Gastrocystoplasty

An alternative solution to the problem of urological reconstruction in the severely compromised patient

M. C. Adams, M. E. Mitchell, R. C. Rink

Research output: Contribution to journalArticle

174 Citations (Scopus)

Abstract

An isolated segment of stomach was used for bladder augmentation in 10 patients or construction of a continent urinary reservoir in 3. Diagnosis in these 13 patients included cloacal exstrophy (5), myelodysplasia (4), posterior urethral valves (2), radiation cystitis (1) and neurogenic bladder secondary to a rectal pull-through procedure (1). Indications for the use of stomach in bladder reconstruction were decreased renal function and acidosis (6 patients), insufficient large and small bowel (6) and decreased mucus production (1). Postoperative followup averaged 13 months (range 6 to 23 months). All patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 10 require intermittent clean catheterization to empty and 11 are completely continent. Nine patients have remained free of infection, while 4 had asymptomatic bacteriuria. Mucus production is reduced relative to other intestinal segments and 10 patients require no bladder irrigations. Postoperative urodynamic evaluation is similar to that of ileocystoplasty or colocystoplasty. Use of stomach has protected these patients from the development of new or worsened hyperchloremic acidosis. Serum chloride values have decreased and serum total carbon dioxide values have increased after bladder reconstruction, particularly in patients with impaired renal function. Stomach should be considered when lower urinary tract reconstruction is necessary in such compromised patients.

Original languageEnglish
Pages (from-to)1152-1156
Number of pages5
JournalJournal of Urology
Volume140
Issue number5 PART II
StatePublished - 1988

Fingerprint

Stomach
Urinary Bladder
Mucus
Acidosis
Kidney
Continent Urinary Reservoirs
Intermittent Urethral Catheterization
Neurogenic Urinary Bladder
Bacteriuria
Cystitis
Urodynamics
Serum
Urinary Tract
Carbon Dioxide
Chlorides
Radiation
Infection

ASJC Scopus subject areas

  • Urology

Cite this

Gastrocystoplasty : An alternative solution to the problem of urological reconstruction in the severely compromised patient. / Adams, M. C.; Mitchell, M. E.; Rink, R. C.

In: Journal of Urology, Vol. 140, No. 5 PART II, 1988, p. 1152-1156.

Research output: Contribution to journalArticle

Adams, M. C. ; Mitchell, M. E. ; Rink, R. C. / Gastrocystoplasty : An alternative solution to the problem of urological reconstruction in the severely compromised patient. In: Journal of Urology. 1988 ; Vol. 140, No. 5 PART II. pp. 1152-1156.
@article{e06aa8c22cfb42a2a87bcbbd7c709118,
title = "Gastrocystoplasty: An alternative solution to the problem of urological reconstruction in the severely compromised patient",
abstract = "An isolated segment of stomach was used for bladder augmentation in 10 patients or construction of a continent urinary reservoir in 3. Diagnosis in these 13 patients included cloacal exstrophy (5), myelodysplasia (4), posterior urethral valves (2), radiation cystitis (1) and neurogenic bladder secondary to a rectal pull-through procedure (1). Indications for the use of stomach in bladder reconstruction were decreased renal function and acidosis (6 patients), insufficient large and small bowel (6) and decreased mucus production (1). Postoperative followup averaged 13 months (range 6 to 23 months). All patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 10 require intermittent clean catheterization to empty and 11 are completely continent. Nine patients have remained free of infection, while 4 had asymptomatic bacteriuria. Mucus production is reduced relative to other intestinal segments and 10 patients require no bladder irrigations. Postoperative urodynamic evaluation is similar to that of ileocystoplasty or colocystoplasty. Use of stomach has protected these patients from the development of new or worsened hyperchloremic acidosis. Serum chloride values have decreased and serum total carbon dioxide values have increased after bladder reconstruction, particularly in patients with impaired renal function. Stomach should be considered when lower urinary tract reconstruction is necessary in such compromised patients.",
author = "Adams, {M. C.} and Mitchell, {M. E.} and Rink, {R. C.}",
year = "1988",
language = "English",
volume = "140",
pages = "1152--1156",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "5 PART II",

}

TY - JOUR

T1 - Gastrocystoplasty

T2 - An alternative solution to the problem of urological reconstruction in the severely compromised patient

AU - Adams, M. C.

AU - Mitchell, M. E.

AU - Rink, R. C.

PY - 1988

Y1 - 1988

N2 - An isolated segment of stomach was used for bladder augmentation in 10 patients or construction of a continent urinary reservoir in 3. Diagnosis in these 13 patients included cloacal exstrophy (5), myelodysplasia (4), posterior urethral valves (2), radiation cystitis (1) and neurogenic bladder secondary to a rectal pull-through procedure (1). Indications for the use of stomach in bladder reconstruction were decreased renal function and acidosis (6 patients), insufficient large and small bowel (6) and decreased mucus production (1). Postoperative followup averaged 13 months (range 6 to 23 months). All patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 10 require intermittent clean catheterization to empty and 11 are completely continent. Nine patients have remained free of infection, while 4 had asymptomatic bacteriuria. Mucus production is reduced relative to other intestinal segments and 10 patients require no bladder irrigations. Postoperative urodynamic evaluation is similar to that of ileocystoplasty or colocystoplasty. Use of stomach has protected these patients from the development of new or worsened hyperchloremic acidosis. Serum chloride values have decreased and serum total carbon dioxide values have increased after bladder reconstruction, particularly in patients with impaired renal function. Stomach should be considered when lower urinary tract reconstruction is necessary in such compromised patients.

AB - An isolated segment of stomach was used for bladder augmentation in 10 patients or construction of a continent urinary reservoir in 3. Diagnosis in these 13 patients included cloacal exstrophy (5), myelodysplasia (4), posterior urethral valves (2), radiation cystitis (1) and neurogenic bladder secondary to a rectal pull-through procedure (1). Indications for the use of stomach in bladder reconstruction were decreased renal function and acidosis (6 patients), insufficient large and small bowel (6) and decreased mucus production (1). Postoperative followup averaged 13 months (range 6 to 23 months). All patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 10 require intermittent clean catheterization to empty and 11 are completely continent. Nine patients have remained free of infection, while 4 had asymptomatic bacteriuria. Mucus production is reduced relative to other intestinal segments and 10 patients require no bladder irrigations. Postoperative urodynamic evaluation is similar to that of ileocystoplasty or colocystoplasty. Use of stomach has protected these patients from the development of new or worsened hyperchloremic acidosis. Serum chloride values have decreased and serum total carbon dioxide values have increased after bladder reconstruction, particularly in patients with impaired renal function. Stomach should be considered when lower urinary tract reconstruction is necessary in such compromised patients.

UR - http://www.scopus.com/inward/record.url?scp=0023796324&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023796324&partnerID=8YFLogxK

M3 - Article

VL - 140

SP - 1152

EP - 1156

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 5 PART II

ER -