Posterior urethral injuries and the Mitrofanoff principle in children

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dc.contributor.authorFreitas Filho, Luiz Gonzaga de [UNIFESP]
dc.contributor.authorCarnevale, J.
dc.contributor.authorMelo, A. R.
dc.contributor.authorVicente, N. C. [UNIFESP]
dc.contributor.authorHeinisch, A. C.
dc.contributor.authorMartins, Jose Luiz [UNIFESP]
dc.contributor.institutionHosp Infantil Darcy Vargas
dc.contributor.institutionHosp Santa Marcelina
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T12:33:44Z
dc.date.available2016-01-24T12:33:44Z
dc.date.issued2003-03-01
dc.description.abstractOBJECTIVETo report our experience of children with trauma causing posterior urethral injury who at some stage underwent a Mitrofanoff intervention, as post-traumatic urethral injuries can demand long-term treatment which (regardless of the surgical intervention) requires a period of dilatation of the reconstructed urethra.PATIENTS and METHODSFrom 1992 to 2001, 14 patients with urethral injuries underwent a Mitrofanoff procedure. Thirteen had been run over by a motor vehicle and had severe hip injuries, and one had a direct non-penetrating perineal impact lesion (13 boys and one girl, aged 2-13 years at the time of the accident). in all cases the Mitrofanoff procedure involved interposing the appendix between the bladder and the umbilicus. Only one of the children (because of extremely high bladder filling pressures) also underwent an augmentation cystoplasty and closure of the bladder neck because there were bony fragments in the urethra.RESULTSThe Mitrofanoff technique was considered useful in most cases. All patients during a given period used the Mitrofanoff conduit to empty their bladder every 3 h; 10 of the 14 are currently voiding urethrally, with an adequate flow, and four are not, but emptying the bladder periodically via the appendicovesicostomy. the only girl in the group has a major hip deformity and is unlikely to undergo urethroplasty; two patients are expecting definitive treatment and the other, although having a patent urethra, has no urinary flow. He is currently 19 years old and has no erections.CONCLUSIONSThe treatment of posterior urethral injuries represents a challenge to surgical teams. Although primary suturing of the separated urethral ends is accepted as the best treatment, the construction of a temporary continent urinary diversion may be considered in the most severe cases.en
dc.description.affiliationHosp Infantil Darcy Vargas, São Paulo, Brazil
dc.description.affiliationHosp Santa Marcelina, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent402-405
dc.identifierhttp://dx.doi.org/10.1046/j.1464-410X.2003.04086.x
dc.identifier.citationBju International. Oxford: Blackwell Publishing Ltd, v. 91, n. 4, p. 402-405, 2003.
dc.identifier.doi10.1046/j.1464-4096.2003.04086.x
dc.identifier.issn1464-4096
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/27154
dc.identifier.wosWOS:000181228300027
dc.language.isoeng
dc.publisherBlackwell Publishing Ltd
dc.relation.ispartofBju International
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjecturethral strictureen
dc.subjectwoundsen
dc.subjectinjuriesen
dc.subjectpelvisen
dc.subjectfractureen
dc.subjectcatheterizationen
dc.titlePosterior urethral injuries and the Mitrofanoff principle in childrenen
dc.typeinfo:eu-repo/semantics/article
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