self-catheterization and for whom the urethral route is impracticable.

Catheters, Indwelling↗
PubMedDate not supplied

Temporary tube cystostomy as a treatment for urinary obstruction secondary to adrenal disease in four ferrets.

Adrenal neoplasia is a common problem in middle-aged to older ferrets. Male ferrets may present for stranguria and dysuria due to prostatic/paraurethral tissue enlargement secondary to elevation in androgens produced by the neoplastic tissue. Progressive urethral compression followed by complete urinary obstruction can result. Urinary obstruction can persist for days following surgery requiring urinary diversion. Four ferrets presenting with signs consistent with urinary obstruction secondary to adrenal disease were immediately treated with urethral catheterization or cystocentesis followed by adrenalectomy and temporary tube cystostomy. The tube cystostomy placement and use were associated with minimal complications and allowed recovery from surgery.

Adrenal Cortex Neoplasms↗
PubMedDate not supplied

The effects of indwelling transurethral catheterization and tube cystostomy on urethral anastomoses in dogs.

The influence of urinary diversion procedures on urethral healing was studied in 15 male dogs following transection and anastomosis of the intrapelvic portions of their urethras. Dogs were randomly assigned to one of three treatment groups and had urine diverted from the surgical site by indwelling transurethral catheter, cystostomy catheter, or a combination of transurethral catheter and cystostomy catheter. There were no statistically significant differences in urethral healing when considering the different diversion methods, based on clinical, radiographic, and urodynamic parameters evaluated.

Animals↗
PubMed1995

Placement of a permanent cystostomy catheter to relieve urine outflow obstruction in dogs with transitional cell carcinoma.

Permanent cystostomy catheters were placed in 7 dogs to relieve urine outflow obstruction from presumed transitional cell carcinoma of the bladder trigone and urethra. The catheters were easily managed at home by the owners. Complications were minimal. The most frequent complication was urinary tract infection. Two owners complained of difficulty in draining the bladder 1 week before euthanasia of their dogs. The primary reason for euthanasia of all dogs was progression of the tumor. Survival times of these dogs were similar to those previously reported for dogs with transitional cell carcinoma involving the bladder and urethra, irrespective of treatment. Placement of a permanent cystostomy catheter should be considered in dogs with transitional cell carcinoma associated with urine outflow obstruction when, owing to the dog's condition or the owner's preference, radical surgery or other treatment is not an option.

Animals↗
PubMed1997

Continent cystostomy (Mitrofanoff's procedure) for neurogenic bladder in children and adolescent (56 cases: long-term results).

Between 1978 and 1991 we made a continent cystostomy according to Mitrofanoff's technique in 56 patients - children or adolescents - with a neurogenic bladder. We study the complications and the long-term results (follow-up ranging from 3 to 17 years - average 10 years). One patient died from a urological complication, another one died 2 years after from a neurological complication. Two patients were lost to follow-up after 3 years. Among the other patients 36 i.e. 64.3% have had urological complications. Analysis of these complications and their treatment demonstrates that most could now be avoided. At the present time the continent cystostomy with an appendicular or ureteral conduit is the safest and most comfortable way to treat the incontinence of wheel-chair bound patients who cannot or do not wish to use transurethral catheterisation.

Adolescent↗
PubMed1983

Visual internal urethrotomy with postoperative cystostomy or urethral catheter.

Visual internal urethrotomy is nowadays considered by many to be a very useful method of treating urethral strictures. There is still controversy, however, about how long the postoperative urethral catheter should be left in situ. A prospective randomised study was therefore performed to evaluate the influence on the results of urethral catheterisation versus a suprapubic cystostomy for 5 weeks. After 12-36 months of follow-up (mean 25 months) there was a significant difference in result in favour of the urethral catheter. In the catheterised group, 13 out of 20 patients were without recurrence, compared to 4 out of 17 patients in the cystostomy group. Of the total number of 76 patients treated by postoperative urethral catheterisation, 37 (48%) had a normal or slightly subnormal flow-rate 12-60 months after the urethrotomy. Young patients and patients with stricture treated for the first time showed significantly better results than older patients or patients who had previously been treated twice or more. The stricture diameter-prestenotic urethral diameter ratio, obtained by combined retrograde and antegrade urethrography, provided a fairly accurate measure of the functional significance of a stricture.

Adult↗
PubMed1984

Suprapubic cystostomy catheterization in open-heart surgery.

Monitoring of the urinary output is mandatory during open-heart surgery and in the immediate postoperative period. During 1980-81 we noticed an alarming rise in the number of post-catheterization urethral strictures affecting men who had undergone open-heart surgery. To avoid this serious complication, we switched from conventional urethral catheterization to suprapubic cystostomy for these patients. The first 93 cases with suprapubic drainage have now been analysed as regards the advantages and complications of this technique. The advantages were clear: The patients were satisfied with the method and no urethral strictures developed. The only side effect was haematuria, which in 9 cases led to occlusion of the catheter and required extraneous maneouvres. Suprapubic cystostomy thus seems to be a good alternative to conventional urethral catheterization in open-heart surgery. The possible causes of the urethral complications in this particular group of patients also are discussed.

