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Urinary Tract Calculi VI: Surgical Management

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...

Urinary Tract Calculi III: Medical Management

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...

Imaging Studies VI: Voiding Cystourethrography and Cystography

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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...

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...

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[Urinary diversions and bladder replacement surgery: evolution, current situation and long-term outcomes].

Dario Fontana¹, Andrea Buffardi, Paolo Destefanis

¹Divisione Universitaria di Urologia 2 - AOU San Giovanni Battista Molinette, Torino - Italy. dario.fontana@unito.it

|February 2, 2013

Summary

Radical cystectomy for muscle invasive bladder cancer often involves orthotopic neobladder reconstruction. Long-term outcomes of the "Y Neobladder" were evaluated against traditional ileal conduits, focusing on function and complications.

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Vessel-sparing Excision and Primary Anastomosis

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Vessel-sparing Excision and Primary Anastomosis

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Area of Science:

Urology
Surgical Oncology

Background:

Radical cystectomy is the primary treatment for muscle-invasive bladder cancer.
Orthotopic neobladder reconstruction is increasingly preferred over urinary diversion after cystectomy.
The ileal conduit remains a benchmark, but long-term data for newer diversions are limited.

Purpose of the Study:

To evaluate the long-term results of various urinary diversions after radical cystectomy.
To assess the functional outcomes and long-term complications of the "Y Neobladder".
To critically compare quality of life between "Y Neobladder" and ileal conduit patients.

Main Methods:

Literature review of long-term outcomes for major urinary diversion techniques.
Analysis of functional outcomes and long-term complications specific to the "Y Neobladder" at our institution.
Comparative assessment of quality of life data between "Y Neobladder" and ileal conduit recipients.

Main Results:

The "Y Neobladder" is a prominent urinary diversion, alongside Bricker's ileal conduit.
Long-term functional outcomes and complication rates for the "Y Neobladder" were analyzed.
The study critically examined the perceived superior quality of life with "Y Neobladder" compared to ileal conduit.

Conclusions:

Long-term data on urinary diversions, particularly neobladders, are crucial for treatment decisions.
The "Y Neobladder" demonstrates specific functional and complication profiles that require careful consideration.
Further critical evaluation is needed to confirm quality of life benefits of "Y Neobladder" over ileal conduits.