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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5514_Библиотеки_им_академика_М_И_Перельмана.pdf
468
Index
Female epispadias, 272, 273
outcomes, 273
Female exstrophy repair
abdominal wall closure, 97
bladder closure, 95
bladder neck reconstruction, 95
complications, 97–100
fascial closure, 96
Grady monsplasty, 96–97
incision and initial dissection, 94
intersymphyseal bands, 94
labiaplasty, 95
pubic bone closure, 96
umbilicoplasty, 97
urethral plate dissection, 94, 95
urethroplasty, 95
Y-V vaginoplasty, 95
Fertility, 251, 420
gynecology, 437
Fetal anatomic survey, 34
Fetal sex determination, 16
Fetal ultrasonography (FUS), 104
Fibrosis, 285
Fine needle-tip cautery, 155
First trimester, 442
Fistula formation, 269
Fluid-lled urinary bladder, 34
Fluorescence in situ hybridization (FISH), 26
Frenulum, 150
Functional renements, 184
Funneled bladder, 194
G
Gastrointestinal function, bladder
exstrophy, 398
Gender rearing, 251
Gene expression studies, 29–30
Genetic counseling, 21
Genetic implications, 26
Genetics
advanced technology and methods, 27–30
CNV studies, 28–29
gene expression studies, 29–30
GWAS, 30
Genital reconstruction, 19, 248
Genital tubercle, 4, 6, 7
Genitoplasty, 193, 434
Genome sequencing, 16
Genome-wide association study (GWAS), 30
Glans closure, 136
Glansplasty, 166, 290
Glanuloplasty, 262–263
Global health, 313, 314
Global Health Inequities, 457
Global Health Initiatives, 457–459
Glomerular ltration rate (GFR), 380, 385
Grady monsplasty, 96
Greenstick fracture, 211
Gynecology
anatomy, 431
assessment, 432–434
contraception and routine gynecologic
fertility, 437
obstetric considerations, 438–441
pelvic organ prolapse, 436, 437
puberty, 434
sexual health and function, 435, 436
H
Health-related quality of life (HRQOL), 426
Heitz-Boyer-Hovelacque procedure, 295
High income countries (HICs), 314
History, bladder exstrophy, 7
Holistic care, 393
Hypertension, 386
I
IFE, see Isolated female epispadias
Ileocecal loop, 368
Ileocystoplasty, 364
Immobilization techniques, 116, 203
bladder exstrophy, 398
complications of, 118
Implantation technique, 345
Incontinence during sexual activities, 424
Inevitable vesicoureteric reux, 141
Infancy, 432
BEEC, 414, 415
Inferior vesical artery, 153
Infraumbilical wall defect, 34
Inguinal hernia, 19, 227, 247
Inner preputial skin, 166
Inpatient nursing care, 394
Internal sphincter, 141
International Classication of Functioning,
Inter symphyseal bands, 94, 151, 161
female exstrophy repair, 94
incision, 191
male exstrophy repair, 88
Intraoperative pubic reduction xation, 203
Ischial tuberosity, 159
Ischiocavernosus muscle, 146
, 432
care, 438
Disability and Health (ICF)
model, 404
Index
469
Ischiopubic osteotomy, 162
Ischiopubic ramus, 146, 162
Isolated female epispadias (IFE), 46, 51, 189
bladder capacity in, 196
Isolated penile epispadias, 4
K
Kelly procedure, 129–131
complications and outcomes, 137, 138
in females, 137
operative steps of, 131, 132
corpora and urethral plate, disassembly
of, 134, 135
corpora detachment and release of
penis, 133, 134
deconstruction, 132
pudendal neurovascular bundle,
identication of, 132, 133
tension free bladder neck
construction, 135
urethral reconstruction and glans
closure, 136
wound closure and penile skin
reconstruction, 136, 137
postoperative management, (see also
Radical soft tissue mobilization
(RSTM)), 137
Kelly repair, 273
Kidney function, measurement, 385, 386
Kidney outcomes, screening and ongoing
monitoring, 384
L
Labiaplasty, 95
Lipomyelomeningocele, 45
Local support groups, advocacy, 453–454
Logistics, 396
Low-and-middle income countries
