Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cystostomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources
PubMed1997

[Clinical studies on lower urinary tract injury].

A total of 61 patients with lower urinary tract injuries were treated at Nara Medical University and its affiliated hospitals, between January 1985 and June 1995. There were 9 patients with bladder injuries and 52 patients with urethral injuries. The main cause of bladder injury was a traffic accident sustained in 4 patients (44.5%) and that of urethral injury was an occupational accident sustained in 27 cases (51.9%). The major associated injuries were a bone fracture seen in 45 patients (73.8%) and an intrascrotal hematoma seen in 28 patients (45.9%). Posterior urethral injuries associated with pelvic bone fractures were classified into 3 types according to the classification reported by Colapinto et al.; 8 patients (32.0%) into Type I, 8 (32.0%) into Type II and 9 (36.0%) into Type III. Of the 25 patients with posterior urethral injuries, 8 (32.0%) underwent immediate surgical treatment, 12 (48.0%) underwent initial cystostomies and delayed surgical treatment and 5 (20.0%) received indwelling of urethral catheters. Postoperative complications of urethral injury included urethral stricture in 30 patients (57.7%), incontinence in 3 (5.8%) and impotence in 3 (5.8%). A significant relationship between the duration of cystostomy and the incidence of postoperative urethral stricture was observed in our patients. Therefore at least three weeks of cystostomy will be necessary in the management of patients with complicated urethral injuries.

Accidents, Occupational↗
PubMed1997

Immediate management of posterior urethral disruptions due to pelvic fracture: therapeutic alternatives.

PURPOSE: We retrospectively reviewed the results of 3 types of initial management of pelvic fracture urethral disruption in children. MATERIALS AND METHODS: From 1980 to 1994, 35 boys 2 to 15 years old (mean age 8.1) with prostatomembranous urethral disruption were treated, including 17 who also had associated injuries. Immediate treatment included suprapubic cystostomy and delayed urethroplasty in 19 patients (group 1), urethral catheter alignment without traction and concomitant suprapubic cystostomy in 10 (group 2), and primary retropubic anastomotic urethroplasty in 6 (group 3). RESULTS: In all patients in groups 1 and 2 severe urethral obliteration developed. Four group 3 patients (66%) had a stricture at the site of anastomotic repair. After delayed urethroplasty 16 group 1 (84%) and all 10 group 2 patients were continent. However, only 3 group 3 patients (50%) achieved continence. Retrospectively associated bladder neck injury occurred in 5 of the 6 incontinent boys. Erections were observed before and after treatment in all but 3 children. Unstable pelvic ring fractures (type IV) comprised 28% of all pelvic fractures with a high rate of associated injuries. CONCLUSIONS: As described, urethral alignment was not beneficial for avoiding urethral obliteration. Therefore we recommend suprapublic cystostomy as the only form of initial treatment in these cases. Urinary incontinence seems more likely related to associated bladder neck rupture and the severity of pelvic fracture rather than to initial treatment or delayed urethral repair. Consequently, when associated bladder neck injury is present, we advocate immediate surgical repair.

Adolescent↗
PubMed1997

Infectious peritonitis complicating suprapubic catheter removal.

Peritonitis following suprapubic catheter placement may result from inadvertent placement of the drain through the large and small bowel and bladder base. The author describes a case of infectious peritonitis which developed after suprapubic catheter removal. The patient, underwent suprapubic catheter placement after Burch Colposuspension for genuine stress incontinence. The catheter was removed with a full bladder after an uneventful postoperative course, but the patient subsequently developed acute infectious peritonitis due to extravasated urine from the cystostomy site. It was concluded that suprapubic catheters should be removed after the bladder is emptied, to prevent this complication. This may be most important in patients who void without residual prior to epithelialization of the cystostomy site.

Adult↗
PubMed2002

Treatment of posterior and anterior urethral trauma.

