Incontinent Ileovesicostomy Research Articles

Urinary undiversion by conversion of the incontinent ileovesicostomy to augmentation ileocystoplasty in spinal cord injured patients

Context: Spinal cord injury (SCI) patients with neurogenic bladder and the inability to self-catheterize may require incontinent diversion to provide low-pressure drainage while avoiding the use of indwelling catheters. We demonstrate that in patients with significant functional improvement, the ileovesicostomy can be a reversible form of diversion, with simultaneous bladder augmentation using the same segment of ileum utilized for the ileovesicostomy. Multidisciplinary management should be utilized to assure mastery of intermittent catheterization before urinary undiversion. This technique allows for transition to a regimen of intermittent self-catheterization with excellent functional and urodynamic outcomes. Design: Case Series. Setting: Tertiary care hospital, Philadelphia, Pennsylvania. Participants: Three individuals with an SCI. Interventions: Conversion of bladder management from an incontinent ileovesicostomy to an augmentation ileocystoplasty, with intermittent catheterization. Outcome Measures: Ability to regain urinary continence with preservation of renal function as determined by serum creatinine and renal ultrasound. Results: Three SCI patients who had an incontinent ileovesicostomy developed sufficient functional improvement to intermittently self-catheterize reliably and underwent conversion of ileovesicostomy to ileocystoplasty. For each, the ileovesicostomy channel was taken down and detubularized, then used to create an ileal patch for augmentation ileocystoplasty. Intermittent catheterization was then used for periodic bladder drainage. All achieved large capacity, low-pressure bladders with complete continence and stable creatinine. Conclusion: In motivated SCI patients, it is possible to regain continence by converting the ileovesicostomy into augmentation ileocystoplasty, avoiding the disadvantages of a urostomy. A multidisciplinary collaborative approach facilitates the optimal rehabilitation of SCI individuals.

Hyaluronidase to reduce a prolapsed incontinent ischemic ileovesicostomy

Stomal prolapse is a known late complication of urinary diversions commonly used in urology. While rare, it can lead to ischemia, necrosis, and obstruction of the stoma, requiring urgent reduction before formal revision can be undertaken. Several measures can be attempted to reduce the prolapse including manual pressure and topical osmotic agents. One method that has not been reported in the urologic literature is the use of hyaluronidase. Herein, we report the first case in the literature of hyaluronidase usage to assist in reduction of an ischemic and obstructed prolapsed incontinent ileovesicostomy after manual compression failed.

PD36-11 INCONTINENT ILEOVESICOSTOMY FOR NEUROGENIC BLADDER DYSFUNCTION: LONG TERM CLINICAL AND URODYNAMIC PATIENT OUTCOMES

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction II1 Apr 2018PD36-11 INCONTINENT ILEOVESICOSTOMY FOR NEUROGENIC BLADDER DYSFUNCTION: LONG TERM CLINICAL AND URODYNAMIC PATIENT OUTCOMES Mihir Shah, Ali Syed, Alana Murphy, Akhil Das, and Patrick Shenot Mihir ShahMihir Shah More articles by this author , Ali SyedAli Syed More articles by this author , Alana MurphyAlana Murphy More articles by this author , Akhil DasAkhil Das More articles by this author , and Patrick ShenotPatrick Shenot More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1734AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ileovesicostomy is useful in patients with severe lower urinary tract dysfunction who are unwilling or unable to perform intermittent catheterization or are refractory to medical therapy. We evaluated the long term urodynamic outcomes changes in bladder management in a series of patients treated with ileovesicostomy for neurogenic bladder dysfunction. METHODS We retrospectively reviewed the charts of 19 men and 12 women with a mean age of 44.9 years who underwent incontinent ileovesicostomy at our institution between 1992 and 2002. Mean follow-up was 156 months (range 126-183 months). We compared detrusor leak point (DLPP) preoperatively and postoperatively and determined long-term urinary tract management. RESULTS Two male patient underwent conversion of the incontinent ileovesicostomy to ileocystoplasty using the same segment of bowel and now manage their bladder by intermittent catheterization. These patients were excluded from analysis. Three female patient underwent conversion to ileal conduit at a mean of 2.1 years after initial ileovesicostomy due to urethral incontinence. DLPP was less than 20 cm H2O in all of these patients. Urodynamic study (UDS) was performed in the remaining 26 patients with at least one UDS performed a minimum of ten years after initial ileovesicostomy. Initial DLPP in this cohort was 68 ± 21 cm H2O. With an extended follow-up of greater than ten years, DLPP on last follow-up was 12 ± 4 cm H2O. Of these 26 patients, intermittent catheterization is utilized at least once daily due to stasis with recurrent UTI (6/26 patients) and UTI with mild hydronephrosis in (2/26 patients). All of these patients have functioning ileovesicostomy with a DLPP of less than 20 cm H2O. CONCLUSIONS In this series of patients with ileovesicostomy, nearly 40% of patients will require the addition of intermittent catheterization after ten years despite low pressure drainage of the bladder through a functioning ileovesicostomy. We hypothesize that complications such as recurrent urinary tract infections are in part related to urinary stasis within the bladder and that although low pressure storage is achieved, there remains a significant residual urine within the bladder. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e730 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Mihir Shah More articles by this author Ali Syed More articles by this author Alana Murphy More articles by this author Akhil Das More articles by this author Patrick Shenot More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Outcomes of Incontinent Ileovesicostomy in the Pediatric Patient

