The use of ileum for correction of advanced or complicated bilharzial lesions of the urinary tract

Ghoneim, Mohamed A.; Shoukry, I

doi:10.1007/bf02081890

Cited by 19 publications

(8 citation statements)

References 10 publications

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“…Surgery is indicated in cases where the bladder capacity is reduced to < 100 mL. The procedure of choice is augmentation cystoplasty, using either ileum or colon [16,17].…”

Section: The Management Of Benign Superficial Bilharzial Lesionsmentioning

confidence: 99%

Bilharziasis of the genitourinary tract

Ghoneim

2002

BJU International

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“…Surgery is indicated in cases where the bladder capacity is reduced to < 100 mL. The procedure of choice is augmentation cystoplasty, using either ileum or colon [16,17].…”

Section: The Management Of Benign Superficial Bilharzial Lesionsmentioning

confidence: 99%

Bilharziasis of the genitourinary tract

Ghoneim

2002

BJU International

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“…Most of these patients would never have been considered for ileal replacement, but the 2 with bilateral long strictures may have been. Both did well after unilateral nephrectomy and unilateral reimplantation, whereas ileal replacement procedures have had a significant mortality and morbidity rate at these hospitals, and Weinberg (1970) and Ghoneim and Shoukry (1972), have reported mortality rates of 8 to 25% in small numbers of patients having ileal replacement for bilharzial ureteric disease.…”

Section: Discussionmentioning

confidence: 96%

The Surgical Management of Bilharzial Strictures of the Ureter

Mee

Youssef

1982

British Journal of Urology

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“…[ 12 ] Others[ 7 ] stressed the role of antireflux procedure in preventing further worsening of renal functions in patients with already impaired renal functions. Many authors[ 1 13 ] concluded that antireflux procedure is not necessary at all as the natural isoperistaltic waves of ileal tube can prevent reflux from reaching the kidney[ 14 ] and an ileal loop longer than 15 cm was considered a safeguard against the harmful effect of reflux on the kidney[ 8 ] and may be safely excluded in patients who have normal preoperative renal and voiding function. Hence, there is no common consensus on the use of distal implantation technique and its effect on renal function.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, the length of bowel used should preferably be as short as possible to prevent these complications. [ 13 ] Rate of hyperchloremic metabolic acidosis reported in various studies is 0%–14%. [ 9 10 15 16 ] In another study, half of the patients with serum creatinine more than 2 mg/dL developed hyperchloremic metabolic acidosis requiring conversion to the conduit.…”

Section: Discussionmentioning

confidence: 99%

Use of ileum for complex ureteric reconstruction: Assessment of long-term outcome, complications, and impact on renal function

et al. 2018

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Introduction:Defect in ureteral continuity can be due to various etiologies. The surgical options for management of complex long-segment ureteric defects are limited. Use of ileum is indicated in these cases; however, the technique is challenging and outcomes need to be assessed in detail.Material and Methods:It is an observational study conducted over 4 years. After preoperative optimization, ureteric reconstruction was performed using standard techniques of ileal interposition in cases of unilateral and bilateral long-segment ureteric defects. Patients were followed up at regular interval to assess outcomes and see for complications.Results:A total of 14 patients were studied. Two most common indications for performing ileal ureter were iatrogenic injury and radiation-induced strictures (5–5 cases). Most common site of ureteric involvement was lower and midureter seen in 6 cases. The mean length of the ileum used was 11.2 cm. Mean preoperative nadir creatinine level was 1.57 mg/dL in this study. Average postoperative creatinine level at 4-week follow-up was 1.75 mg/dL and 1.45 mg/dL and 1.37 mg/dL, at 3 and 12 months, respectively. The most common short-term complication was paralytic ileus and long-term complication was recurrent urinary tract infection UTI. There was no mortality.Conclusion:Ileal ureter is found to be relatively easy and safe surgery even in patients with borderline high creatinine. There was no worsening of renal function attributable to the conduit in this study. In patients with limited surgical options, it is a suitable alternative, rather than keeping patient on permanent percutaneous nephrostomy or regular stent change. Metabolic acidosis and mucous-associated complications such as pain, infection, and stone formation can be minimized by adherence to strict protocol.

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The use of ileum for correction of advanced or complicated bilharzial lesions of the urinary tract

Cited by 19 publications

References 10 publications

Bilharziasis of the genitourinary tract

Bilharziasis of the genitourinary tract

The Surgical Management of Bilharzial Strictures of the Ureter

Use of ileum for complex ureteric reconstruction: Assessment of long-term outcome, complications, and impact on renal function

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