OBJECTIVE: To assess the occurrence and treatment of posterior urethral (most often caused by traffic accidents and comprising half of all cases of urinary tract traumas) and anterior urethral injury (usually iatrogenic during catheterization or cystoscopy, or caused by blunt trauma, e.g. straddle injury or penetrating trauma). PATIENTS AND METHODS: The records and details of patients with posterior and anterior urethral trauma were analysed from 61 urological departments in Poland between 1995 and 1999. RESULTS: During the 5-year period there were 268 cases of posterior and 255 of anterior urethral injury; for the former, most occurred during traffic accidents, and of the latter 206 were iatrogenic (during catheterization or cystoscopy), of which 48 were accompanied by perineal injury. The posterior injuries were isolated or involved many organs, mainly pelvic bones. Both types of injuries were diagnosed using ascending urethrography, voiding cysto-urethrography and urethroscopy/endoscopy. Treatment for posterior injuries included cystostomy alone or cystostomy with abdominal drainage or perineal drainage; some patients also had their urethra reconstructed. The treatment for anterior injuries was conservative in 193 patients and surgical in 62. CONCLUSION: The early detection and appropriate surgical treatment of posterior and anterior urethral injury is crucial for the recovery of urethral function, and avoids many complications.

Accidental Falls↗
PubMedDate not supplied

Contrast radiography of the lower urinary tract in the management of obstructive urolithiasis in small ruminants and swine.

Contrast radiographic visualization of the small ruminant and porcine lower urinary tract is an infrequently used modality for the evaluation and management of obstructive urolithiasis. The administration of contrast medium through a tube cystostomy catheter used to divert urine flow until the resolution of the obstruction may provide an easy method to evaluate the status of the urethral obstruction. Contrast fluoroscopy is utilized to monitor and visualize therapeutic flushing of the urethra. A review of 26 patients seen at the Veterinary Medical Teaching Hospital suggested that among the radiographic techniques used, positive contrast normograde cystourethrography through the tube cystostomy catheter allowed the best visualization of the lower urinary tract structures and enabled assessment of the resolution of the obstructive lesion.

Animals↗
PubMedDate not supplied

[Endourethral drainage of the bladder in patients with prostatic adenoma].

Cystostomy catheterization of urinary bladder is the commonest method of choice in the treatment of patients with prostatic adenoma complicated by pronounced intercurrent pathology. To avoid the necessity of male urinals the technique of intraurethral splinting was used in 5 patients with nitinol spiral introduced in the prostatic part of the urethra. Therefore, the urination was normalized in three of them (one person had cystostomy catheter). The long-term observation evidenced of spiral stable position and step-by-step rehabilitation of detrusor function. There was a case of spiral incrustation and still another of spiral displacement when an attempt was made to pass the urethral catheter down the inside of nitinol splint. Though the aforementioned method of recovery of normal urination is a promising one, further clinical trials are required.

Aged↗
PubMed1998

Urinary obstruction in a hermaphroditic llama.

A 24-hour-old cria was admitted for evaluation of stranguria evident shortly after birth. On physical examination, the prepuce appeared to be normally formed and small drops of fluid dripped from it as the cria strained to urinate. Testes could not be palpated. Ultrasonographic examination revealed that the bladder was distended. The only abnormality detected on serum biochemical analysis was high creatinine concentration. Tube cystostomy was performed, and the cria was treated with saline (0.9% NaCl) solution administered intravenously and antibiotics. Four days after admission, the cria could not urinate normally when the cystostomy tube was occluded. Five days after admission, normograde cystography and retrograde urethrography were performed. Radiographic findings indicated the cria was an intersex llama with urethral duplication. The llama was euthanatized at the owner's request. Necropsy revealed bilateral ovotestes with a phenotypically female reproductive tract and urethral duplication. Urethral duplication should be considered as a cause of stranguria in male neonatal crias, and hermaphroditism should be included as a cause of urethropathies in llamas.

Animals↗
PubMed1987

Acute ureteral obstruction as a complication of suprapubic catheterization.

Suprapubic cystostomy catheters are an important tool for the management of patients who require urinary drainage. Although complications occur after the procedure, they are usually minor. A case of acute obstruction at the ureterovesical junction caused by a suprapubic cystostomy catheter tip is presented.

Acute Disease↗
PubMed1995

Modified pelvic anterior exenteration.

During a 20-year time period, 117 patients with various histologic types of cancer underwent pelvic exentereation. Six of the 107 patients who needed anterior exenteration with urinary diversion received partial excision of the urinary bladder and modification surgery, of which three had uretero-cystostomy, two had mobilization of bladder and uretero-cystostomy and one had uretero-uterostomy. These six patients, except for two, died of disease in 1 year. Two patients are alive and happy, with quality of life because they can urinate normally. We suggest that anterior exenteration should be modified whenever possible to preserve the bladder and not to do an urinary diversion.

