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KMID : 0371319680100070491
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Journal of the Korean Surgical Society
1968 Volume.10 No. 7 p.491 ~ p.498
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The Use of Ileal Loop for Reconstruction of contracted Urinary Bladder Due to Tuberculosis
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宋運永/Song, Woon Young
李會白/金世煥/Roth, Robert F./金榮祐/Lee, Hoi Paik/Kim, She Whan/--/Kim, Young U
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Abstract
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Urinary tract tuberculosis is common in Korea, and it is estimated that approximately 10 per cent of urinary tract tuberculosis cases may have contracted bladder by the time they seek surgical correction. The contracted bladder usually lead to vesico-ureteral reflux or obstruction causing further renal damage, annoying urinary frequency and burning, jeopardizing normal social life and activity. Three cases of contracted bladder were operated on at the Wonju Union Christian Hospital with satisfactory result:
Case Ⅰ. A 27 yr old seminary student was admitted with urinary frequency every 30 minutes, hematuria, and a bladder capacity of 70 cc. He could not continue college due to frequency, dysuria, etc. An approximately 20 cm long ileal loop was anastomosed to the bladder end-to-end, and side to-side bilateral ureteroileal anastomosis was carried out. Two years following the surgery, patient has resumed his normal social Flife without remarkable frequency, burning or other symptoms.
Case Ⅱ. A 18 yr old female was admitted with far advanced right renal tuberculosis and contracted bladder. She had a bladder capacity of about 70 cc and had to void every 30 minutes during the day, and and about every two hours during the night. Right nephrectomy and an approximately 40 cm ileal loop transplantation was carried out with end-to-end ileo-vesical, and a side-to side uretero-ileal anastomosis. Eight months following the surgery, the patient feels fine without remarkable urinary freauency or dysuria.
Case Ⅲ. A 25 yr old male with far advanced right renal tuberculosis and contractde bladder was admitted because of frequency of urination, about half hour. Right nephrectomy and a 35 cm long ileal loop transplansplantation was done with end-to-end ileo-vesical, side-to-side uretero-ileal anatomois. Three months following the surgery, bladder capacity increased to 350 cc from a pre-operative capacity of 80 cc, and frequency, burning etc were almost completely relieved.
Literatures were surveyed, and rationale and techniques of bladder reconstruction for contracted bladder discussed. The advantage and disadvantage of the use of ileal loop and sigmoid colon segments were discussed. Although our limited experience proved that the ileal loop transplanation is successful in enlarging the bladder capacity, preventing further renal damage, and in relieving the urinary frequecy, burning, etc, the authors feel on the basis of world literature that the use of sigmoid colon loop may bring similar or better results.
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