Search

In 129 patients with tuberculosis of the urinary system subjected to enterocytoplasty repeated surgical interventions took place. Repeated operations were performed in 103 patients after sigmocytoplasty. Operations of the reconstructive-reparative character prevailed among the repeated operations (reimplantation of the ureter into the intestinal transplant, resection of the intestine-bladder anastomosis and combination of these two operations). Remote results were studied in 106 out of 129 patients after repeated operations. Good results were obtained in 55.6%, satisfactory--in 18.9%, bad--in 6.6% of cases. Twenty patients died from the increasing renal insifficiency.

Based on the experience with 98 operations performed for replacement of the urinary bladder with an isolated intestinal segment, it was demonstrated that the most frequent complications were peritonitis, inflammation of the lung that develop mainly with the postoperative paresis of the digestive tract in the background. Therefore, a complex of prophylactic and therapeutic measures for the postoperative intestinal paresis is recommended, the technic of surgical intervention being described in detail. A comparison of the results of surgery, taking into account the mode of the urine outflow in cystectomy, enabled to consider cystectomy with replacement of the bladder with an intestinal graft as the method of choice.

In tuberculous microcysts two technics of plastic surgery are suggested depending on the state of the prostatic gland and urethra. In patients with microcysts without specific lesions of the prostatic gland and urethra vertical sigmocystoplasty was performed after subtotal resection of the urinary bladder. In microcysts associated with tuberculosis of the prostatic gland or urethra perineal sigmocystoplasty after the authors' technic was employed.