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Hai X, Yang J. A neo-rectal bladder by uretero-rectal anastomosis: a case report. Transl Androl Urol 2021; 10:3080-3083. [PMID: 34430410 PMCID: PMC8350253 DOI: 10.21037/tau-21-298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/18/2021] [Indexed: 11/17/2022] Open
Abstract
Urinary diversion has always been a great challenge for urologists. There are many reasons and various methods for urinary diversion in clinical practice. In this report, who was diagnosed with a pelvic fracture complicated by enterostomy, urethral stricture, and bilateral inferior ureteral stricture. We performed laparoscopic bilateral ureterorectal reimplantation for this patient. Postoperatively, the patient recovered well and was able to perform volitional emptying. Bilateral DJ stents were removed under ureteroscopy at 6 weeks postoperatively. Six months after operation, no hydronephrosis was found in both kidneys. No increase of blood urea nitrogen (BUN) and creatinine were observed in renal function examination. It is clearly stated that in the present report a modified version of Heitz-Boyer-Houvelac uretero-rectostomy technique was carried out, as the technically demanding surgical step of retrorectal pull-through of the sigmoid colon was unneccesary given that the patient already had enterostomy. This surgery was performed laparoscopically and that the most relevant benefit for the patient was to avoid incontinent urinary diversion or possibly a more complex surgical procedure.
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Affiliation(s)
- Xin Hai
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingyan Yang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Ben Ahmed Y, Boulma R, Landolsi M, Boukesra T, Boussetta R, Hamza M, Chibani I, Guitouni A, Charieg A, Nouira F, Jlidi S. Quality of life of children operated for bladder exstrophy. Prog Urol 2021; 32:146-154. [PMID: 34244063 DOI: 10.1016/j.purol.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/13/2021] [Accepted: 05/28/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Bladder exstrophy is a rare malformation with functional and psychological issues affecting children's quality of life. This study aims to evaluate the urinary continence and the quality of life of patients operated for bladder exstrophy in our institution. METHODS This is a retrospective study including fifteen patients operated for bladder exstrophy between 1995 and 2015. All patients underwent a physical examination and an interview with a psychiatrist. Urinary continence was evaluated by dryness periods. Quality of life was evaluated by the QoL SF-36 scale. RESULTS All patients underwent primary early bladder closure. Posterior osteotomy was performed initially in 6 cases, and during the redo surgery in 7 cases. Leakage was recorded in 4 cases, fistula in 9 patients. Twelve patients had one or more redo surgery. Final bladder closure success rate was of 80%. Additional continence surgical procedures were performed by a Young Dees technique in 8 cases and with bladder enlargement associated with Mitrofanoff continent derivation in 5 cases. Only two patients over fifteen did not use diapers. All the items of QoL score according SF-36 were under the normal value (75%) except physical functioning and physical limitation. These scores go worst with age. Scores were better for continent boys in both physical and psychological items, but the difference was not significant However, significant difference was observed between boys having less than 3 surgeries and those having more than three procedures. Psychological and social scores were better for girls than for boys and differences were significant. CONCLUSIONS The risk of urinary incontinence is high in children managed for bladder exstrophy. Boys are more affected than girls with subsequent psychological and social repercussions. In our study, quality of life depends more on number of surgery than continence results. Psychological problems should be screened early for accurate treatment. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Y Ben Ahmed
- Paediatric surgery department, Children Hospital Bachir Hamza, Tunis, Tunisia
| | - R Boulma
- Urology unit surgery department FSI Hospital Tunis, Tunisia.
| | - M Landolsi
- Paediatric surgery department, Children Hospital Bachir Hamza, Tunis, Tunisia
| | - T Boukesra
- Paediatric surgery department, Children Hospital Bachir Hamza, Tunis, Tunisia
| | - R Boussetta
- Paediatric orthopedy department Children Hospital Bachir Hamza, Tunis, Tunisia
| | - M Hamza
- Pedo-psychiatric department, Marsa Hospital, Tunisia
| | - I Chibani
- Paediatric surgery department, Children Hospital Bachir Hamza, Tunis, Tunisia
| | - A Guitouni
- Paediatric surgery department, Children Hospital Bachir Hamza, Tunis, Tunisia
| | - A Charieg
- Paediatric surgery department, Children Hospital Bachir Hamza, Tunis, Tunisia
| | - F Nouira
- Paediatric surgery department, Children Hospital Bachir Hamza, Tunis, Tunisia
| | - S Jlidi
- Paediatric surgery department, Children Hospital Bachir Hamza, Tunis, Tunisia
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Caione P, Angotti R, Molinaro F, Pellegrino C, Scuglia M, Gerocarni Nappo S, Messina M. Urethral duplication in male epispadias: a very uncommon association. MINERVA UROL NEFROL 2019; 72:229-235. [PMID: 30957471 DOI: 10.23736/s0393-2249.19.03271-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Urethral duplication associated with epispadias is a rare malformation. Few cases are described in Literature. We report the experience of two centers to add to the literature. METHODS A retrospective study was conducted in two Italian Centers. All patients with urethral duplication associated with epispadias, treated from 1997 to 2017 were included. The preoperative work-up included renal-urinary ultrasonography and voiding cystourethrogram. All patients underwent surgery according to the Mitchell-Caione technique. Cosmetic result, urinary continence and satisfaction degree of patients at the last follow-up were evaluated as outcomes. Six male patients with urethral duplication in epispadias were included. Two patients presented penile epispadias and four penopubic epispadias. Only one patient had urinary incontinence as presenting symptomatology. The diagnosis of urethral duplication was accidental during preoperative evaluation in the remaining five patients. RESULTS At last follow-up (mean 8.3 years) all patients but one presented good cosmetic result, one patient presented mild stress urinary incontinence, one presented nocturnal enuresis. The physical genital appearance was improved in all patients. Urethral duplication in association with epispadias is a rare urogenital abnormality. No classification is universally accepted. CONCLUSIONS Based on our experience, we believe that the presence of any duplication should be carefully searched during surgery for male epispadias.