Female↗
PubMed1984

Intraventricular noncolloid epithelial cyst in an infant.

A rare case of giant intraventricular noncolloid epithelial cyst associated with multicompartmental hydrocephalus in an infant is presented. The cyst was located in the third ventricle and extended through the foramina of Monro into the lateral ventricles. Multiple modes of therapy were performed, including shunting procedures and transcortical and transcallosal cystostomies. It is concluded that extensive cystostomy coupled with a shunting procedure is the preferred method of treatment for giant cystic lesions around the foramina of Monro, if total excision is not feasible.

Brain Diseases↗
PubMed1980

Diffuse cystitis glandularis. Associated with adenocarcinomatous change.

Although cystitis glandularis has been considered a premalignant lesion, the instance of cystitis glandularis progression to adenocarcinoma or cystitis glandularis associated with adenocarcinomatous change is rare. This article includes 4 cases of neurogenic bladder with urinary diversion for different periods of time. In the first case with ureterocutaneostomy for twenty-five years diffuse cystitis glandularis with multifocal adneocarcinomatous change developed. The second case with suprapubic cystostomy for twenty-two years had diffuse cystitis glandularis of gastrointestinal type without evidence of malignancy. The other 2 cases with suprapubic cystostomy for merely ten years showed only mild to moderate cystitis glandularis and chronic cystitis with squamous metaplasia, respectively. The extent of cystitis glandularis appeared to correlate with the duration of urinary stasis. Ureterocutaneostomy rendered constant infection of the urinary bladder of the first case because of inadequate drainage. Thus, we assume that the intensity of the infection with a toxic product and virulence of organism may be responsible for the development of adenocarcinoma in this patient. Cystitis glandularis, especially diffuse type, can undergo malignant degeneration under constant irritation, but it is a long-term process.

Adenocarcinoma↗
PubMed2002

Endoscopic cystenterostomy of nonbulging pancreatic fluid collections.

BACKGROUND: A prerequisite for endoscopic drainage of pancreatic fluid collections without EUS is the presence of a visible bulge in the GI wall. Our experience with endoscopic cystostomy of nonbulging pancreatic fluid collections is described. METHODS: Thirty-three patients underwent 34 endoscopic attempts at transmural drainage of nonbulging pancreatic fluid collections over a 2-year period. The etiology of the nonbulging pancreatic fluid collections was chronic pancreatitis in 26 cases and acute pancreatitis in 7. Indications for drainage included one or more of the following: abdominal pain, infection, biliary obstruction, and external fistula. The diameter of the collections ranged from 20 to 160 mm (median 52 mm). RESULTS: Thirty-two of 34 drainage attempts were successful (94%). Eighteen cystostomies were performed under fluoroscopy alone and 14 by EUS together with fluoroscopy. Procedure-related complications occurred with 3 of 34 attempts (8%). Surgery was not required for treatment of the complications and there were no deaths from the procedure. Follow-up was available for 31 patients (median 21 months, range 9 to 40 months). One nonbulging pancreatic fluid collections recurred 7 months after drainage. CONCLUSIONS: Endoscopic cystenterostomy of nonbulging pancreatic collections is feasible, and the results of the procedure are similar to those of cystenterostomy for bulging collections.

Acute Disease↗
PubMed1989

Major perineal trauma in children.

Between 1976 and 1987, 22 children aged 3 to 17 years (mean age, 9.5 years) were admitted to our institution with major perineal trauma. There were 14 urethral ruptures and 9 rectal lesions. The lesions were multiple and combined: vaginal and urethral or vaginal and rectal injuries were found in 10 females, while only 1 of 12 males had both urethral and rectal lesions. In most instances, perineal physical signs did not reflect the severity of the lesion. Among the patients with urethral lesions, there was no sex or age predominance; complete rupture occurred in four females and eight males. The insertion of a urethral catheter was of no diagnostic help. Retrograde urethrogram demonstrated a lesion in seven of eight cases. The intravenous pyelogram (IVP) showed evidence of extravasation in two of the eight cases, and in four instances there were indirect rupture signs. A suprapubic cystostomy was performed in 12 of the 14 urethral injuries. A primary repair with urethral stenting was carried out twice without bladder drainage. Immediate repair was performed in eight cases and delayed in five others. Within this last group, two patients were cured without sequelae by stenting without suture, while the three others who underwent only cystostomy necessitated multiple reconstructive operations with poor results. It is of interest that the four treatment failures occurred in the youngest patients (4 to 7 years of age). The rectal lesions were related to impalement in seven of nine patients. Rectoscopy allowed localization of perforations but did not permit identification of sphincter injuries when the mucosa was intact. Primary repair was possible in all cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Closure of the bladder neck in spinal cord injury patients with urethral sphincteric incompetence and irreparable urethral pathological conditions.

