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Urinary Diversion
Urinary diversion is a surgical technique used to create a new pathway for urine to exit the body, often following the removal of the bladder as part of treatment for bladder cancer. In addition to bladder cancer, urinary diversion may be necessary in cases of severe trauma, congenital abnormalities, or other conditions that compromise the normal urinary tract, such as infections or chronic inflammation. The procedure can be either temporary or permanent, depending on the patient’s condition and treatment plan. There are several types of urinary diversions, each tailored to the patient’s needs. Incontinent diversions involve creating a stoma, an opening on the abdominal wall, where urine is redirected into an external collection bag. Common techniques for this include the use of an ileal or colonic conduit, which repurposes a segment of the intestine to transport urine from the kidneys to the stoma. In contrast, continent urinary diversions are designed to allow the patient g ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Nephrostomy
A nephrostomy or percutaneous nephrostomy is an artificial opening created between the kidney and the skin which allows for the urinary diversion directly from the upper part of the urinary system ( renal pelvis). It is an interventional radiology/surgical procedure in which the renal pelvis is punctured whilst using imaging as guidance. Images are obtained once an antegrade pyelogram (an injection of contrast), with a fine needle, has been performed. A nephrostomy tube may then be placed to allow drainage. An urostomy is a related procedure performed more distally along the urinary system to provide urinary diversion. Uses A nephrostomy is performed whenever a blockage keeps urine from passing from the kidneys, through the ureter and into the urinary bladder. Without another way for urine to drain, pressure would rise within the urinary system and the kidneys would be damaged. The most common cause of blockage necessitating a nephrostomy is cancer, especially ovarian canc ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Renal Pelvis
The renal pelvis or pelvis of the kidney is the funnel-like dilated part of the ureter in the kidney. It is formed by the convergence of the major calyces, acting as a funnel for urine flowing from the major calyces to the ureter. It has a mucous membrane and is covered with transitional epithelium and an underlying lamina propria of loose-to-dense connective tissue. The renal pelvis is situated within the renal sinus alongside the other structures of the renal sinus. Clinical significance The renal pelvis is the location of several kinds of kidney cancer and is affected by infection in pyelonephritis. A large " staghorn" kidney stone may block all or part of the renal pelvis. The size of the renal pelvis plays a major role in the grading of hydronephrosis. Normally, the anteroposterior diameter of the renal pelvis is less than 4 mm in fetuses up to 32 weeks of gestational age and 7 mm afterwards. [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Urostomy
A urostomy is a surgical procedure that creates a stoma (artificial opening) for the urinary system. A urostomy is made to avail for urinary diversion in cases where drainage of urine through the bladder and urethra is not possible, e.g. after extensive surgery or in case of obstruction. fro Cancer.org (American Cancer Society).Last Medical Review: 03/17/2011. Last Revised: 03/17/2011 Techniques  Techniques include:
:::::::*Ileal conduit ...
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Ileal Conduit Urinary Diversion
An ileal conduit urinary diversion is one of various surgical techniques for urinary diversion. It has sometimes been referred to as the Bricker ileal conduit after its inventor, Eugene M. Bricker. It is a form of incontinent urostomy, and was developed during the 1940s and is still one of the most used techniques for the diversion of urine after a patient has had their bladder removed, due to its low complication rate and high patient satisfaction level. It is usually used in conjunction with radical cystectomy in order to control invasive bladder cancer. To create an ileal conduit, the ureters are surgically resected from the bladder and a ureteroenteric anastomosis is made in order to drain the urine into a detached section of ileum at the distal small intestine, though the distal most 25 cm of terminal ileum are avoided as this is where bile salts are reabsorbed. The end of the ileum is then brought out through an opening (a stoma) in the abdominal wall. The residual small b ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Indiana Pouch
An Indiana pouch is a surgically-created urinary diversion used to create a way for the body to store and eliminate urine for patients who have had their urinary bladders removed as a result of bladder cancer, pelvic exenteration, bladder exstrophy or who are not continent due to a congenital, neurogenic bladder. This particular urinary diversion results in a ''continent'' reservoir that the patient must catheterize to empty urine. This concept and technique was developed by Drs. Mike Mitchell, Randall Rowland, and Richard Bihrle at Indiana University. Description With this type of surgery, a reservoir, or pouch, is created out of approximately two feet of the ascending colon and a portion of the ileum (a part of the small intestine). The ureters are surgically removed from the bladder and repositioned to drain into this new pouch. The end of the segment of small intestine is brought out through a small opening in the abdominal wall called a stoma. Since a segment including th ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Neobladder To Urethra Diversion
