Own methods of construction of continent urinary stoma in selected cases of patients with neuropathic bladder
Article published in Urologia Polska 2007/60/1.

authors

Lidia Skobejko-Włodarska: Klinika Urologii Dziecięcej, Instytut "Pomnik - Centrum Zdrowia Dziecka" w Warszawie

keywords

urinary bladder, neuropathic bladder, earlier augmentation, paraplegia and bone deformities, continent urinary stoma construction

summary

The aims of the study. Evaluating the usefulness of own methods of continent urinary stoma construction in selected cases with earlier augmentation cystoplasty and long distance between bladder and place of sutured stoma.

Material and methods. Construction of continent urinary stoma was performed in 80 patients with neuropathic bladder. In 6 patients with neuropathic bladder after previous augmentation cystoplasty, intestinal patch of augmented bladder was used in continent stoma construction. In 26 out of 80 patients qualified for continent urinary stoma construction, another own method of continent stoma creation was applied using diagonal tubularized flap, which gives about 3-4 cm longer channel of stoma.

Results. Patients' follow-up ranged from 2 months to 2 years for stoma which was constructed from intestinal patch previously used for bladder augmentation and from 1 year to over 4 years for another method of stoma creation. All constructed from intestinal patch urinary stomas are continent and easily catheterizable. The complications were observed in 5 patients, in whom the other own method of continent urinary stoma construction was applied and they included: 1 stomal stenosis, 2 stomal incontinence and 2 stomal angulation.

Conclusions. Construction of continent stoma from intestinal patch previously used in bladder augmentation allows to limit extension of surgical approach only to extraperitoneal space and allows to avoid bowel resection. The second described method is one of the simple ways to construct a continent urinary stoma. The method enables to create longer tunnel of continent stoma in case of long distance between bladder and the place of stoma.

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