ABSTRACT
Objective This study was carried out to evaluate the urodynamic characteristics of the Camey II; Kock's and W-configured ileal reservoirs utilized for orthotopic urinary diversion. Patients and Methods Between January 2000 and 2002; 42 male patients prospectively underwent radical cystoprostatectomy for bladder cancer followed by orthotopic urinary diversion at the urology department of Cairo University hospitals. All cases were evaluated clinically; bacteriologically; radiologically and urodynamically including uroflowmetry; medium-fill and voiding enterocystometry and urethral pressure profilometry; which was done in the early and late postoperative period (at 3-6 months and 6-18 months). Patients were divided into four groups: Group I: 11 cases with preservation of the prostatic apex and creation of a W-neobladder. Group II: 11 cases without prostatic apex preservation and creation of a W-shaped ileal pouch. Group III: 12 cases without prostatic apex preservation and creation of a Camey II pouch. Group IV: 8 cases without prostatic apex preservation and creation of a Kock's pouch. Results The patients of Group I had a larger mean neobladder capacity (699 ml) and volume at which the first contraction occurred (315 ml) and a larger amount of residual urine (224 ml) as compared to Group II (511.1; 285 and 77.5 ml; respectively); Group III (375; 200 and 55 ml; respectively) and Group IV (563; 266 and 600 ml; respectively). Also Group I with a preserved prostatic apex had a higher mean intraluminal opening pressure (55 cm H2O) and a higher pressure at maximum flow (62.36 cm H20) as compared to the patients with complete prostatic resection. Conclusion We conclude that the patients with a preserved prostatic apex (Group I) had a statistically significant higher mean residual urine in the early and late postoperative period and a significantly higher mean maximum cystometric capacity in the late postoperative period as compared to those recorded in patients with complete prostatic resection (Groups II; III; IV). A higher incidence of upper tract deterioration was detected in Group I (35) vs. 4.6; 27.8and 12.5in Groups II; III and IV; respectively
Subject(s)
Cystectomy , Ileum , Urinary Bladder , Urinary Diversion , UrodynamicsABSTRACT
A methanol extract of Syzygium guineense bark inhibited intrinsic contractions of rabbit isolated ileum. The inhibition; at bath concentrations of 0.5 - 2.0 mg/ml; was dose-related but non-linear. It produced sustained hypotension in anaesthetized rats. A dose of 5 ug lowered systolic; diastolic and mean blood pressure by 16; 22and 17; respectively below the pre-drug levels. Maximum effect was obtained at a dose of 40 ug when the systolic; diastolic and mean blood pressures fell by 23; 36and 28; respectively below the pre-drug levels. The greater fall in blood pressure was in diastolic than systolic blood pressure. The extract caused a weaker but similar effect to isoprenaline on rabbit isolated heart. While the effect on rabbit isolated ileum supports the folkloric use of the plant as an antispasmodic; further work is required to confirm and categorize the observed pharmacological activities