Urinary diversion is a surgical technique used to create a new pathway for urine to exit the body, often following the removal of the bladder as part of treatment for bladder cancer. In addition to bladder cancer, urinary diversion may be necessary in cases of severe trauma, congenital abnormalities, or other conditions that compromise the normal urinary tract, such as infections or chronic inflammation. The procedure can be either temporary or permanent, depending on the patient’s condition and treatment plan. There are several types of urinary diversions, each tailored to the patient’s needs. Incontinent diversions involve creating a stoma, an opening on the abdominal wall, where urine is redirected into an external collection bag. Common techniques for this include the use of an ileal or colonic conduit, which repurposes a segment of the intestine to transport urine from the kidneys to the stoma. In contrast, continent urinary diversions are designed to allow the patient g ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Ureters
The ureters are tubes composed of smooth muscle that transport urine from the kidneys to the urinary bladder. In an adult human, the ureters typically measure 20 to 30 centimeters in length and about 3 to 4 millimeters in diameter. They are lined with urothelial cells, a form of transitional epithelium, and feature an extra layer of smooth muscle in the lower third to aid in peristalsis. The ureters can be affected by a number of diseases, including urinary tract infections and kidney stone. is when a ureter is narrowed, due to for example chronic inflammation. Congenital abnormalities that affect the ureters can include the development of two ureters on the same side or abnormally placed ureters. Additionally, reflux of urine from the bladder back up the ureters is a condition commonly seen in children. The ureters have been identified for at least two thousand years, with the word "ureter" stemming from the stem relating to urinating and seen in written records since at ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Bricker End-to-side Anastomosis
A surgical anastomosis is a surgical technique used to make a new connection between two body structures that carry fluid, such as blood vessels or bowel. For example, an arterial anastomosis is used in vascular bypass and a colonic anastomosis is used to restore colonic continuity after the resection of colon cancer. A surgical anastomosis can be created using suture sewn by hand, mechanical staplers and biological glues, depending on the circumstances. While an anastomosis may be end-to-end, equally it could be performed side-to-side or end-to-side depending on the circumstances of the required reconstruction or bypass. The term reanastomosis is also used to describe a surgical reconnection usually reversing a prior surgery to disconnect an anatomical anastomosis, e.g. tubal reversal after tubal ligation. __TOC__ Medical uses * Blood vessels: Arteries and veins. Most vascular procedures, including all vascular bypass operations (e.g. coronary artery bypass), aneurysmectomy ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Incisional Hernia
An incisional hernia is a type of hernia caused by an incompletely-healed surgical wound. Since median incisions in the abdomen are frequent for abdominal exploratory surgery, ventral incisional hernias are often also classified as ventral hernias due to their location. Not all ventral hernias are from incisions, as some may be caused by other trauma or congenital problems. Signs and symptoms Clinically, incisional hernias present as a bulge or protrusion at or near the area of a surgical incision. Virtually any prior abdominal operation can develop an incisional hernia at the scar area (provided adequate healing does not occur due to infection), including large abdominal procedures such as intestinal or vascular surgery, and small incisions, such as appendix removal or abdominal exploratory surgery. While incisional hernias can occur at any incision, they tend to occur more commonly along a straight line from the xiphoid process of the sternum straight down to the pubis, ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Fistula
In anatomy, a fistula (: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") is an abnormal connection (i.e. tube) joining two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow organs to each other, often resulting in an abnormal flow of fluid from one space to the other. An anal fistula connects the anal canal to the perianal skin. An anovaginal or rectovaginal fistula is a hole joining the anus or rectum to the vagina. A colovaginal fistula joins the space in the colon to that in the vagina. A urinary tract fistula is an abnormal opening in the urinary tract or an abnormal connection between the urinary tract and another organ. An abnormal communication (i.e. hole or tube) between the bladder and the uterus is called a vesicouterine fistula, while if it is between the bladder and the vagina it is known as a vesicovaginal fistula, and if between the urethra and the vagina: a urethrovaginal fistu ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Normal Anion Gap Acidosis
Normal anion gap acidosis is an acidosis that is ''not'' accompanied by an abnormally increased anion gap. The most common cause of normal anion gap acidosis is diarrhea with a renal tubular acidosis being a distant second. Differential diagnosis The differential diagnosis of normal anion gap acidosis is relatively short (when compared to the differential diagnosis of ''acidosis''): * Hyperalimentation (e.g. from TPN containing ammonium chloride) * Chloride administration, often from normal saline * Acetazolamide and other carbonic anhydrase inhibitors * Renal tubular acidosis * Diarrhea: due to a loss of bicarbonate. This is compensated by an increase in chloride concentration, thus leading to a normal anion gap, or hyperchloremic, metabolic acidosis. The pathophysiology of increased chloride concentration is the following: fluid secreted into the gut lumen contains higher amounts of Na+ than Cl−; large losses of these fluids, particularly if volume is replaced with fluids cont ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