Cardiac Surgical Procedures↗
PubMed1980

[Trans-appendicular continent cystostomy in the management of the neurogenic bladder].

The comfort obtained in some cases of neurogenic bladder of the girl, thanks to unsterile self catheterization, and usual absence of septic complications, incite to search for a process which could be used for the boys as well as girls in those cases where urethral catheterization cannot be done. What's more, if the catheterization is easy to achieve even by young children and if the process brings complete dryness, almost perfect conditions of comfort would be achieved. A cystostomy with a continent opening easy to catheterize and associated with a closure of the vesical neck, was the objective. We had the idea to use the appendix in order to create a passage between the skin and the bladder, the tip of the appendix opening into the bladder at the end of an anti-reflux submucosal tunnel and the other end hemmed to the skin. The bladder neck is usually closed in the course of the same operation. From October 1976 to January 1979, 16 children have gone through such a vesicostomy. In two more cases a trans-ureteral cystostomy was created. Five cases were a failure owing to a too small bladder and required a cutaneous diversion. The continence of the vesicostomy is total and the comfort obtained is excellent for the other 13 cases. Some complications result directly from this technique. It concerns more particularly cutaneous fistula (1 case) or with urethral repermeation (2 cases). Other problems, common to all conservative treatments of a neurogenic bladder, are discussed:vesico-renal reflux, dilatation of the upper urinary tract, urinary infections and of course, risk for the renal function. They appear to be related with a small and hypertonic bladder. Obviously these problems must be kept in mind and require a strict selection for the vesicostomy and a strict followup.

Adolescent↗
PubMed1976

A simple technique for closure of temporary cystostomy.

To overcome the problem of persistent urinary wound discharge after prostatectomy with temporary cystostomy, a simple suture technique is introduced. Two monofilament nylon sutures are inserted through the abdominal wall, tangentially to the dome of the bladder, together making a purse-string suture around the cystostomy. The sutures are left untied until the top catheter is removed. Then they are tied and subsequently removed along with the skin stitches. The technique has fulfilled its purpose in 19 consecutive patients without giving rise to any complications.

Humans↗
PubMed1990

Prostatomembranous urethral disruptions: management by suprapubic cystostomy and delayed urethroplasty.

Management of prostatomembranous urethral disruptions associated with pelvic fractures remains a major controversy in urology. A group of 64 patients who suffered a prostatomembranous urethral disruption in association with a pelvic fracture and who were managed initially by suprapubic cystostomy with delayed urethroplasty was compared to 17 patients managed initially by primary realignment. No statistically significant difference in the incidence of impotence or urinary incontinence was found between the 2 groups (p greater than 0.5) Secondary reconstructions for impassable strictures developed in 95% of the patients treated by a suprapubic tube alone compared to 53% of those treated by primary realignment. Indeed, only 1 patient in the latter group achieved urethral continuity that did not require further intervention. We conclude that while primary realignment is associated with no increase in the instance of impotence and urinary incontinence, it subjects the patient to a major operation at a critical time and provides little in the way of long-term positive gains for the effort expended. In the final analysis the outcome is more dependent upon the nature of the injury and the quality of the repair than upon the order in which the repair is effected.

Cystostomy↗
PubMed2000

Marjolin's ulcer of the suprapubic cystostomy site infiltrating the urinary bladder: a rare occurrence.

We report a case of a 40-year-old man who had presented with a spontaneous suprapubic urinary leak from a well-healed suprapubic cystostomy tract scar, 20 years following a successful scrotal tube substitution urethroplasty done for a post-traumatic urethral stricture. Preoperative contrast studies suggested a recurrent bulbomembranous urethral stricture. Excision biopsy of the suprapubic fistulous tract revealed scar cancer infiltrating the bladder wall. Of 3 similar cases reported in the past, only 1 had bladder involvement. Ours is the second such case with bladder involvement.

Adult↗
PubMed1993

Percutaneous suprapubic cystostomy.

Suprapubic urinary diversion for the management of lesions of the bladder outlet or urethra has been facilitated by the advent of percutaneous access techniques. Prior to percutaneous endourologic techniques, an open surgical approach was necessary when the transurethral route was impassable. A variety of percutaneous suprapubic cystostomy techniques have evolved in recent years. These have been based on several different access principles and offer the urologist a number of options. Selection of an individual technique is usually a matter of preference and familiarity with a particular manufacturer's product. The list of indications for such an approach is diverse and continues to expand.

Cystostomy↗