Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option

Marcelo Ferreira Cassini; Antônio Antunes Rodrigues Júnior; Carlos Augusto Fernandes Molina; Adauto José Cologna; Alessandra Mazzo; SílvioTucci Júnior

doi:doi:10.11648/j.js.20130102.14

Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option

Marcelo Ferreira Cassini, Antônio Antunes Rodrigues Júnior, Carlos Augusto Fernandes Molina, Adauto José Cologna, Alessandra Mazzo, SílvioTucci Júnior

Published in Journal of Surgery (Volume 1, Issue 2)

Received: 15 May 2013 Published: 10 June 2013

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Abstract

Introduction: Many patients need to be submitted to a continent urinary derivation surgery. Lost of bladder compliance secundary to neurogenic bladder injuries, severe and untractable urethral stenos is are some of the main indications. We present here the initial results and outcomes of twelve procedures performed using the association between Mitrofanoff’s principle and Monti’s technique as a surgical option for a continenturinarydiversion in patients with short appendices or obese. Materials and Methods: We analyzed data from twelve patients who were submitted to ileocistoplasty and urinary continent derivation by association between Mitrofanoff’s principle and Monti’s technique performed from january2009 to december 2012 in our institution. In all patients the appendices were too short to reach the skin, some of them, because the obesity. Results: Twelve patients were submitted to the Mitrofanoff and Monti techniques association. The most common surgical complications were stoma skin stenosis (02 cases) and urinary leakage through the re-opened bladder neck in 02 patients. Urinary infection (01 sepse) was the main clinical complication. Eleven patients are totally adapted to intermittent clear catheterization through the naveland satisfyed with urinary continence and quality of life.There were no deaths and no urinary or intestinal fistulas secondary to the procedure. Conclusions: The association between Mitrofanoff’s principle and Monti’s technique is safe, feasible and a very useful alternative in urologic cases, (i.e., severe and untractable urethral stenos is and low compliance neurogenic bladder, for example) of continent urinary diversion, when the ileocecal appendix is too short to reach the skin (i.e., obese patients).

Published in	Journal of Surgery (Volume 1, Issue 2)
DOI	10.11648/j.js.20130102.14
Page(s)	22-27
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Mitrofanoff, Principle, Monti, Technique, Bladder Augmentation, Urethral Stenosis, Continent Urinary Diversion

References

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[13]	Van Savage JG, Khoury AE, McLorie GA, Churchill BM. Outcome analysis of Mitrofanoff principle applications using appendix and ureter to umbilical and lower quadrant stomal sites. J Urol 1996;156:1794e7.
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[17]	Castellan MA, Gosalbez R, Labbie A, Ibrahim E, DiSandro M. Outcomes of continent catheterizable stomas for urinary and diversion: their nature and timing. J Urol. 2008;180(Suppl. 4):1856-1860.
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APA Style

Marcelo Ferreira Cassini, Antônio Antunes Rodrigues Júnior, Carlos Augusto Fernandes Molina, Adauto José Cologna, Alessandra Mazzo, et al. (2013). Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option. Journal of Surgery, 1(2), 22-27. https://doi.org/10.11648/j.js.20130102.14

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ACS Style

Marcelo Ferreira Cassini; Antônio Antunes Rodrigues Júnior; Carlos Augusto Fernandes Molina; Adauto José Cologna; Alessandra Mazzo, et al. Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option. J. Surg. 2013, 1(2), 22-27. doi: 10.11648/j.js.20130102.14

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AMA Style

Marcelo Ferreira Cassini, Antônio Antunes Rodrigues Júnior, Carlos Augusto Fernandes Molina, Adauto José Cologna, Alessandra Mazzo, et al. Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option. J Surg. 2013;1(2):22-27. doi: 10.11648/j.js.20130102.14

