Normal Urinary Tract Function Research Articles

Single-stage operation without temporary colostomy for persistent cloaca with a short common channel

Colorectal decompression with a catheter was performed for evacuation of stool before definitive surgery in two patients with a persistent cloaca. Two newborn female infants with persistent cloaca received placement of a silicone balloon-tipped catheter in the rectum via the cloacal orifice under fluoroscopic guidance at the time of diagnosis. The length of the cloaca was 2 and 1.5 cm, respectively. The diameter of the catheter was matched to the patients' rectal size and the open end was wrapped in a diaper to allow continuous drainage of stool. The infants underwent bowel irrigation with warm saline thrice a day, at home. Total urogenital mobilization was carried out in the infants at the age of 7 and 8 months, respectively. Both infants had no abdominal distension, colorectal dilatation, or urinary tract infection while the catheter was in situ. The postoperative course was uneventful, except for minimal wound dehiscence in one patient. At present, both infants can void spontaneously without any urological problems. In infants with a persistent cloaca less than 3 cm long and normal urinary tract function, adequate evacuation of stool may be achieved by colorectal decompression with a catheter, thus avoiding the need for a colostomy.

Urinary tract dysfunction after radical hysterectomy for cervical cancer.

To evaluate the urinary tract dysfunction following a radical hysterectomy and to compare the baseline urodynamical parameters of women who had uterine cervical carcinoma with women who had CIN 3. A prospective case-control study was conducted to evaluate preoperative and postoperative urinary tract function of thirty-two cervical carcinoma patients using twenty-seven CIN 3 patients' preoperative urodynamical parameters as a baseline control. The rate of detrusor instability in women with preoperative cervical carcinoma was higher than that of women with CIN 3 (37.5 % vs. 14.8 %, P < 0.05). In the cervical carcinoma patients, there were 53.1 % who had normal urinary tract function, but after a radical hysterectomy they began voiding by abdominal straining. The impairment of bladder sensation, alteration of bladder capacity and bladder compliance, compromise of detrusor function, reduction of maximal urethral pressure and maximal urethral closure pressure, and the decrease of the pressure transmission ratio were significantly noted after a radical hysterectomy. The rate of genuine stress incontinence did not increase significantly (9.4 % vs. 18.8%, P > 0.05), but the rate of detrusor instability decreased significantly (37.5% vs. 15.6%, P < 0.05) after a radical hysterectomy. Changes of urinary tract function after a radical hysterectomy might be related to the partial sympathetic and parasympathetic denervation during a radical dissection. More than half of the women who preoperatively had normal urinary tract function needed to void by abdominal straining after radical surgery.