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Related Concept Videos

Urinary Bladder01:23

Urinary Bladder

The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
Anatomy of the Genitourinary System II: Bladder and Urethra01:19

Anatomy of the Genitourinary System II: Bladder and Urethra

The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
Urodynamic Studies: Uroflowmetry01:19

Urodynamic Studies: Uroflowmetry

Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
The Micturition Reflex01:26

The Micturition Reflex

Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...

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A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction
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A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction

Published on: December 20, 2014

Bladder function after total urogenital mobilization for persistent cloaca.

Futoshi Matsui1, Kenji Shimada, Fumi Matsumoto

  • 1Department of Urology and Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. f.matsui@mch.pref.osaka.jp

The Journal of Urology
|September 22, 2009
PubMed
Summary

Total urogenital mobilization effectively treats persistent cloaca, with most patients achieving urinary continence. However, bladder dysfunction, including detrusor overactivity, is common post-surgery and may impact continence.

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Area of Science:

  • Pediatric Surgery
  • Urology
  • Pediatric Urology

Background:

  • Persistent cloaca is a complex congenital anomaly requiring surgical intervention.
  • Total urogenital mobilization (TUM) is a surgical technique used for cloacal reconstruction, often favored for avoiding vaginal reconstruction complications.

Purpose of the Study:

  • To evaluate bladder function and urological outcomes in patients with persistent cloaca treated with total urogenital mobilization.
  • To assess the rate of urinary continence and identify factors influencing it after TUM.

Main Methods:

  • Retrospective review of 11 patients with persistent cloaca who underwent TUM between 1991 and 2008.
  • Assessment of urinary continence, including spontaneous voiding and need for clean intermittent catheterization.
  • Postoperative urodynamic studies to evaluate bladder function, including detrusor activity and compliance.

Main Results:

  • A low rate of surgical complications (9%) was observed.
  • Urinary continence was achieved in 86% of patients, with 43% voiding spontaneously and 43% requiring catheterization.
  • Urodynamic studies revealed detrusor underactivity or acontractile detrusor in all patients during voiding, with 71% exhibiting detrusor overactivity, which resolved in 40% of cases.

Conclusions:

  • Total urogenital mobilization is a successful approach for achieving urinary continence in most patients with persistent cloaca.
  • A significant proportion of patients develop bladder dysfunction, such as detrusor overactivity, post-TUM.
  • While detrusor overactivity may resolve, persistent cases can hinder the achievement of urinary continence.