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@article{10.11648/j.js.20130102.14,
  author = {Marcelo Ferreira Cassini and Antônio Antunes Rodrigues Júnior and Carlos Augusto Fernandes Molina and Adauto José Cologna and Alessandra Mazzo and SílvioTucci Júnior},
  title = {Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option},
  journal = {Journal of Surgery},
  volume = {1},
  number = {2},
  pages = {22-27},
  doi = {10.11648/j.js.20130102.14},
  url = {https://doi.org/10.11648/j.js.20130102.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20130102.14},
  abstract = {Introduction: Many patients need to be submitted to a continent urinary derivation surgery. Lost of bladder compliance secundary to neurogenic bladder injuries, severe and untractable urethral stenos is are some of the main indications. We present here the initial results and outcomes of twelve procedures performed using the association between Mitrofanoff’s principle and Monti’s technique as a surgical option for a continenturinarydiversion in patients with short appendices or obese. Materials and Methods: We analyzed data from twelve patients who were submitted to ileocistoplasty and urinary continent derivation by association between Mitrofanoff’s principle and Monti’s technique performed from january2009 to december 2012 in our institution. In all patients the appendices were too short to reach the skin, some of them, because the obesity. Results: Twelve patients were submitted to the Mitrofanoff and Monti techniques association. The most common surgical complications were stoma skin stenosis (02 cases) and urinary leakage through the re-opened bladder neck in 02 patients. Urinary infection (01 sepse) was the main clinical complication. Eleven patients are totally adapted to intermittent clear catheterization through the naveland satisfyed with urinary continence and quality of life.There were no deaths and no urinary or intestinal fistulas secondary to the procedure. Conclusions: The association between Mitrofanoff’s principle and Monti’s technique is safe, feasible and a very useful alternative in urologic cases, (i.e., severe and untractable urethral stenos is and low compliance neurogenic bladder, for example) of continent urinary diversion, when the ileocecal appendix is too short to reach the skin (i.e., obese patients).},
 year = {2013}
}

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TY  - JOUR
T1  - Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option
AU  - Marcelo Ferreira Cassini
AU  - Antônio Antunes Rodrigues Júnior
AU  - Carlos Augusto Fernandes Molina
AU  - Adauto José Cologna
AU  - Alessandra Mazzo
AU  - SílvioTucci Júnior
Y1  - 2013/06/10
PY  - 2013
N1  - https://doi.org/10.11648/j.js.20130102.14
DO  - 10.11648/j.js.20130102.14
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 22
EP  - 27
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20130102.14
AB  - Introduction: Many patients need to be submitted to a continent urinary derivation surgery. Lost of bladder compliance secundary to neurogenic bladder injuries, severe and untractable urethral stenos is are some of the main indications. We present here the initial results and outcomes of twelve procedures performed using the association between Mitrofanoff’s principle and Monti’s technique as a surgical option for a continenturinarydiversion in patients with short appendices or obese. Materials and Methods: We analyzed data from twelve patients who were submitted to ileocistoplasty and urinary continent derivation by association between Mitrofanoff’s principle and Monti’s technique performed from january2009 to december 2012 in our institution. In all patients the appendices were too short to reach the skin, some of them, because the obesity. Results: Twelve patients were submitted to the Mitrofanoff and Monti techniques association. The most common surgical complications were stoma skin stenosis (02 cases) and urinary leakage through the re-opened bladder neck in 02 patients. Urinary infection (01 sepse) was the main clinical complication. Eleven patients are totally adapted to intermittent clear catheterization through the naveland satisfyed with urinary continence and quality of life.There were no deaths and no urinary or intestinal fistulas secondary to the procedure. Conclusions: The association between Mitrofanoff’s principle and Monti’s technique is safe, feasible and a very useful alternative in urologic cases, (i.e., severe and untractable urethral stenos is and low compliance neurogenic bladder, for example) of continent urinary diversion, when the ileocecal appendix is too short to reach the skin (i.e., obese patients).
VL  - 1
IS  - 2
ER  -

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Author Information

Marcelo Ferreira Cassini

Division of Urology, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
Antônio Antunes Rodrigues Júnior
Carlos Augusto Fernandes Molina

Division of Urology, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
Adauto José Cologna

Division of Urology, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
Alessandra Mazzo

Faculty of Nursing, of Ribeirao Preto, University of Sao Paulo, Brazil
SílvioTucci Júnior

Division of Urology, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil

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APA Style

Marcelo Ferreira Cassini, Antônio Antunes Rodrigues Júnior, Carlos Augusto Fernandes Molina, Adauto José Cologna, Alessandra Mazzo, et al. (2013). Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option. Journal of Surgery, 1(2), 22-27. https://doi.org/10.11648/j.js.20130102.14

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ACS Style

Marcelo Ferreira Cassini; Antônio Antunes Rodrigues Júnior; Carlos Augusto Fernandes Molina; Adauto José Cologna; Alessandra Mazzo, et al. Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option. J. Surg. 2013, 1(2), 22-27. doi: 10.11648/j.js.20130102.14

