Browsing by Author "Bančević, Vladimir (12773286300)"

Introduction. Surgery complications during and after ureteroscopic procedures are rare, mostly temporary and require no special additional procedures. However, major complications, nevertheless their small incidence (less than 1-2%), can be very serious and they include ureter perforation and avulsion. Case report. We represented a patient with complicated ureter iatrogenic stenosis developed after ureteroscopic procedure of stone removal. After several hospitalizations, septic condition with retroperitoneal abscess and an attempt of endoscopic and open surgical solution, the kidney auto-transplantation was successfully done. Conclusion. There are a small number of complications with ureteroscopic procedures, but when ureter avulsion or perforation occurs, and when the mission is to preserve pair organs, kidney auto-transplantation has the advantage over other methods of ureter reconstruction. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Background/Aim. The ileal neobladder should be a lowpressure reservoir with acceptable volume and relatively small resorptive surface. A larger inner surface of the ileal pouch is associated with the high resorption of urine metabolites through intestinal mucosa and systemic metabolic disturbances, while a too small pouch results in a higher frequency of voiding and incontinency. The aim of this study was to investigate it is possible to create a neobladder from a shorter ileal segment compared to standard surgical techniques, and reduce metabolic complications. Methods. This prospective study included 77 male patients, scheduled for radical cystectomy and orthotopic neobladder derivation. The patients were divided into two groups: the standard pouch (SP) group of 37 patients scheduled for standard orthotopic neobladder, using a 50−70 cm long terminal ileum segment; the “Belgrade pouch” (BP) group of 40 patients scheduled for original, orthotopic urinary reservoir, using a 25−35 cm long terminal ileum segment. We measured neobladder capacity, acidosis, base excess and bicarbonate concentration in the postoperative month 3rd, 6th, 12th and 15th. Results. At the end of the study, the patients from the SP group had much higher neobladder capacity than the natural bladder − 750 mL (range 514−2,050 mL); in contrast, the patients from the BP group had average capacity of 438 mL (range 205−653 mL) (p < 0.001). At the end of the study, there were more patients with acidosis (37.8%: 2.5%), base excess (35.1%: 7.5%) and low bicarbonate level (40.5%: 20.0%) in the SP group, than in the BP group, respectively (p < 0.001). Conclusion. “Belgrade pouch”, make from 25−35 cm long terminal ileum segment may obtain adequate capacity and lower rate of metabolic disturbances than standard, high capacity orthotopic neobladders. © 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Introduction. Pheochromocytoma of the urinary bladder is a rare tumor and presents less than 0.06% of all urinary bladder tumors. Case report. We presented a 49-year-old female patient with a history of daily paroxysmal hypertension accompanied with flushing of the face and upper chest, palpitations and excessive sweating prior to micturition. Ultrasonography reported a 3 cm bladder wall tumor. The 131I-metaiodobenzylguanidine (131I-MIBG) scan showed a pathological isotope accumulation in the projection of the bladder. The patient underwent a partial cystectomy. One year following the operation the patient was normotensive and without recurrence. Conclusion. The most efficient treatment option for bladder pheochromocytoma is surgical resection. The most important fact in the diagnostics is suspicion on this rare condition. © 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.