ABSTRACT
PURPOSE: To report stoma stenosis rates and efferent channel (EC) complications at long term follow-up for Turin pouch (TP). METHODS: This is a retrospective analysis of the prospectively maintained database of patients who underwent TP between March 2006 and May 2018. The TP is a U-shaped right colon pouch. The EC was conceived by the tubularization of 5 cm of the colon wall with the use of a stapler and sutured to the skin (EC-cutaneostomy). The ureters are sutured separately to the last 10 cm of ileum before the ileocecal valve. In literature, catheterization problems have been described on average in 20.3% of patients and stoma stenosis in 19.5% of the patients with flap valve systems. RESULTS: Thirty-eight consecutive patients underwent a TP procedure. The median age was 55 years (IQR: 52-60). Median operative time was 201 min (IQR: 170-210), median reconstructive time was 61 min (IQR: 55-65) and the blood loss was 244 ml (IQR: 150-300) and 4 patients (10.5%) needed blood transfusions. The median follow-up was 52 months (IQR: 37-92). Complete 24h continence was achieved in 34 (89%) patients. Seven (18.4%) patients reported difficulties in EC catheterization and 4 (10.5%) patients had stoma stenosis. This study is limited by the relatively small number of patients. CONCLUSION: In relation to similar systems, the TP seems to offer comparatively good functional results but EC and stoma complications were lower than other pouch variants in literature.
Subject(s)
Colonic Pouches , Urinary Diversion , Constriction, Pathologic/epidemiology , Female , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Retrospective Studies , Surgical Stomas , Time Factors , Treatment OutcomeABSTRACT
We describe the augmentation phalloplasty according to G. Tritto technique. The procedure is based on the use of dermo-fat free graft taken from the cruro-gluteal area and allows a penile lengthening varying from 2.5 to 3 cm. This technique can be performed in patients with the so-called "small penises" and psychosexual dysfunctions.