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AMA Style

Marcelo Ferreira Cassini, Antônio Antunes Rodrigues Júnior, Carlos Augusto Fernandes Molina, Adauto José Cologna, Alessandra Mazzo, et al. Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option. J Surg. 2013;1(2):22-27. doi: 10.11648/j.js.20130102.14

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@article{10.11648/j.js.20130102.14,
  author = {Marcelo Ferreira Cassini and Antônio Antunes Rodrigues Júnior and Carlos Augusto Fernandes Molina and Adauto José Cologna and Alessandra Mazzo and SílvioTucci Júnior},
  title = {Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option},
  journal = {Journal of Surgery},
  volume = {1},
  number = {2},
  pages = {22-27},
  doi = {10.11648/j.js.20130102.14},
  url = {https://doi.org/10.11648/j.js.20130102.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20130102.14},
  abstract = {Introduction: Many patients need to be submitted to a continent urinary derivation surgery. Lost of bladder compliance secundary to neurogenic bladder injuries, severe and untractable urethral stenos is are some of the main indications. We present here the initial results and outcomes of twelve procedures performed using the association between Mitrofanoff’s principle and Monti’s technique as a surgical option for a continenturinarydiversion in patients with short appendices or obese. Materials and Methods: We analyzed data from twelve patients who were submitted to ileocistoplasty and urinary continent derivation by association between Mitrofanoff’s principle and Monti’s technique performed from january2009 to december 2012 in our institution. In all patients the appendices were too short to reach the skin, some of them, because the obesity. Results: Twelve patients were submitted to the Mitrofanoff and Monti techniques association. The most common surgical complications were stoma skin stenosis (02 cases) and urinary leakage through the re-opened bladder neck in 02 patients. Urinary infection (01 sepse) was the main clinical complication. Eleven patients are totally adapted to intermittent clear catheterization through the naveland satisfyed with urinary continence and quality of life.There were no deaths and no urinary or intestinal fistulas secondary to the procedure. Conclusions: The association between Mitrofanoff’s principle and Monti’s technique is safe, feasible and a very useful alternative in urologic cases, (i.e., severe and untractable urethral stenos is and low compliance neurogenic bladder, for example) of continent urinary diversion, when the ileocecal appendix is too short to reach the skin (i.e., obese patients).},
 year = {2013}
}

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TY  - JOUR
T1  - Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option
AU  - Marcelo Ferreira Cassini
AU  - Antônio Antunes Rodrigues Júnior
AU  - Carlos Augusto Fernandes Molina
AU  - Adauto José Cologna
AU  - Alessandra Mazzo
AU  - SílvioTucci Júnior
Y1  - 2013/06/10
PY  - 2013
N1  - https://doi.org/10.11648/j.js.20130102.14
DO  - 10.11648/j.js.20130102.14
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 22
EP  - 27
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20130102.14
AB  - Introduction: Many patients need to be submitted to a continent urinary derivation surgery. Lost of bladder compliance secundary to neurogenic bladder injuries, severe and untractable urethral stenos is are some of the main indications. We present here the initial results and outcomes of twelve procedures performed using the association between Mitrofanoff’s principle and Monti’s technique as a surgical option for a continenturinarydiversion in patients with short appendices or obese. Materials and Methods: We analyzed data from twelve patients who were submitted to ileocistoplasty and urinary continent derivation by association between Mitrofanoff’s principle and Monti’s technique performed from january2009 to december 2012 in our institution. In all patients the appendices were too short to reach the skin, some of them, because the obesity. Results: Twelve patients were submitted to the Mitrofanoff and Monti techniques association. The most common surgical complications were stoma skin stenosis (02 cases) and urinary leakage through the re-opened bladder neck in 02 patients. Urinary infection (01 sepse) was the main clinical complication. Eleven patients are totally adapted to intermittent clear catheterization through the naveland satisfyed with urinary continence and quality of life.There were no deaths and no urinary or intestinal fistulas secondary to the procedure. Conclusions: The association between Mitrofanoff’s principle and Monti’s technique is safe, feasible and a very useful alternative in urologic cases, (i.e., severe and untractable urethral stenos is and low compliance neurogenic bladder, for example) of continent urinary diversion, when the ileocecal appendix is too short to reach the skin (i.e., obese patients).
VL  - 1
IS  - 2
ER  -

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