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  Global Journal of Surgery. Volume 2, Issue 2 (2011) pp. 75-80
  Research Article
Substitution of intestinal segments in the genitourinary system: Our experience
  Vishwajeet Singh, Rahul Janak Sinha*, S N Sankhwar  
Department of Urology,CSMMU (formerly KGMU),Lucknow, (U.P.), India
  Introduction: To document the surgical outcome after incorporating intestinal segments in the genitourinary system for the purpose of reconstruction or diversion as required in various congenital and acquired genitourinary diseases. Experimental: Between January, 2004 and December, 2009, vascularized intestinal segments were incorporated in 48 patients who underwent either reconstructive surgery or urinary diversion for various urological diseases. The indications were: augmentation cystoplasty for tubercular contracted bladder in 10 patients, orthotopic neobladder reconstruction following radical cystectomy in 18 patients, ileal conduit following radical cystectomy in 6 patients, colonic conduit following radical cystectomy in 2 patients, sigmoid vaginoplasty in 3 patients, clam cystoplasty for neurogenic bladder in 4 patients, ileal ureters in 3 patients and continent cutaneous pouch for adult exstrophy bladder in 2 patients. The ileal segment was incorporated in 22 patients, colonic segment in 16 patients, ileocecal segment in 9 patients (appendix was also used 2 of these patients) and stomach in 1 patient respectively. The intestinal segment is either detubularized and refashioned or used as such, depending upon the indications. Results and Discussion: The mean patient age was 32 years (18 - 50 years). Male to female ratio was 30:18. Good intestinal viability and satisfactory function of the intestinal segment was observed in all the patients. Patients who underwent bladder augmentation had remarkable improvement in storage and voiding functions. Orthotopic neobladder resulted in good storage and voiding functions. Patients with sigmoid neo-vagina had satisfactory sexual function. Conclusions: Vascularized intestinal segments give satisfactory result if they are incorporated in the genitourinary system. Complications are minimal and manageable. They fulfill the indications for which they are utilized.
  Reconstructive surgical procedure; Intestines; Genitourinary system  

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