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  • 1
    Electronic Resource
    Electronic Resource
    The continent cecal reservoir for urinary diversion (1985)
    Springer
    World journal of urology 3 (1985), S. 173-178 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Urinary diversion was accomplished through a continent cecal reservoir in 27 patients. An intussuscepted ileal nipple valve was used as a continence-providing principle. To achieve continence and ease of catheterization, several constructional modifications of the valve were required. Satisfactory functional results were obtained with a nipple valve protruding into the cecal cavity, mesenteric exclusion from the valve and, for stability, a fascial strip sling around the nipple base. The ureters were implanted into the cecum using an anti-reflux technique. Complications were sliding of the nipple valve, which necessitated revisional procedures in a substantial number of patients, and stricture of the ureterocecal anastomosis. Renal function was well-preserved after long-term follow-up. The continent cecal reservoir offers a better quality of life than conduit diversion, and can be an attractive alternative to other methods for selected patients at centers with a special interest in this field.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00326989
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Sprouting of bladder nerves into cystoplastic cecal segment in the rat (1999)
    Springer
    Urological research 27 (1999), S. 476-482 
    Details
    ISSN: 1434-0879
    Keywords: Key words Urinary bladder ; Enterocystoplasty ; Cecocystoplasty ; Innervation ; Nerve growth ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Incorporation of bowel into the bladder (enterocystoplasty) has been widely used to increase bladder capacity. It has been reported by others that the response of smooth muscle from the cystoplastic segment of the intestine shifts from that of the intestine (relaxation to α-agonists and ATP) to that of the bladder (contraction to α-agonists and ATP). This suggests a functional integration of the intestinal muscle into the bladder; the mechanisms are unknown. The aims of the present study were (1) to elucidate if there are signs of bladder nerves sprouting across the anastomosis into the intestinal segment, and (2) to study what happens with the intrinsic innervation of the intestinal segment. As a model, we used cecocystoplasty in rats. The bladder was opened and a patch of cecum with intact vascular supply was anastomosed to the bladder. After two to 11 months the rats were sacrificed and the bladders mounted as wholemounts and stained for acetylcholinesterase-containing nerves, or embedded in paraffin for histology. A pronounced degeneration of the myenteric plexus was found in the cecal segments. In some areas, this had proceeded to the extent that the ganglia were isolated ovoid lumps of cells with no apparent connection to other ganglia. Areas lacking ganglia and nerve trunks but still with muscle could be found in all specimens. Abundant axon bundles were demonstrated sprouting from the cut bladder nerves close to the anastomosis. The bundles spread out in a fan-like pattern or were organized as fewer thicker nerves. There were many nerve bundles entering the cecal segment where they branched and the diameter decreased till they no longer became visible. Some nerves reached surviving lumps of myenteric ganglion cells. The results show that the bladder nerves sprout into the anastomosed cecal segment. It is reasonable to assume that these nerves are responsible for the changes in receptor pharmacological properties of the cecal smooth muscle towards that of bladder muscle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002400050138
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Detubularized right colonic reservoir with intussuscepted ileal nipple valve or stapled ileal (“Lundiana”) outlet (1996)
    Springer
    World journal of urology 14 (1996), S. 78-84 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a prospective randomized study, patients undergoing cystectomy and continent urinary diversion by means of a detubularized right colonic reservoir were randomized to one of two types of outlet: either an intussuscepted ileal nipple value (n=15) or a stapled ileal (“Lundiana”) outlet (n=15). There were no early complications from the reconstruction. Subsequently, one ileal nipple outlet required revision because of progressive catheterization difficulties. In the Lundiana group, perforation of the reservoir occurred in one case and a narrow stomal opening was revised in local anesthesia in two cases. Urodynamic assessment revealed similar pressures at rest for the two outlets. At stress (concomitant with reservoir contraction), there was a distinct increase in outlet pressure in the nipple valves, but this was rarely encountered in the Lundiana group. Questionnaires showed episodes of urinary leakage to be more common in the Lundiana group, whereas the reverse applied to catheterization difficulties. In both groups, however, the great majority of patients were satisfied or very satisfied with the function of the urinary tract.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00182562
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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