Outcomes of Incontinent Ileovesicostomy in the Pediatric Patient

This Month in Pediatric Urology

No AccessJournal of UrologyThis Month in Pediatric Urology1 Feb 2014This Month in Pediatric Urology Michael L. Ritchey Michael L. RitcheyMichael L. Ritchey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.10.138AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "This Month in Pediatric Urology." The Journal of Urology, 191(2), pp. 283–284 References 1 : Outcomes of incontinent ileovesicostomy in the pediatric patient. J Urol2014; 91: 445. Google Scholar 2 : Immunofluorescent analysis of testicular biopsies with germ cell and Sertoli cell markers shows significant MVH negative germ cell depletion with older age at orchiopexy. J Urol2014; 191: 458. Abstract, Google Scholar 3 : New contralateral vesicoureteral reflux after unilateral ureteral reimplantation: predictive factors and clinical outcomes. J Urol2014; 191: 451. Link, Google Scholar 4 : High recurrence rate at 5-year followup in children after upper urinary tract stone surgery. J Urol2014; 191: 440. Link, Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 191Issue 2February 2014Page: 283-284 Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael L. Ritchey More articles by this author Expand All Advertisement PDF downloadLoading ...

First study of incontinent ileovesicostomy in children

Although a moderate body of evidence supports the efficacy of ileovesicostomy for neurogenic bladder in adults, its use in children has been largely undocumented. However, recent data show that this procedure should be considered for a selected paediatric population.

Outcomes of Incontinent Ileovesicostomy in the Pediatric Patient

Ileovesicostomy is a reconstructive option in complex urological cases but pediatric specific outcomes are lacking. We report our results with pediatric ileovesicostomy. We retrospectively evaluated patients younger than 18 years undergoing incontinent ileovesicostomy at Vanderbilt University. History, urinary tract management and operative course were reviewed in the electronic medical record. Particular attention was given to immediate and long-term postoperative complications. Nine patients underwent incontinent ileovesicostomy between 2000 and 2013 at a mean age of 10.3 years (range 1.4 to 15.5). Surgical indication was sequelae of neurogenic or nonneurogenic neurogenic bladder (such as infection or worsening hydronephrosis) in 5 patients, reversal of vesicostomy in 3 and closure of cloacal exstrophy in 1. All 9 patients were thought incapable of reliable clean intermittent catheterization due to family unwillingness, poor social support or patient refusal. Median followup was 11.5 months (mean 48.2, range 1.3 to 144.8). Immediate postoperative complications included ileus requiring total parenteral nutrition and a wound infection in 1 patient. Long-term complications included urinary tract infection in 2 patients (febrile in 1 and positive culture for foul smelling urine in 1), stomal issues in 2 and temporary urethral leakage in 1. Constipation affected 3 children in long-term followup (all with neurogenic bowel preoperatively). Postoperative creatinine was stable or improved in all patients. Ileovesicostomy is a viable approach in children left with few other options, particularly those who are noncompliant or physically/socially unable to handle catheterization. This operation can help keep such patients out of diapers.

