The reconstructive urology urinary obstructions corrected via
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Dr. Angel Roncales answered questions about reconstructive urological surgery, which is the sum of surgical procedures to correct different types of obstruction of urinary via, plus replace, modify or refer the conduct of urine. This is the ultimate goal of preserving renal function.
¿That is reconstructive urology
?
The reconstructive urological surgery can be defined as the sum of surgical procedures to correct different types of obstruction of urinary via, and to replace, modify or refer the conduct of urine, all with the goal of preserving renal function.
¿, are the problems dealing
?
It should be noted on the one hand obstructions (unless secondary to prostatic hypertrophy and/or stones ), both of the upper urinary tract, including the urethra. In addition, any pathology that involves removing the bladder or ureteral some segment, mainly due to malignancies, in which the use of the intestine, get rebuild, redirect or modify the anatomical configuration of the urinary tract. Besides these two groups have emphasized, there is a miscellany of surgical procedures in the urogenital and Andrological sphere to treat multiple infectious diseases, malformation, inflammatory, etc cause.
¿We could describe your procedure
?
The plastias pielo-uretero-ureteral and bladder endoscopic and laparoscopic approaches allowed, and occasionally by conventional surgery. To correct urethral strictures, endoscopy is of very limited effectiveness, so usually we resort to conventional surgery. In function of the location and its extension, the use of flaps is necessary and especially grafts, including best results offered are those obtained from the buccal mucosa, the inside of the cheek.
The use of the intestine, allowing the replacement of the bladder, in its anatomical location, to maintain urination through urethra, with voluntary control, reproducing the natural model. If not possible, therefore anatomical or extension of neoplastic disease reasons, we use derivative techniques that carry urine through the gastrointestinal tract or a cutaneous stoma collection bag needs.
¿What are the risks for the patient
?
Apart from the overall risks to any surgery in reconstructive techniques there is always a hypothetical risk of reproducing the cause that caused the indication, ie a new stricture, or even the recurrence of a tumor previously had removed. On the other hand, because of urinary via the passage of urine requires the placement of internal or external tubes for driving and avoid possible the appearance of fistulas.
¿How is the recovery after this intervention
?
Sometimes postoperative can be prolonged, especially in cases of cystectomy with substitution or transintestinal derivation, aggressive and mutilating surgery to treat bladder tumor that is sometimes very aggressive, requiring complementary therapies. Convalescence he trains the patient to the recovery of continence mechanism and achieve voluntary control of urination.
