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[Lower urinary tract urodynamics after reconstruction of the pelvic part of the ureter].
Urologiia. 2020 JunU

Abstract

INTRODUCTION

The problem of impaired urodynamics of the lower urinary tract after reconstructive surgery of the pelvic ureter remains almost unexplored in modern literature. There are only a few publications about the effect of operations in the area of the ureterovesical segment on bladder function.

AIM

To study the function of bladder after replacing the pelvic ureter with bladder flap, small intestine or appendix.

MATERIALS AND METHODS

We performed a retrospective analysis of reconstructive operations of the distal ureter, which were performed in 273 patients. Boari flap or its modifications were used in 142 (52%) cases; ureteroappendicocystanastomosis - 23 (8.4%) patients, and replacement of the pelvic ureter with small intestine in 105 (38.5%) cases. A follow-up urodynamics was carried out on the 10-14th day of the postoperative period, after 3 months, then after 6 and 12 months. We evaluated: uroflowmetry, cystometry, and pressureflow study.

RESULTS

In 75 (53%) of 142 patients who underwent Boari flap or its modifications, varying degrees of disturbance of bladder urodynamics were observed. After isoperistaltic intestinal ureteroplasty in 2 (2.5%) of 79 patients, detrusor hyperactivity was observed, which was regressed following conservative therapy. Urodynamics of bladder did not suffer after appendicoplasty.

CONCLUSION

Deformation, denervation and devascularization of detrusor are the main causes of bladder dysfunction after flap operations. Ileal ureter substitution with isoperistaltic position of the graft provides physiological passage urine from the kidney to the bladder, following good bladder function. The inclusion of antiperistaltic ileal loop in the urinary tract negatively affects the urodynamics.

Authors+Show Affiliations

Department of Urology, North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia. Multidisciplinary City Hospital, Department of Urology, St. Petersburg, Russia.Department of Urology, North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia. Multidisciplinary City Hospital, Department of Urology, St. Petersburg, Russia.Department of Urology, North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia. Multidisciplinary City Hospital, Department of Urology, St. Petersburg, Russia.Department of Urology, North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia. Multidisciplinary City Hospital, Department of Urology, St. Petersburg, Russia.Department of Urology, North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia. Multidisciplinary City Hospital, Department of Urology, St. Petersburg, Russia.

Pub Type(s)

English Abstract
Journal Article

Language

rus

PubMed ID

32597579

Citation

Komyakov, B K., et al. "[Lower Urinary Tract Urodynamics After Reconstruction of the Pelvic Part of the Ureter]." Urologiia (Moscow, Russia : 1999), 2020, pp. 10-14.
Komyakov BK, Ochelenko VA, Al-Attar TH, et al. [Lower urinary tract urodynamics after reconstruction of the pelvic part of the ureter]. Urologiia. 2020.
Komyakov, B. K., Ochelenko, V. A., Al-Attar, T. H., Mhanna, H. M., & Shevnin, M. V. (2020). [Lower urinary tract urodynamics after reconstruction of the pelvic part of the ureter]. Urologiia (Moscow, Russia : 1999), (3), 10-14.
Komyakov BK, et al. [Lower Urinary Tract Urodynamics After Reconstruction of the Pelvic Part of the Ureter]. Urologiia. 2020;(3)10-14. PubMed PMID: 32597579.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Lower urinary tract urodynamics after reconstruction of the pelvic part of the ureter]. AU - Komyakov,B K, AU - Ochelenko,V A, AU - Al-Attar,T H, AU - Mhanna,H M, AU - Shevnin,M V, PY - 2020/6/30/entrez KW - Boari flap KW - intestinal plastic KW - stricture KW - ureter KW - urodynamic SP - 10 EP - 14 JF - Urologiia (Moscow, Russia : 1999) JO - Urologiia IS - 3 N2 - INTRODUCTION: The problem of impaired urodynamics of the lower urinary tract after reconstructive surgery of the pelvic ureter remains almost unexplored in modern literature. There are only a few publications about the effect of operations in the area of the ureterovesical segment on bladder function. AIM: To study the function of bladder after replacing the pelvic ureter with bladder flap, small intestine or appendix. MATERIALS AND METHODS: We performed a retrospective analysis of reconstructive operations of the distal ureter, which were performed in 273 patients. Boari flap or its modifications were used in 142 (52%) cases; ureteroappendicocystanastomosis - 23 (8.4%) patients, and replacement of the pelvic ureter with small intestine in 105 (38.5%) cases. A follow-up urodynamics was carried out on the 10-14th day of the postoperative period, after 3 months, then after 6 and 12 months. We evaluated: uroflowmetry, cystometry, and pressureflow study. RESULTS: In 75 (53%) of 142 patients who underwent Boari flap or its modifications, varying degrees of disturbance of bladder urodynamics were observed. After isoperistaltic intestinal ureteroplasty in 2 (2.5%) of 79 patients, detrusor hyperactivity was observed, which was regressed following conservative therapy. Urodynamics of bladder did not suffer after appendicoplasty. CONCLUSION: Deformation, denervation and devascularization of detrusor are the main causes of bladder dysfunction after flap operations. Ileal ureter substitution with isoperistaltic position of the graft provides physiological passage urine from the kidney to the bladder, following good bladder function. The inclusion of antiperistaltic ileal loop in the urinary tract negatively affects the urodynamics. SN - 1728-2985 UR - https://www.unboundmedicine.com/medline/citation/32597579/[Lower_urinary_tract_urodynamics_after_reconstruction_of_the_pelvic_part_of_the_ureter] DB - PRIME DP - Unbound Medicine ER -
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