Supine and upright urodynamic evaluation of incontinent ileovesicostomy in wheelchair-bound adults with neurogenic bladder

Prospective. To evaluate detrusor leak point pressure (DLPP) of the incontinent ileovesicostomy in the supine and upright position. California, USA. Urodynamic assessment of patients, 6-36 months after ileovesicostomy, was performed in the supine position and then immediately repeated in the upright position in the patient's wheelchair. Upright and supine urodynamic evaluation was performed following the Good Urodynamic Practice Guidelines. Ten patients (seven male and three female) were evaluated. Etiology of neurogenic bladder (NGB) included seven patients with spinal cord injury and one patient each with multiple sclerosis, myelomeningocele and cerebral palsy. Mean DLLP in the supine position was 8.6 cm H2O (range 2-20); mean DLLP in the sitting position was 11.6 cm H2O (range 5-25). Mean change in DLPP from supine to sitting was 3.1 cm H2O (range 1-12). The difference in DLPP between supine and sitting is statistically significant (P=0.0429); however, this does not appear to be a clinically significant difference. Ileovesicostomy is a safe option for management of the NGB in a selected patient population. A small and clinically insignificant or no change in DLPP was documented in all ten patients. We demonstrated that DLPP remains low within an ileovesicostomy while in the sitting position.

Incontinent ileovesicostomy: Long‐term outcomes and complications

Incontinent ileovesicostomy was popularized in the mid-1990s as a surgical option for patients with neurogenic voiding dysfunction who lack the dexterity to perform clean catheterization. There are several case series in the literature, but few studies look at the long-term outcomes and complications associated with this procedure. We review the outcomes of 12 patients who underwent incontinent ileovesicostomy for management of neurogenic voiding dysfunction since its introduction at our institution in 1998. We discuss, specifically, the preoperative and postoperative problems encountered as well as complications pertaining to ileovesicostomy itself. At an average of 5 1/2 years follow-up, all 12 patients who underwent incontinent ileovesicostomy have experienced some form of urinary tract problem either associated with the ileovesicostomy or with their underlying neurogenic voiding dysfunction. After ileovesicostomy, seven of 12 patients (58%) have been able to reduce antibiotic usage and/or hospital admission related to chronic upper tract infection. Two patients (17%) have subsequently been converted to ileal conduit. Incontinent ileovesicostomy is a useful option for patients with lower urinary tract dysfunction who are unable to perform clean intermittent catheterization. It should be reserved for those patients who have exhausted less invasive therapy and in whom quality of life benefits cannot be achieved without diversion. Experience shows that there are no absolute indications for this procedure. The clinician and the patient must be aware of the importance of continued surveillance after this procedure for problems related to neurogenic voiding dysfunction and/or the ileovesicostomy itself.

INCONTINENT ILEOVESICOSTOMY: LONG-TERM COMPLICATIONS AND OUTCOMES

You have accessJournal of Urology1 Apr 2008INCONTINENT ILEOVESICOSTOMY: LONG-TERM COMPLICATIONS AND OUTCOMES Nicholas J Hellenthal, Scott S Short, Stanley A Yap, Jonathan A Eandi, and Anthony R Stone Nicholas J HellenthalNicholas J Hellenthal More articles by this author , Scott S ShortScott S Short More articles by this author , Stanley A YapStanley A Yap More articles by this author , Jonathan A EandiJonathan A Eandi More articles by this author , and Anthony R StoneAnthony R Stone More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(08)61303-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "INCONTINENT ILEOVESICOSTOMY: LONG-TERM COMPLICATIONS AND OUTCOMES." The Journal of Urology, 179(4S), p. 444 © 2008 by American Urological AssociationFiguresReferencesRelatedDetails Volume 179Issue 4SApril 2008Page: 444 Advertisement Copyright & Permissions© 2008 by American Urological AssociationMetricsAuthor Information Nicholas J Hellenthal More articles by this author Scott S Short More articles by this author Stanley A Yap More articles by this author Jonathan A Eandi More articles by this author Anthony R Stone More articles by this author Expand All Advertisement PDF downloadLoading ...

Blasenfunktionsstörungen bei Multipler Sklerose was ist praxisrelevant?

