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Urinary reconstruction using appendix as a urinary and catheterizable conduit in 12 patients
Summary
The appendix vermiformis offers a viable option for urinary reconstruction, serving as a catheterizable outlet or urinary conduit in adult patients. This technique demonstrates good to excellent outcomes, enhancing continence and catheterization ease.
Area of Science:
- Urology
- Surgical Reconstruction
- Appendiceal Use in Urology
Background:
- The appendix vermiformis is a potential conduit for urinary reconstruction.
- This study evaluates its use in adult patients for continent urinary reservoirs and catheterizable outlets.
Purpose of the Study:
- To assess the clinical experience and outcomes of using the appendix in urinary reconstruction in adult patients.
- To determine the efficacy and safety of appendiceal conduits for urinary diversion.
Main Methods:
- 12 adult patients underwent urinary reconstruction using the appendix.
- Indications included pelvic malignancies and neurogenic bladder.
- The appendix was employed as a catheterizable conduit (8 patients) or urinary conduit (4 patients) using submucosal embedding or Mitrofanoff techniques.
Main Results:
- Overall, 8 patients had excellent, 3 good, and 1 poor outcome.
- Early complications (3 patients) included wound infection and anastomotic leak.
- Late complications (3 patients) involved hydronephrosis and stomal stenosis, mostly managed conservatively.
Conclusions:
- The appendix is advantageous for continent urinary reservoirs and as a urinary conduit, especially when ureters are short.
- It facilitates complete continence and easy catheterization.
- Appendiceal construction can serve as an alternative to ileal conduits in high-risk patients.