الفهرس | Only 14 pages are availabe for public view |
Abstract successful continent cutaneous urinary diversion depends on a suitable channel. The ideal channels needs to be easily catheterizable and have long term continence and a low complication rate. At present, the most commonly used channel is the appendix. The appendix can be safely mobilized from the cecum and has a small caliber to allow creation of adequate tunnel length to achieve continence through the Mitrofanoff principle. However, the appendix may be unusable owing to its absence, scarring, insufficient length or it is necessary to preserve the appendix for simultaneous appendicocecostomy in appropriate patients, requiring the use of another channel. Multiple conduits have been constructed, ranging from fallopian tubes and stomach to tapered ileum. In 1997, Monti described a catheterizable channel by transversely retubu-larizing a short segment of bowel. The Monti ileovesicostomy has become an integral component of lower urinary tract reconstruction. It is now considered best Mitrofanoff channel when the appendix can not be used or preserved for MACE procedure. The aim of this work was to comprehensively evaluate continent cutaneous urinary diversion using Yang-Monti technique regarding the success rate of continence and incidence of tube and stomal complications. Twenty-five patients of both sexes and of different age groups who were attending the outpatient Urology clinic at Ain-Shams University hospitals in the period from November 2007 to November 2009 were the material of this work. |