Results of Closed Loop Ileocystoplasty
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We herein presented the results of twenty-one closed loop ileocystoplasties which were performed solely for the contracted tuberculous bladder during the 10 year period beginning in 1963. In general the results, except two deaths; an operative mortality rate of 9.5 percent, have been fairly encouraging. After ileocystoplasty, hydronephrosis improved in 11 kidney units, remained unchanged in nine and was reversely deteriorated in one. In the group of 12 patients with impaired preoperative renal function, there were eight improvements and two deteriorations. The other two patients' renal function remained unchanged. One patient, in the group of patients with normal preoperative renal function, was considered to have become worse following the operation. Early and late complications were reviewed; there were one acute renal failure and one obstructive anuria as serious early complications, and two ileo-cystostomy stenoses, one acute intestinal obstruction, one spontaneous perforation of the ileal segment, three urinary tract stones and two metabolic acidoses associated with electrolyte imbalance as severe late complications. The inquiries by mail indicated that closed loop ileocystoplasty may afford nearly complete symptomatic relief except for a weak pulsive force of the ileobladder to evacuate urine, and persistent mucus formation. The contracted tuberculous bladder is gradually becoming less common, as tuberculous diseases are succumbing to antituberculous chemotherapy. However, it is sporadically found in Japan, where tuberculosis is found to be much more liable in bladder contractions than any other etiology. As the contraction progresses to such a degree that the upper urinary tracts are affected, the kidneys gradually lead to destruction. Surgical correction is necessary in order to reverse the threat of this deterioration and to relieve the patient from such complaints as frequent miction and/or overflow incontinence. Ileocystoplasty, one of the available surgical corrections, has been widely used for bladder contractions with various etiologies. However, it is not without criticism. Extensive literature has grown up in which various series of the operation have been reported from a number of urological centers, some of them drawing attention to several drawbacks of this operation in contrast to other kinds of intestinocystoplasty. Until two years ago, when we adopted the colocystoplasty operation, we had performed closed loop ileocystoplasties for ten years. In summerized fashion, we herein report the results of our experience of the operation on 21 patients.
- Yamaguchi University Graduate School of Medicineの論文
Yamaguchi University Graduate School of Medicine | 論文
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