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At least 19 recordsLinked to original sources
PubMed1979

Conduit urinary diversion and urinary-tract infection. II. Raised serum antibody titers against Escherichia coli and Proteus mirabilis in relation to bacteriologic findings.

Elevated serum antibody titers against Escherichia coli and/or Proteus mirabilis were found in 35% of 89 patients with a conduit urinary diversion. Statistical analysis showed significant correlation between the titers and growth of E. coli or P. mirabilis in conduit urine. But 17 (24%) of 72 patients without E. coli in urine cultures had raised E. coli antibody titer. Only 3 (4%) of 68 patients without growth of P. mirabilis had raised P. mirabilis antibody titer. When the post-diversion observation period was more than five years, the frequency of antibody titer elevation was greater than in patients with shorter post-diversion follow-up. The volume of residual urine in the conduit showed statistically significant correlation with presence of bacteriuria and with the antibody titer level against P. mirabilis. Patients with high antibody titers tended to have high readings of serum creatinine. Antibiotic therapy reduced elevated E. coli and P. mirabilis antibody titers. Titration of antibodies to E. coli and P. mirabilis is recommended in the follow-up care of patients with conduit urinary diversion.

Adolescent↗
PubMed1977

Supravesical urinary diversion in renal transplantation.

Urinary diversion may be used in patients without a bladder or with irreversible, lower urinary tract abnormalities who might not otherwise be suitable candidates for renal transplantation. Three cases have been described to illustrate three different methods of supravesical urinary diversion that have been employed in association with renal transplantation.

Adolescent↗
PubMed1978

Use of the stomach for bladder replacement and urinary diversion.

The current methods of urinary diversion and bladder replacement have many drawbacks. The pyloric antrum of the stomach was chosen for this purpose because of its good blood supply, relatively poorly absorbing mucosa, acidification of urine, and good contractility. This was first tried out in dogs with extremely encouraging results in the form of both bladder replacement and conduits. Since 1969 these techniques have been applied to human clinical use. Extensive postoperative studies have shown that the pyloric antrum functions well in the urinary tract and that its use for bladder replacement and urinary diversion is probably superior to other recognised methods for these purposes.

Adolescent↗
PubMed1978

Electrolyte distrubances after jejunal conduit urinary diversion.

The use of jejunum in conduit urinary diversion may lead to electrolyte disturbances, characterized by hyponatremia, hypochloremia, hyperkalemia, acidosis, and azotemia, and a clinical picture of nausea, vomiting, dehydration, anorexia, and lethargy. Four out of six patients deviated with a jejunal loop developed this syndrome, the cause of which is discussed. It is concluded that the use of jejunum in urinary diversion should be avoided.

Acidosis↗
PubMed1975

Palliative urinary diversion for pelvic malignancy.

Palliative urinary diversion was done in 47 cases for ureteral obstruction secondary to advanced pelvic malignancy. The average survival time was 5.3 months, with only 50 per cent of the patients alive at 3 months and only 22.7 per cent alive at 6 months. After the diversion 63.8 per cent of the survival time was spent in the hospital. Patients with carcinoma of the prostate fared better than those with other sites of tumor origin, which may reflect the natural history of this tumor.

Adult↗
PubMed1976

Ileal conduit urinary diversion. Ten-year review.

The experience with ileal conduit urinary diversion at Emory University and Affiliated Hospitals over a ten-year period is presented. Included in this review are patients with benign and malignant disease. The indications, technique, results, and complications of this type of urinary diversion are considered. Some differences between ileal conduit diversion of children and adults are discussed.

Adolescent↗
PubMed1979

Chronic papillomatous dermatitis as a peristomal complication in conduit urinary diversion.

In 76 patients with conduit urinary diversion, the skin in the stomal area was studied with regard to complications. No such complications had occurred in 39 cases. Superficial erosive dermatitis was present or had been a transient episode in 27 cases. The immediate peristomal area was found in ten cases to show a different type of complication. This was characterized by hyperplastic, papillomatous skin lesions of a chronic nature. A rubber urinary collecting device for long-term use had been fitted in nine of the ten patients, and none of them had a protruding nipple stoma. The clinical, microbiologic and histologic features of these hyperplastic lesions are described and aetiologic factors are discussed. Change to another type of collecting device was followed within three to six weeks by healing of the lesions.

Adolescent↗
PubMed1979

The long-term results of ileal conduit urinary diversion in children.

