Faculty Collaboration Database

Gastrocystoplasty: an alternative solution to the problem of urological reconstruction in the severely compromised patient. J Urol 1988 Nov;140(5 Pt 2):1152-6

Date

11/01/1988

Pubmed ID

3184289

DOI

10.1016/s0022-5347(17)41986-0

Scopus ID

2-s2.0-0023796324 (requires institutional sign-in at Scopus site)   248 Citations

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 List

Adams MC, Mitchell ME, Rink RC

Author

Michael Ernst Mitchell MD Emeritus Professor in the Urology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Blood Chemical Analysis
Child
Child, Preschool
Female
Humans
Hydrogen-Ion Concentration
Infant
Kidney Concentrating Ability
Male
Postoperative Complications
Replantation
Stomach
Ureteral Obstruction
Urinary Bladder
Urine
Urodynamics
Urologic Diseases