Efferent Tube Suspension as a Continent Diversion Mechanism: A Preliminary Report of a Clinical Study

Xu, Yuhong; Ye, Qiao; Wu, D.; Sa, Yu; Zhon, Chen; Chen, Rong; Zhang, Xinru; Zhang, Jiong; JIN, ZHON-RUI; Jin, San-Bao

doi:10.1016/s0022-5347(05)64288-7

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…The length, diameter, and the overall wall tension of the embedded tube determine the closure pressure and the degree of continence [2]. Several types of tissues are used to create flap valves, preferably the vermiform appendix [3–9].…”

Section: General Biophysical Propertiesmentioning

confidence: 99%

“…Several variations have been developed since. Its acclaimed versatility allows the use of several tissues and structures such as the vermiform appendix, ureter, small and large bowels, Fallopian tubes, foreskin, skin flaps, stomach, and bladder wall [3–6,8,9,28,29]. Without a doubt, the appendix flap valve is the most popular variation of the Mitrofanoff procedure.…”

Section: The Flap‐valve Principle and Its Variationsmentioning

confidence: 99%

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The efferent segment in continent cutaneous urinary diversion: a comprehensive review of the literature

Ardelt

Woodhouse

Riedmiller³

et al. 2011

BJU International

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Study Type – Prognosis (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? While the ileal conduit and orthotopic neobladder are the most commonly used diversions today, continent cutaneous reservoirs remain an invaluable treatment option for a well‐defined subset of indications. After several decades of surgical experience a continuous optimisation process, especially for the continence mechanism, is still ongoing. The continence mechanism largely determines the treatment success in terms of patient satisfaction and quality of life. At present, no consensus has been reached regarding an optimal technique. Common problems include stomal stenosis with impaired catheterisation, urinary incontinence, and nipple gliding. This review critically examines published reports on the various efferent segments used in continent catheterisable urinary reservoirs. It compares data regarding the complications as well as clinical performance. Hence, it provides a valuable comparison and insight into some of the biophysical properties, shortcomings and complications of the different outlets. Also, this view clearly demonstrates that literature evidence for each technique remains poor. OBJECTIVE • To critically assess the biophysical properties and current status of outlet formation in heterotopic intestinal urinary diversion. As despite three decades of clinical experience with continent cutaneous urinary diversion through bowel segments, no consensus has been reached for the optimal efferent segment although its function largely determines patient satisfaction. METHODS • A comprehensive Medline literature search using the Medical Subject Headings database (search terms: continent urinary diversion followed by either efferent segment, nipple, Mitrofanoff, Yang‐Monti, Benchekroun, tapered ileum, intussuscepted ileum, Kock pouch, T‐valve, or Ghonheim) was conducted to identify all full‐length original articles addressing the various principles and techniques of outlet formation as well as their outcomes and complications. • Examined series were published in English between 1966 and 2010. • All studies were systematically evaluated using a checklist (study design, number of patients, etc.) and rated according to the Oxford Centre for Evidence‐Based Medicine Levels of Evidence (LoE). RESULTS • While there was a continuous flow of publications over the last three decades, the vast majority of studies were retrospective case series with numerous confounding factors and poorly defined, non‐standardized outcomes (LoE, 3). Only a few investigations compare different efferent segments (LoE, 2a). • No randomized studies exist. • The major biophysical principles are based on the use of flap, nipple, and hydraulic valves. • Vermiform appendix, intussuscepted ileal nipple, and the Yang‐Monti tube are the most popular techniques and have well‐established data on outcomes, complications, and failure rates. • Artificial sphincter systems and tissue engineering have provided disappointing results thus far. M...

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Section: General Biophysical Propertiesmentioning

confidence: 99%

Section: The Flap‐valve Principle and Its Variationsmentioning

confidence: 99%

The efferent segment in continent cutaneous urinary diversion: a comprehensive review of the literature

Ardelt

Woodhouse

Riedmiller³

et al. 2011

BJU International

View full text Add to dashboard Cite

show abstract

“…Clean intermittent catheterization (CIC) introduced by Lapides (1972) and the Mitrofanoff procedure (1980) revolutionized the management of urinary incontinence. Many structures have been proposed in an attempt to create continent conduits similar to the appendix following the Mitrofanoff principle . Regardless of the type of conduit used, failure due to incontinence is reported in around 10% of cases in the literature …”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of the pressure profilometry of vesicocutaneous continent catheterizable conduits between patients with and without rectus abdominis neosphincter (Yachia principle)

Rondon

Leslie

Arcuri

et al. 2014

Neurourology and Urodynamics

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Efferent Tube Suspension as a Continent Diversion Mechanism: A Preliminary Report of a Clinical Study

Abstract: This study suggests that the continent mechanism of the tapered ileum can be greatly enhanced by a suspension technique. This maneuver also provides easy catheterization and surgical simplicity.

Cited by 2 publications

References 8 publications

The efferent segment in continent cutaneous urinary diversion: a comprehensive review of the literature

The efferent segment in continent cutaneous urinary diversion: a comprehensive review of the literature

Comparative analysis of the pressure profilometry of vesicocutaneous continent catheterizable conduits between patients with and without rectus abdominis neosphincter (Yachia principle)

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