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Affiliation(s)
- Paolo Caione
- Division of Pediatric Urology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Rossella Angotti
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy -
| | - Francesco Molinaro
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Chiara Pellegrino
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Marianna Scuglia
- Division of Pediatric Urology, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Mario Messina
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
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Dellenmark-Blom M, Sjöström S, Abrahamsson K, Holmdahl G. Health-related quality of life among children, adolescents, and adults with bladder exstrophy-epispadias complex: a systematic review of the literature and recommendations for future research. Qual Life Res 2019; 28:1389-1412. [PMID: 30725391 DOI: 10.1007/s11136-019-02119-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Bladder exstrophy-epispadias complex (BEEC) is a rare spectrum of genitourinary malformations. Children risk long-term urinary and genital dysfunctions. To achieve a comprehensive understanding, this study aimed to review the literature on generic and disease-specific health-related quality of life (HRQOL) in BEEC patients, and methodologies used. METHODS A literature search was conducted in Pubmed/CINAHL/Embase/PsycINFO/Cochrane, from inception to May 2018. A meta-analysis of HRQOL in BEEC patients compared to healthy references was performed. RESULTS Twenty-one articles (published 1994-2018), describing HRQOL of children and adolescents (n = 5) and adults only (n = 5), or integrated age populations (n = 11), were identified (median sample size 24, loss to follow-up 43%, response rate 84%). Overall HRQOL was reduced in BEEC patients compared to healthy references in 4/4 studies. Impaired physical or general health in BEEC patients has been described in 9 articles, diminished mental health in 11, restricted social health in 10, and sexual health/functioning or body perception impairments in 13 articles. Urinary incontinence was the most common factor related to worse HRQOL (12 studies). In six studies, HRQOL was better than healthy norms. In eligible studies (n = 5), the pooled estimate of the effect of BEEC indicated worse HRQOL for children and adults (0 > effect sizes < 0.5). Thirty-six HRQOL assessments were used, none developed and validated for BEEC. CONCLUSIONS HRQOL in BEEC patients may be negatively impacted, particularly considering mental and social HRQOL. Sexual health/functioning or body perception impairments may be present in adolescents and adults. However, HRQOL is heterogeneously assessed and subsequent findings are differently reported. Additional research is warranted and can be improved.
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Affiliation(s)
- Michaela Dellenmark-Blom
- Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85, Gothenburg, Sweden. .,Department of Pediatrics, The Queen Silvia Children's Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 416 86, Gothenburg, Sweden.
| | - Sofia Sjöström
- Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85, Gothenburg, Sweden.,Department of Pediatrics, The Queen Silvia Children's Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 416 86, Gothenburg, Sweden
| | - Kate Abrahamsson
- Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85, Gothenburg, Sweden.,Department of Pediatrics, The Queen Silvia Children's Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 416 86, Gothenburg, Sweden
| | - Gundela Holmdahl
- Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85, Gothenburg, Sweden.,Department of Pediatrics, The Queen Silvia Children's Hospital, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 416 86, Gothenburg, Sweden
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Angotti R, Molinaro F, Ferrara F, Bindi E, Aglianò M, Bianchi A, Messina M. Modified Heitz-Boyer-Hovelacque rectal bladder in children: Reassuring histology after median follow-up of 10.5 years. J Pediatr Urol 2018; 14:308-309. [PMID: 29705140 DOI: 10.1016/j.jpurol.2018.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 03/09/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Rossella Angotti
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
| | - Francesco Molinaro
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Francesco Ferrara
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Edoardo Bindi
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Margherita Aglianò
- Section of Human Anatomy, Department of Medical Sciences, Surgical Sciences and Neurosciences, University of Siena, Italy
| | - Adrian Bianchi
- Neonatal and Paediatric Reconstructive Surgeon, Manchester, UK
| | - Mario Messina
- Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
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Penna FJ, Bägli DJ. Commentary to 'Continence and quality of life with the modified Heitz-Boyer-Hovelaque rectal bladder for children with urinary incontinence following bladder exstrophy'. J Pediatr Urol 2016; 12:175-6. [PMID: 27107629 DOI: 10.1016/j.jpurol.2016.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 03/22/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Frank J Penna
- Division of Paediatric Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.
| | - Darius J Bägli
- Division of Paediatric Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
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