Urodynamic Evaluation of Continent Cutaneous Urinary Stoma
Rehab Helmy Murad;
Abstract
Our study supported the practical significance of the urodynamic evaluation of the Mitrofanoff & Monti conduits. The 100% accuracy of the urodynamic confirmation of historically stated clinical incontinence was shown.
Mitrofanoff conduit gives better continence than Monti, so it’s the 1st choice when the appendix is available. So we don’t encourage incidental appendectomy in children.
There are several factors affecting stoma continence mechanism including;
• Adequate tunnel length , smaller lumen of the conduit, we recommend the ratio between them to be 5:1
• Functional profile length is an important factor as regards continence reflecting static & dynamic maximal closure pressure.
To treat incontinent catheterizable stoma, surgical revision is sometimes necessary. Revision might include lengthening the intramural tunnel, which should increase the functional profile length, and static and dynamic maximal closure pressures.
It is preferred than submucosal bulking agents that might accomplish this goal by increasing the static and dynamic maximal closure pressures, even without increasing functional profile length.
Uninhibited contraction of the pouch & peristaltic contraction of the conduit has no effect on continence mechanism, regardless the direction of peristaltic waves.
Prophylactic antibiotic is recommended in all cases of CIC, as the bacteriuria was presented in our studies and multiple different studies in high percent.
Mitrofanoff conduit gives better continence than Monti, so it’s the 1st choice when the appendix is available. So we don’t encourage incidental appendectomy in children.
There are several factors affecting stoma continence mechanism including;
• Adequate tunnel length , smaller lumen of the conduit, we recommend the ratio between them to be 5:1
• Functional profile length is an important factor as regards continence reflecting static & dynamic maximal closure pressure.
To treat incontinent catheterizable stoma, surgical revision is sometimes necessary. Revision might include lengthening the intramural tunnel, which should increase the functional profile length, and static and dynamic maximal closure pressures.
It is preferred than submucosal bulking agents that might accomplish this goal by increasing the static and dynamic maximal closure pressures, even without increasing functional profile length.
Uninhibited contraction of the pouch & peristaltic contraction of the conduit has no effect on continence mechanism, regardless the direction of peristaltic waves.
Prophylactic antibiotic is recommended in all cases of CIC, as the bacteriuria was presented in our studies and multiple different studies in high percent.
Other data
| Title | Urodynamic Evaluation of Continent Cutaneous Urinary Stoma | Other Titles | تقييم ديناميكية التبول فى تحويل مجرى البول بفتحة تحكمية على الجلد | Authors | Rehab Helmy Murad | Issue Date | 2014 |
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