RESUMO
No disponible
Assuntos
História do Século XX , História do Século XXI , Urologia/história , EspanhaRESUMO
OBJECTIVE: To review the results achieved with the Mainz II detubularized ureterosigmoidostomy for urinary diversion in patients undergoing bladder resection. METHODS: This study was conducted on 12 prospective patients undergoing radical cystectomy for urothelial carcinoma after 1996. All patients met the following selection criteria: no changes in upper urinary tract functions, normal rectosigmoid, no previous radiation to the area and good anal continence. RESULTS: All patients had a diagnosis of infiltrating urothelial carcinoma of the bladder. Four of these patients died from tumor progression. Renal function is preserved at 31.7 months' mean follow-up, although 3 patients developed moderate metabolic acidosis despite the prophylactic alkalization therapy instituted after surgery. One patient presented recurrent pyelonephritis and stricture of the ureterointestinal anastomosis that required surgical correction. Colonoscopy was unremarkable in all but one patient who showed adenomatous polyp of the colon, which was removed endoscopically, and no other local changes. Continence was complete from the time the urinary catheters were removed. Voiding occurred every 2.9 hours during the day and 2.2 times during the night. CONCLUSIONS: The Mainz II modified ureterosigmoidostomy clearly reduces the upper urinary tract complications because accommodation of the reservoir is better and the pressure inside the pouch is reduced. This technique of urinary diversion is well-accepted by the patients because voiding can be achieved comfortably, a stoma is not required and body image is preserved. The degree of patient satisfaction was high in all cases.
Assuntos
Cistectomia , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária/métodos , Idoso , Colo Sigmoide/cirurgia , Seguimentos , Previsões , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Derivação Urinária/tendênciasRESUMO
OBJECTIVE: Rupture of the corpus cavernosum is an uncommon condition that requires immediate treatment in the emergency services. The diagnostic methods and therapeutic approaches are discussed and the literature reviewed. METHODS: Two cases of rupture of the corpus cavernosum diagnosed 8 years and 3 months earlier are presented. One was treated conservatively and the other was submitted to early surgical management. Images showing the technique utilized for cavernosal repair in one of the patients and the satisfactory clinical course of both patients are presented. RESULTS/CONCLUSIONS: Rupture of the corpus cavernosum is an uncommon urological emergency in our setting. Patient history and examination are diagnostic in most of the cases. Early surgical management is advocated.
Assuntos
Pênis/lesões , Adulto , Humanos , Masculino , Ruptura , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/cirurgiaRESUMO
W. H. Wollaston, who first described cystine stones, as well as the most outstanding contemporary figures and their contribution to the understanding of this uncommon type of lithiasis are described.
Assuntos
Cistina/história , Cálculos Urinários/história , Europa (Continente) , História do Século XVIII , História do Século XIX , HumanosRESUMO
Vesical hernias occur in a significant number of patients with inguinal hernia, though massive inguinoscrotal vesical hernias are uncommon. This paper presents a case report of a male patient where massive inguinoscrotal vesical hernia, and scrotum-located multiple vesical lithiasis was associated to a large amount of lithiasic mass and bilateral ureterohydronephrosis. We consider this association of urinary conditions extremely rare, since to our knowledge bilateral ureterohydronephrosis has only been formerly documented in one case.