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Titolo:
Urological management of cloacal anomalies
Autore:
Shimada, K; Hosokawa, S; Matsumoto, F; Johnin, K; Naitoh, Y; Harada, Y;
Indirizzi:
Osaka Med Ctr & Res Inst Maternal & Child Hlth, Dept Urol, Osaka 5941101, Japan Osaka Med Ctr & Res Inst Maternal & Child Hlth Osaka Japan 5941101 Japan
Titolo Testata:
INTERNATIONAL JOURNAL OF UROLOGY
fascicolo: 6, volume: 8, anno: 2001,
pagine: 282 - 289
SICI:
0919-8172(2001)8:6<282:UMOCA>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSTERIOR SAGITTAL ANORECTOPLASTY; TECHNICAL CONSIDERATIONS; MALFORMATIONS; REPAIR;
Keywords:
cloacal anomaly; urological management; vaginal reconstruction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
15
Recensione:
Indirizzi per estratti:
Indirizzo: Shimada, K Osaka Med Ctr & Res Inst Maternal & Child Hlth, Dept Urol, 840 Murodo Cho,Osaka 5941101, Japan Osaka Med Ctr & Res Inst Maternal & Child Hlth 840 Murodo Cho Osaka Japan 5941101
Citazione:
K. Shimada et al., "Urological management of cloacal anomalies", INT J UROL, 8(6), 2001, pp. 282-289

Abstract

Background: A cloacal anomaly results from incomplete urorectal division and is frequently associated with genitourinary abnormalities. Experience ofthe urological reconstruction of this entity is reported. Methods: Nine girls with cloacal malformation have been treated at the Osaka Medical Center in the past 9 years. Seven patients were detected by prenatal ultrasonography as having: megacystis (two patients); hydronephrosis (two patients); or hydrometrocolpos (three patients). Two patients underwentprenatal shunt placement between the enlarged bladder and the amniotic space. Results: For neonatal urinary diversion, four patients received cystostomy. Six of seven patients with associated hydrocolpos required intermittent catheterization to decompress an enlarged vagina. Vesicoureteral reflux was detected in 12 ureters of seven patients. Antireflux surgery was indicated in four patients before definitive repair. Definitive reconstruction was performed on eight patients. The posterior sagittal approach was used in all patients. Vaginal reconstruction was done utilizing a perineal skin flap (one patient), a tubularized vaginal flap (three patients), distal rectum (three patients) and total urogenital mobilization (one patient). Postoperatively, urethrovaginal fistula was created in one patient and complete occlusion was seen in one patient. Conclusion: The anatomical variety of this entity determines the management options from in utero. It involves not only the creation of three perineal orifices, but also a continent, catheterizable urethra under the stabilization of renal function. Accomplishment of the definitive repair requires the combined expertise of experienced pediatric surgeons and pediatric urologists.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 17:43:26