The authors report their experience in the treatment of recurrent stricture of the appendiceal stump in continent diversion (Indiana pouch) after cystectomy by means of the Memotherm ureteral stent. The patient presented was treated successfully with this device after failure of repeat cold-knife incisions of the stricture. At 9-months' follow-up from positioning, the stent is in place, covered by mucosa. Self-catheterization of the pouch is easily performed five or six times a day with a 12F catheter.
The Authors report their experience in the recovery of bladder function in 8 female patients (5 of whom had undergone radical hysterectomy + CHT + RT for gynecological tumours) by means of ileovesicoplasty and bilateral ureteral reimplantation. They underline the improvement of bladder capacity (7/7), continence (7/7), voiding (good results in 5/7) and upper urinary tract function (5/7). All patients are satisfied at a mean follow-up of 31 months. The Authors propose this surgical procedure as an alternative to external diversion.
Although surgery is considered the ultimate treatment for hydrocele, sclerotherapy can be a valuable alternative, avoiding postoperative complications such as bleeding, hematoma, wound infections and anesthesia related problems mostly in the elderly. It's also a cost-saving procedure when used in out-patients practice. We treated 50 patients using a 2.5% phenol solution for sclerotherapy. The treatment was successful in 96% of patients, with a mean follow-up of 15.5 months. Only minor complications such as scrotal pain and 1 hematocele occurred. Phenol sclerotherapy nowadays seems to be the best choice for out-patient management of hydrocele in selected cases.
— Since 1990 9 patients with vesi-covaginal fistulae located in the trigonal area of the bladder have been treated using the Leach, Raz transvaginal approach (1983). 6 women had been operated previously (4 women once / 2 women twice). Although it is customary to recommend the transabdominal route when operative repair fails, we preferred the transvaginal technique. When the urethral catheter was removed on the tenth to fifteenth postoperative day, all patients were dry. The outpatient voiding diary documented urgency/frequency syndrome in 2 cases and urinary retention in 1 due to psychosocial causes and neurogenic etiology (previous abdominoperineal resection). This technique is certainly interesting and we recommend it before attempting any abdominal surgical repair in particularly unsuccessful cases because it offers several advantages: excellent exposure, no opening of the bladder, minimal dissection, multilayer closure, reduced postoperative discomfort and shorter hospital stay.
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