Bladder dysfunctions, particularly voiding disorders, are commonly seen in multiple sclerosis. 96% of those suffering from multiple sclerosis for more than ten years show urological findings. The impact on quality of life is high. Complications like hydronephrosis, stone formation, vesicourethral reflux, infections and renal failure can affect the upper urinary tract. Symptoms such as urgency, frequency, urinary incontinence and signs of obstruction, e.g. urinary retention, can, but need not be secondary to multiple sclerosis and may even present as primary clinical manifestation of the ailment. As multiple sclerosis is a dynamic disease with exacerbations and remissions, lower urinary tract symptoms and urodynamic findings change. Due to the poor correlation between symptoms, origin and bladder function, an initial urodynamic evaluation is advised. Therapy should be individualised, adapted to the stages of multiple sclerosis and planned in an interdisciplinary setting. Oral anticholinergics and intermittent self-catheterisation are important and effective treatments. Measurement of post-void residual bladder volume by ultrasound or catheterisation helps control therapy and bladder function. Cystoscopic botulinum-A toxin injection may be a promising new treatment option for many different urological dysfunctions. 10% of patients with bladder dysfunction, however, will still require surgery such as suprapubic cystostomy, augmentation cystoplasty, incontinent ileovesicostomy and sphincterotomy when conservative treatment fails.

Urethral Reconstruction In Spinal Cord Injury Patients

Bladder management programs for patients with spinal cord injury and neurological disease (SCIND) include intermittent catheterization and sphincterotomy with external catheter drainage. These programs depend on maintaining a patent urethra. Once urethral stricture, erosion, diverticulum or urethrocutaneous fistula occurs, the only treatments available are urethral reconstruction and urinary diversion. We evaluate the role of urethral reconstruction in this subset of patients. The charts of 18 patients with SCIND (spinal cord injury 16, cerebral palsy 1, meningomyelocele 1) were retrospectively analyzed. Different surgical procedures had been performed according to the presenting pathology and tissue availability. Urethral reconstruction was performed in 17 patients with a mean age of 42.2 years (range 27 to 60). Of the patients 13 are paraplegic and 4 are quadriplegic. Urethral defects included urethral stricture in 6 cases, urethral erosion in 4, urethrocutaneous fistula in 3, urethral diverticula in 1 and combined defects in 3. Mean followup is 3.7 years (range 1 to 13) and the mean number of reoperations was 1.4 (range 0 to 4). Of the 17 patients 11 (64.7%) who underwent urethral reconstruction eventually required urinary diversion for end stage urethral pathology (incontinent ileovesicostomy 5, right colon pouches 2, other procedures 4). The mean time from first urethral reconstruction to eventual urinary diversion was 3.3 years (range 0.7 to 7). Four patients maintain a patent urethra while 1 patient was lost to followup. Patients with SCIND in whom urethral reconstruction is considered should be advised that urethral surgery carries a high risk of reoperation and eventual need for urinary diversion. Clearly, many patients with neurological disease and severe urethral pathology are best treated with urinary diversion.

Reply by the authors

We appreciate the above comments. We have pursued a different course in the management of the patient with DSD. It has been our method to not ablate sphincteric function, realizing that sphincteric resistance preserves some lower urinary tract reservoir function. Therefore, we have elected intensive medical therapy and clean intermittent catheterization as our preferred management technique. Only when this strategy fails do other options such as incontinent ileovesicostomy, bladder augmentation, or bladder replacement enter the therapeutic paradigm. Some experts do attain and maintain good long-term results with external sphincterotomy, but we have not found this procedure to have similar beneficial long-term results. It is hoped that new technologies, such as laser ablation, will provide the results that have been obtained in the above-referenced studies.

