Clinical experience of the VQZ plasty for catheterizable urinary stomas
Toshihiko Itesako1, Keigo Nara, Futoshi Matsui
1Department of Urology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan. i1470jp@yahoo.co.jp
Objective:
To evaluate the effectiveness of VQZ plasty, we analyzed our experience with continent catheterizable urinary stomas using VQZ plasty and V-flap techniques.
Patients And Methods:
We retrospectively reviewed the records of 25 patients who underwent Mitrofanoff procedures in 2000-2009. All stomas were created in the lower quadrant. There were 10 patients who underwent VQZ plasty and 15 in whom the V-flap technique was used. The stomal complications of these two groups were compared.
Results:
Two patients (20%) with VQZ plasty and five (33.3%) with V-flap required surgical revision. Hypertrophic mucosae that excreted mucus and blood periodically were resected in two patients (13.3%) with V-flap. One patient (10%) with VQZ plasty had a surgical site infection. Although the stomal complication rate was lower in patients with VQZ plasty compared to those with V-flap, this difference was not statistically significant (P = 0.4).
Conclusions:
Our results show a tendency towards decreased stomal complications rates in patients with VQZ plasty, suggesting its superiority over the V-flap technique because of good cosmesis. To successfully construct VQZ stomas, surgeons should work to preserve the blood supply of skin flaps and reduce the subcutaneous dead space, and thus reduce the risk of surgical site infection.
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