Montis procedure as an alternative technique in complex urethral distraction defect
Int. braz. j. urol
;
36(3): 317-326, May-June 2010. ilus, tab
Artículo
en Inglés
| LILACS
| ID: lil-555191
ABSTRACT
PURPOSE:
Pelvic fracture urethral distraction defect is usually managed by the end to end anastomotic urethroplasty. Surgical repair of those patients with post-traumatic complex posterior urethral defects, who have undergone failed previous surgical treatments, remains one of the most challenging problems in urology. Appendix urinary diversion could be used in such cases. However, the appendix tissue is not always usable. We report our experience on management of patients with long urethral defect with history of one or more failed urethroplasties by Monti channel urinary diversion. MATERIALS ANDMETHODS:
From 2001 to 2007, we evaluated data from 8 male patients aged 28 to 76 years (mean age 42.5) in whom the Monti technique was performed. All cases had history of posterior urethral defect with one or more failed procedures for urethral reconstruction including urethroplasty. A 2 to 2.5 cm segment of ileum, which had a suitable blood supply, was cut. After the re-anastomosis of the ileum, we closed the opened ileum transversely surrounding a 14-16 Fr urethral catheter using running Vicryl sutures. The newly built tube was used as an appendix during diversion.RESULTS:
All patients performed catheterization through the conduit without difficulty and stomal stenosis. Mild stomal incontinence occurred in one patient in the supine position who became continent after adjustment of the catheterization intervals. There was no dehiscence, necrosis or perforation of the tube.CONCLUSION:
Based on our data, Montis procedure seems to be a valuable technique in patients with very long complicated urethral defect who cannot be managed with routine urethroplastic techniques.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Uretra
/
Estrechez Uretral
/
Derivación Urinaria
/
Íleon
Tipo de estudio:
Estudio de etiología
/
Estudio observacional
/
Estudio pronóstico
Límite:
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Int. braz. j. urol
Asunto de la revista:
Urología
Año:
2010
Tipo del documento:
Artículo
País de afiliación:
Irán
Institución/País de afiliación:
Shaheed Beheshti Medical Sciences University/IR
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