Management of neurogenic bladder dysfunction with incontinent ileovesicostomy

Objectives. Incontinent ileovesicostomy is an alternative form of urinary management applied to patients with neurogenic vesical dysfunction who are either unable or unwilling to perform clean intermittent self-catheterization or assisted catheterization. We review our operative results, urodynamic data, and complications observed in patients who underwent creation of incontinent ileovesicostomy at our institution. Methods. Thirteen patients (mean age 43.2 years) with neurogenic bladder dysfunction underwent an incontinent ileovesicostomy between 1994 and 1998. The etiologies of the neurogenic bladder dysfunction were spinal cord injury in 8 patients, multiple sclerosis in 4 patients, and tuberculous meningitis in 1 patient. The preoperative data, surgical records, urodynamic findings, and postoperative complications were assessed. Results. All patients experienced complications of their pretreatment bladder management. The mean operating room time was 242 minutes (range 170 to 395), including 14 additional procedures in 11 patients. The mean estimated blood loss was 403.8 mL (range 50 to 2000). No patient required blood transfusion. There were no intraoperative complications. Only 1 patient required reoperation for stomal revision. One patient had a ureteral stone 2 years after surgery; 1 patient has continued to have urinary tract infections despite a negative workup. The mean follow-up was 23 months (range 6 to 57). The mean bladder leak point pressure through the stoma was 8.2 cm H 2O. Conclusions. The incontinent ileovesicostomy is a useful technique in the treatment of patients with neurogenic bladder unable to perform clean intermittent catheterization. It provides patients with a low-pressure urinary conduit that empties readily without an indwelling catheter.

LONG-TERM OUTCOME OF INCONTINENT ILEOVESICOSTOMY MANAGEMENT OF SEVERE LOWER URINARY TRACT DYSFUNCTION

Purpose We evaluated the extended 5-year followup outcome of incontinent ileovesicostomy. Materials and Methods We reviewed the charts of 25 men and 13 women with a mean age of 44.9 years who underwent incontinent ileovesicostomy, including the original 23 patients whom we reported on in 1993. Mean followup was 52 months. We compared the incidence of complications before and after ileovesicostomy as well as long-term urinary tract status. Results Before ileovesicostomy the incidence of serious complications associated with an indwelling catheter was significant, including poor bladder compliance in 50% of cases, urosepsis in 45%, hydronephrosis in 21%, renal struvite calculi in 18%, urethrocutaneous fistula in 18%, autonomic dysreflexia in 13% and bladder calculi in 2%. After conversion to ileovesicostomy our data show that 83 to 91% of this high risk population maintained a normal upper urinary tract and normal bladder storage compliance. Conclusions Compared with preoperative status the incidence of postoperative complications was relatively low and they were readily corrected. Ileovesicostomy is an excellent long-term management solution for severe lower urinary tract dysfunction in patients who are unable to perform intermittent self-catheterization.

Ileovesicostomy as an alternative form of bladder management in tetraplegic patients

Objectives Bladder management in tetraplegic patients traditionally has been intermittent catheterization by a caretaker, placement of indwelling suprapubic or urethral catheters, sphincterotomy and external catheter drainage, or supravesical urinary diversion with an ileal conduit. The aim of this study was to examine the ileovesicostomy as an alternative form of bladder management in such patients. Methods We report our experience with ileovesicostomy as an incontinent cutaneous urinary diversion not requiring ureteral reimplantation. Six tetraplegic patients who had experienced significant morbidity with their preoperative form of bladder management were managed with an ileovesicostomy fashioned like a funnel from the bladder dome to the right lower quadrant. All patients underwent preoperative and postoperative fluoroscopic and urodynamic evaluations. Patients were evaluated preoperatively and followed postoperatively with serum chemistries, upper urinary tract imaging, and urine bacteriologic studies. Results There were no perioperative complications. Postoperative urodynamics demonstrated subjects to have a mean stomal leak-point pressure of 7.7 cm H 2O (range 5 to 10). Radiographically, patients carried low urinary residuals (less than 100 cc) and did not exhibit vesicoureteral reflux. In follow-up of 12 to 15 months, no patient has demonstrated calculus formation, hydronephrosis, autonomic dysreflexia, or worsening renal function. Conclusions This procedure successfully creates continuous urinary drainage without catheterization, while maintaining the native antireflux mechanism of the ureterovesical junction and avoiding indwelling foreign materials in the urinary tract. Longer follow-up with more cases will be necessary to confirm these findings and to support a recommendation of the incontinent ileovesicostomy as a standard method for managing the neurogenic bladder in tetraplegic patients.

