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Meningomylocele: An update

Therapy-resistant overactivity of detrusor or small capacity and poor compliance, will usually need to be treated by bladder augmentation. Ileal or colonic patches are used frequently for augmenting the bladder, with either intestinal segment appearing to be equally useful. Stomach is rarely used be...

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Detalles Bibliográficos
Autores principales: Kapoor, R., Agrawal, S.
Formato: Texto
Lenguaje:English
Publicado: Medknow Publications 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721530/
https://www.ncbi.nlm.nih.gov/pubmed/19675798
http://dx.doi.org/10.4103/0970-1591.32072
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author Kapoor, R.
Agrawal, S.
author_facet Kapoor, R.
Agrawal, S.
author_sort Kapoor, R.
collection PubMed
description Therapy-resistant overactivity of detrusor or small capacity and poor compliance, will usually need to be treated by bladder augmentation. Ileal or colonic patches are used frequently for augmenting the bladder, with either intestinal segment appearing to be equally useful. Stomach is rarely used because of the associated complications, but it is the only available intestinal segment for patients with impaired renal function. Concerns regarding long-term effects of associated metabolic acidosis, including abnormalities in linear growth and bone metabolism are misplaced. Ureterocystoplasty offers an attractive urothelium-preserving alternative, avoiding the metabolic complications, mucus production and cancer risk of heterotopic epithelium associated with enterocystoplasty. Though ideal for patients with dilated ureter and nonfunctioning kidney, in patients with functioning kidney it carries added risks associated with transuretero-ureterostomy, mainly obstruction. Ureteral dilatation in meningomyelocele patients is avoidable with proper follow-up and treatment. Therefore they rarely should be candidates for this operation. Alternative urothelium-preserving techniques, such as auto augmentation and seromuscular cystoplasty, have not proven to be as successful as standard augmentation with intestinal segment. Work is in progress on various bioengineering techniques to culture and combine bladder cells in tissue culture for regeneration. Early efforts are exciting, but preliminary.
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spelling pubmed-27215302009-08-12 Meningomylocele: An update Kapoor, R. Agrawal, S. Indian J Urol Symposium Therapy-resistant overactivity of detrusor or small capacity and poor compliance, will usually need to be treated by bladder augmentation. Ileal or colonic patches are used frequently for augmenting the bladder, with either intestinal segment appearing to be equally useful. Stomach is rarely used because of the associated complications, but it is the only available intestinal segment for patients with impaired renal function. Concerns regarding long-term effects of associated metabolic acidosis, including abnormalities in linear growth and bone metabolism are misplaced. Ureterocystoplasty offers an attractive urothelium-preserving alternative, avoiding the metabolic complications, mucus production and cancer risk of heterotopic epithelium associated with enterocystoplasty. Though ideal for patients with dilated ureter and nonfunctioning kidney, in patients with functioning kidney it carries added risks associated with transuretero-ureterostomy, mainly obstruction. Ureteral dilatation in meningomyelocele patients is avoidable with proper follow-up and treatment. Therefore they rarely should be candidates for this operation. Alternative urothelium-preserving techniques, such as auto augmentation and seromuscular cystoplasty, have not proven to be as successful as standard augmentation with intestinal segment. Work is in progress on various bioengineering techniques to culture and combine bladder cells in tissue culture for regeneration. Early efforts are exciting, but preliminary. Medknow Publications 2007 /pmc/articles/PMC2721530/ /pubmed/19675798 http://dx.doi.org/10.4103/0970-1591.32072 Text en © Indian Journal of Urology http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Symposium
Kapoor, R.
Agrawal, S.
Meningomylocele: An update
title Meningomylocele: An update
title_full Meningomylocele: An update
title_fullStr Meningomylocele: An update
title_full_unstemmed Meningomylocele: An update
title_short Meningomylocele: An update
title_sort meningomylocele: an update
topic Symposium
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721530/
https://www.ncbi.nlm.nih.gov/pubmed/19675798
http://dx.doi.org/10.4103/0970-1591.32072
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