Total urinary incontinence developed secondary to incompetence of the urethral closing mechanism in 8 spinal cord injury patients who were on Foley catheter drainage (5 patients) or suprapubic cystostomy (3 patients). All patients had irreparable urethrocutaneous fistulas and 4 had urethroperineal erosion. Closure of the bladder neck with drainage via a suprapubic cystostomy tube was used to divert the urinary stream. Bladder neck closure was successful in alleviating total urethral urinary incontinence in all patients. However, suprapubic abdominal leakage developed in 2 patients. This procedure should be recommended cautiously when a maximal bladder capacity greater than 125 cc cannot be maintained unless concomitant augmentation cystoplasty also is considered.

Humans↗
PubMed1977

Experience with management of posterior urethral injury associated with pelvic fracture.

Review of records from 205 patients with pelvic fracture and hematuria revealed that 121 underwent urologic and radiographic evaluation. Of these patients 20 had severe posterior urethral injuries documented by urethrography of voiding cystourethrography: 9 underwent primary repair and 11 had delayed scrotal-inlay urethroplasty after initial cystostomy alone. Patients who underwent primary repair had a 77 per cent incidence of stricture, a 22 per cent incidence of incontinence and a 33 per cent incidence of impotency. Patients who underwent delayed closure had no incidence of stricture, incontinence or impotence. Patients in both groups had urinary tract infections. Simple cystostomy followed by delayed scrotal-inlay urethroplasty appears superior to primary realignment in the management of patients with posterior urethral injuries.

Fractures, Bone↗
PubMed1976

Experience with non-sterile intermittent self-catheterization.

Although a patient subjected to intermittent self-catheterization must carry a catheter and catheterize himself under a non-sterile technique at regular intervals this method is considered the best one available for patients who lead an active social life. When family cooperation is available intermittent catheterization is a cleaner procedure, causes less complications and is easier to manage for a patient confined to bed than the indwelling catheter, cystostomy or other urinary diversion procedures. The technique is also useful for patients with spinal cord injuries, promoting the early return of bladder activity and a life free of the catheter. It is an ideal method for children with meningomyelocele, after the upper tract has been maintained carefully by an indwelling catheter or cystostomy until the child is able to catheterize himself. In these cases a small capacity bladder may be enlarged using the colon and urinary incontinence may be corrected by other operative procedures. We have treated 26 patients with this technique, including 1 with a 17-year followup. The upper urinary tract has not deteriorated in any case and the urine has remained sterile in 39 per cent of the cases.

Adolescent↗
PubMed1977

Urologic injuries.

We have reviewed our experience in 311 cases of urologic trauma seen at Detroit General Hospital. A properly organized emergency surgery team is necessary to handle these types of injures effectively. We feel that, whenever possible, evaluation of any patient suspected of genitourinary trauma should be accomplished by a urologist before the patient enters the operating room. We approach renal injuries with a conservative viewpoint, trying to preserve as much renal tissue as possible, yet realizing that at time an aggressive approach to renal injuries is necessary to accomplish this and to save the patient's life. The injuries of the renal pelvis and ureter should be treated by debridement and a water-tight anastomosis with a fine absorbable material. It is our impression that patients suffering from gunshot wounds, because an ideal anastomosis is not possible, do better with a stented anastomosis. Ruptures of the bladder are simple to repair and attention is focused on the diagnosis and exploration of associated ureteral injuries. The prostatomembranous disruptions are without question one of the most difficult injuries in urology. Although we attempt to stent the urethra in order to align the ends, we condemn a vigorous attempt with interlocking sounds or other instruments since they may lead to iatrogenic injuries of the urogenital diaphragm. In these cases suprapubic cystostomy drainage and secondary repair is indicated. Our results with a group of patients with injuries of the anterior urethra showed that the overwhelming majority of these patients did well with a suprapubic cystostomy and drainage with no immediate repair.

Contusions↗