Sixty-seven children undergoing urinary diversion by ileal conduit tolerated this procedure well. The initial results were most satisfying, but late complications occurred in 55 children (82%), and this is a cause for concern. Even when the surgical complications were avoided, it seemed important to consider carefully the psychological problems that these children with ileal loop diversion could develop as they advanced into adult life.

Adolescent↗
PubMed1978

Some alternatives to urinary diversion in children.

Many children with severe urologic problems have been treated by urinary diversions, often after unsuccessful operations to correct the original pathology. Urinary diversion should be avoided when possible, since often it is accompanied by chronic infection and quality of life is less good than it could be. Most diversions can be prevented by use of other alternatives including 1) reimplanting 1 ureter and transureteroureterostomy of the other, 2) psoas hitch, 3) wide mobilization and downward displacement of the kidney and ureter, 4) use of bowel as ureter, 5) cecal cystoplasty and 6) early repair of complex pathology. Autotransplantation is probably seldom indicated in childhood.

Adolescent↗
PubMed1979

Ureterosigmoidostomy: a 59-year followup and review of long-term urinary diversion.

This case report documents the efficacy of urinary diversion by ureterosigmoidostomy. Our patient has suffered minimal complications with the added advantage of urinary continence for nearly 60 years. While we would not advocate the Coffey I technique for creation of ureterosigmoidostomy, this case does illustrate the longest survival after any form of diversion with normal urinary function reported in the literature.

Child↗
PubMed1979

Bacteriuria with intestinal loop urinary diversion in children.

Bacteriuria and intestinal loop urinary diversion with open (refluxing) ureterointestinal anastomoses did not prevent normal renal and body growth in 44 children, who were followed for 55.2 months. A comparison of the long-term use of sulfamethoxazole and nitrofurantoin with no treatment showed no statistically significant changes in the stoma, loop residual, renal function, serum electrolytes and treatment or prevention of bacteriuria.

Adolescent↗
PubMed1978

Conduit and renal pelvic pressures after ileal and colonic urinary diversion in dogs.

In dogs pressures in the renal pelvis and the conduit were studied in nine ileal conduit urinary diversions with refluxing ureteroileal anastomosis and in seven colonic conduit urinary diversions with antireflux ureterocolonic anastomosis. In the non-diuretic state, increased pressure waves in the non-stomal obstructed ileal conduit were not transmitted to the renal pelvis. With diuresis, higher renal pelvic pressures were noted with both ileal conduit and the colonic conduit. With complete stomal obstruction in the ileal conduit, pressure waves in the conduit were readily transmitted to the renal pelvis. This was not present in the colonic conduits with the antireflux anastomosis.

Abdominal Muscles↗
PubMed1977

The results of urinary diversion in multiple sclerosis.

Out of a total of 78 patients with multiple sclerosis who underwent urological assessment, 12 (15%) were treated by ileal loop diversion. The results of surgery were highly satisfactory in spite of a high incidence of postoperative complications. The surgical trauma that occurs from the operation does not necessarily result in neurological deterioration of the patient. The only absolute contra-indication to urinary diversion is decubitus ulceration. Urinary diversion should be considered much earlier in the treatment of incontinence in multiple sclerosis rather than offered as a last resort.

Adult↗
PubMed1978

Panniculectomy and the difficult ileostomy for urinary diversion.

This paper describes a helpful operation for revision of the difficult ileal stoma for urinary diversion. By using the standard technique of panniculectomy or abdominal lipectomy, the ileal loop can be left in the same position on the abdominal wall and healthy, viable tissue can be mobilized and repositioned to enable the urological surgeon to perform the cutaneous portion of the procedure again and to refashion the ileal loop. This saves the patient an operation of greater magnitude and risk.

Abdominal Muscles↗
PubMed1978

Palliative urinary diversion for malignant ureteral obstruction.

An analysis of 62 palliative urinary diversions for malignant ureteral obstruction is presented. The average postoperative survival was 187 days. Cell type, duration of known disease, tumor grade and stage, renal function and previous therapy did not strongly influence survival. Renal function returned to normal in 64 per cent of the azotemic patients. Morbidity and mortality rates were high, largely because of underlying disease and adjuvant therapy . Nearly two-thirds of the patients left the hospital and this group subsequently spent 84 per cent of their remaining survival time at home. A criterion is presented for patient selection and suggestions are made for the selection of an operative procedure.

Abdominal Neoplasms↗