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Objective To measure the pressure-volume changes and uroflow rate,and assess the function of upper urinary tract in sigmoidorcctal pouch patients.Methods Between 2007 and 2011,a to-tal of 10 patients who had a radical cystectomy because of muscle-invasive bladder tumor underwent a Mainz pouch Ⅱ procedure were evaluated.The ureters were implanted into the post walls of the detubularized sigmoid segment at least 30 cm in length.In all cases,sigmoidoscopy was done and the anal pressure was measured preoperatively,and video urodynamic study of sigmoidorectal pouch as well as the intravenous pyelography was conducted after 3 to 6 months postoperatively.Results Video urodynamic study of sigmoidorectal pouch revealed that no reflux up to an average volume of 360 ml (270-532 ml) of the descending colon.The sigmoidal colon pressure was 26 cm H2O during the 3 to 6 months post-operative follow-up.The anal sphincter pressure was 90 cm H2O on average preoperatively and did not change postoperatively.The renal function and upper urinary tract were preserved well.The Qmax was 30 ml/s and the average uroflow rate was 8 ml/s under abdominal strain.All the patients suffered slight incontinence in the first two months and became continent since the 3 month postoperatively with nocturnal voiding one to four times.Conclusions The sigmoidorectal pouch provides a reservoir with a higher capacity,lower pressure without reflux to the upper urinary tract and descending colon and lower metabolic acidosis problem.It is also a good alternative diversion procedure that would preserve upper urinary tract and good quality of life.
RESUMEN
Objective To investigate the hemodynamic change of venous leakage in venogenic impotence. Methods Thirty-two patients with vasculogenic impotence were evaluated with conventional penile duplex sonography with spectral analysis and color Doppler imaging after intracavernosal injection of PGE1 to induce an erection.The color Doppler appearance of deep dorsal vein of penis,cavernous veins and bulbourethral vein wen observed and the correlativity with resistance index(RI)of cavernous artery were analyzed. Results After five minutes following intracavernous injection,the flow and diameter of the penis vein were continuous increased.The coefficient correlation r between the discharge of deep dorsal vein of penis,cavernous veins and bulbourethral vein with RI of cavernous artery were-0.55,-0.53,-0.24(P＜0.05).Considering the existence of mixed venous leakage,r between the discharge of vein of penis with RI of cavernous artery was-0.88(P＜0.001).Conclusions Higher qualitative ultrasound imaging could demonstrate venous leakage sensitively and assess the location and degree of venous leakage in venogenic impotence initially.