Incontinent ILEO-Vesicostomy Urinary Diversion in the Treatment of Lower Urinary Tract Dysfunction

The combination of high spinal cord injury and neurovesical dysfunction can present formidable problems in urological management. The lack of upper extremity function often prevents intermittent catheterization and leads to alternative methods. A total of 23 patients underwent incontinent ileo-vesicostomy in an effort to gain a low pressure bladder and control of urinary soiling: 17 had been previously treated by catheter drainage, 9 had bladder and/or renal calculi, 9 experienced recurrent sepsis, and 7 had urethrocutaneous fistula and total urinary incontinence. Most patients had poorly compliant bladder dysfunction associated in 9 cases with poor urethral continence function.At a mean followup of 45 months (range 3 to 240 months) 22 of 23 patients had a low pressure reservoir with low pressure egress of urine into a collection device. Complications included stomal stenosis in 3 patients and poor drainage across the ileovesical junction requiring revision in 2. One of these patients ultimately underwent ileal loop diversion. Upper tract function improved or remained stable in all patients.

Bladder Cancer and Squamous Metaplasia in Spinal Cord Injury Patients

The influence of long-term indwelling urethral catheterization was studied by random bladder and urethral biopsies in 62 spinal cord injury patients. Six patients (10 per cent) had diffuse squamous cell bladder carcinoma, 4 of whom had no tumor visible endoscopically. Five of the patients with cancer were among 25 patients (20 per cent) managed with an indwelling urethral catheter for more than 10 years (average 21 years, range 15 to 30 years). The other cancer patient had been free of the catheter for 27 years after suprapubic cystotomy for 4 years. Gross and microscopic hematuria was associated with cancer. Squamous metaplasia of the bladder was significantly greater in patients who had been catheterized for more than 10 years (80 per cent), compared to those catheterized for less than 10 years (42 per cent) and patients without catheters (20 per cent). Urethral squamous metaplasia increased slightly in long-term catheterization patients. Urinary infection was universal and did not distinguish patients with inflammation, metaplasia or cancer. Therefore, the duration of indwelling catheterization seems to be the major factor in squamous changes in these patients.

The Cutaneous Vesicostomy Reappraised

No AccessJournal of Urology1 Jan 1971The Cutaneous Vesicostomy Reappraised Thomas W. Brady, Winston K. Mebust, W.L. Valk, John D. Foret, and Thomas B. Sloss Thomas W. BradyThomas W. Brady More articles by this author , Winston K. MebustWinston K. Mebust More articles by this author , W.L. ValkW.L. Valk More articles by this author , John D. ForetJohn D. Foret More articles by this author , and Thomas B. SlossThomas B. Sloss More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)61464-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1971 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySchwartz S, Kennelly M, McGuire E and Faerber G (2018) Incontinent ILEO-Vesicostomy Urinary Diversion in the Treatment of Lower Urinary Tract DysfunctionJournal of Urology, VOL. 152, NO. 1, (99-102), Online publication date: 1-Jul-1994.Noe H and Jerkins G (2018) Cutaneous Vesicostomy Experience in Infants and ChildrenJournal of Urology, VOL. 134, NO. 2, (301-302), Online publication date: 1-Aug-1985.Walker R (2018) Editorial CommentJournal of Urology, VOL. 134, NO. 2, (302-303), Online publication date: 1-Aug-1985.Cass A, Luxenberg M, Johnson C and Gleich P (2018) Management of the Neurogenic Bladder in 413 ChildrenJournal of Urology, VOL. 132, NO. 3, (521-525), Online publication date: 1-Sep-1984. (2018) CommentJournal of Urology, VOL. 119, NO. 1, (121-121), Online publication date: 1-Jan-1978. (2018) Reply By AuthorsJournal of Urology, VOL. 119, NO. 1, (121-121), Online publication date: 1-Jan-1978.Cohen J, Harbach L and Kaplan G (2018) Cutaneous Vesicostomy for Temporary Urinary Diversion in Infants with Neurogenic Bladder DysfunctionJournal of Urology, VOL. 119, NO. 1, (120-121), Online publication date: 1-Jan-1978.Kendall A and Karafin L (2018) Urinary Diversion in ChildrenJournal of Urology, VOL. 109, NO. 4, (717-722), Online publication date: 1-Apr-1973. Volume 105Issue 1January 1971Page: 81-84 Advertisement Copyright & Permissions© 1971 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Thomas W. Brady More articles by this author Winston K. Mebust More articles by this author W.L. Valk More articles by this author John D. Foret More articles by this author Thomas B. Sloss More articles by this author Expand All Advertisement PDF DownloadLoading ...