ABSTRACT
OBJECTIVE: We assessed the results of a continent urinary diversion (Indiana pouch) in seven women with severe neurogenic urinary incontinence. PATIENTS AND METHODS: There were seven patients (mean follow-up 28 months), in five of whom a complete Indiana pouch was created. In two the bladder was augmented with the Indiana pouch, the bladder neck was closed and an umbilical stoma was created. In three cases the appendix served as outlet whereas in the other patients a continent catheterisable stoma was created by means of a tapered terminal ileum. RESULTS: All the patients were dry (the stoma was continent) and could catheterise themselves while sitting in a wheelchair. There was one complication (bleeding) immediately postoperatively that needed reintervention. The late complications were acceptable: in one patient a stone had to be removed from the pouch and there was a stenosis of the stoma in two others. There was no hyperchloraemic acidosis. CONCLUSION: The Indiana pouch is a safe and effective method for neurogenic incontinence when all available pharmacological treatments and clean intermittent catheterisation have failed. It has little impact on the body image, and the independence and social reintegration of the woman is improved.
Subject(s)
Spinal Cord Injuries/complications , Urinary Diversion/methods , Urinary Incontinence/surgery , Urinary Reservoirs, Continent , Adult , Female , Follow-Up Studies , Humans , Middle Aged , Treatment Outcome , Urinary Bladder/surgery , Urinary Bladder, Neurogenic/etiology , Urinary Bladder, Neurogenic/surgery , Urinary Incontinence/etiologyABSTRACT
OBJECTIVE: To evaluate the results of percutaneous endoscopic treatment of renal pelvic transitional cell carcinoma (TCC). PATIENTS AND METHODS: Ten patients (median age, 70 years; range 56-86) with a renal pelvic TCC were treated by percutaneous endoscopic resection. Seven had a normal contralateral kidney and were treated electively. RESULTS: Follow-up was from 3 to 77 months. There was one recurrence locally and one recurrence in the bladder. There have been no recurrences in the nephrostomy tract. CONCLUSION: We have shown that percutaneous resection of intrarenal TCC is a possible and safe technique. Further follow-up is needed to confirm its safety.
Subject(s)
Carcinoma, Transitional Cell/surgery , Kidney Neoplasms/surgery , Kidney Pelvis , Aged , Aged, 80 and over , Endoscopy , Female , Follow-Up Studies , Humans , In Vitro Techniques , Male , Middle Aged , Nephrostomy, Percutaneous , Treatment OutcomeABSTRACT
We report a rare case of clinically significant secondary prostatic neoplasm. In a patient with outflow obstruction, a transurethral resection of the prostate revealed a metastasis of a signet ring cell carcinoma of the stomach in the resected prostatic tissue.