(LMICs), 314
Low conus medullaris, 45
Lumen of bladder outlet compression
articial urinary sphincter, 335,
337–339
bladder neck bulking agent
injection, 333–335
M
Mainz pouch II, 237, 238
Male classic bladder exstrophy
CPRE, 174, 175
primary closure, historical context and
early attempts, 174
staged repair and Jeffs proposal, 174
Toronto approach, 175
bilateral ureteral advancement
reimplantation, 177
bladder neck tailoring and repair and
bladder closure, 177, 180
challenges and limitations, 185
continence enhancement, 183, 184
cosmetic and functional renements, 184
epispadias repair, 182
pelvic osteotomy, 180
penile skin reconstruction, 182, 183
preoperative assessment and
planning, 176
preoperative testosterone
administration, 182
rationale and strategic pillars, 175
single institution experience with,
184, 185
surgical intervention, lateral dissection
and approach, 176
Male epispadias
anatomic features, 257, 258
embryology, 257
epispadias repair, 259
approaches to, 260, 261
bladder neck reconstruction, 263
corporeal rotation and
cavernocavernostomy, 261
glanuloplasty and skin coverage,
262, 263
history of surgical repair, 259, 260
Mitchell repair, 263
modied Cantwell-Ransley repair,
261, 262
pelvic osteotomy, 261
urethral reconstruction, 261
stula formation, 269
Mitchell-Bagli epispadias repair,
modication, 267
Mitchell repair, 263
bladder neck reconstruction, 265
initial dissection, 263, 264
penile disassembly, 264, 265
primary closure, 266
skin closure, 267
outcomes, 269
renal function, 271
residual curvature, 269
sexual function, 271
urethral stricture, 269
urinary continence, 270, 271
470
Index
Male exstrophy repair
abdominal wall closure and penile shaft
skin coverage, 92
anatomy and preparation
assessment, 86–87
bladder neck reconstruction, bladder/
urethral closure, 90–91
corpora cavernosa, 88, 89
glansplasty and corporal cavernosa
approximation, 92
immobilization, 93, 94
incision and initial dissection, 87–88
intersymphyseal bands, 88, 89
pubic bone closure, 91–92
spongiosum, 88, 89
umbilicoplasty, 93
urethral plate, 88
Malrotation of pelvic ring primordia, 7
Maternal prenatal care, 19, 20
Medical Advisory Council, 455
Medical coping, 415
Midline scrotoperineal approach
of bladder exstrophy reconstruction, 142
bladder exstrophy repair
anesthesia, 155
bladder plate mobilization, 155, 156
incision, 155
patient positioning and draping, 155
preoperative evaluation and
preparation, 153, 155
radical corporal detachment, 159
urogenital diaphragm, exposure
of, 156–159
Mild hydroureteronephrosis, 170
Mitchell repair, 263–265
bladder neck reconstruction, 265
initial dissection, 263, 264
penile disassembly, 264, 265
primary closure, 266
skin closure, 267
Mitrofanoff principle, 344
Mobilized bladder plate, 153
Modern staged repair of bladder exstrophy
(MSRE), 67, 73, 77, 112
Modied Buck’s traction, 280
Modied Cantwell-Ransley repair, 261–263
Modied perineal approach surgical
technique, 191–193
institutional data on, 195, 196
Modied vancouver scar scale (MVSS), 406
Molecular methods, 26
Monsplasty, 193, 228
Mons pubis, 228
MRI
fetal lie and maternal factors, 45
isolated bladder exstrophy, 34
MRI-guided anatomic dissection, 110
MSRE, see Modern staged repair of bladder
exstrophy
Mucosal strip, 190–192
Mucosal violations (MVs)), 124
Mucosa of urethra, 194
Mullerian anomalies, 432, 439
Müllerian duct, 245
Müllerian structure, 249
Multi-Institutional Bladder Exstrophy
Consortium (MIBEC), 271
Multiplex ligation-dependent probe
amplication (MLPA) based
approach, 28
Murine p63+/+ knockout model, 27
Musculoskeletal system, 57–60
Myelocystocele, 45
N
Neourethra, 282
Neourethral channel, 119
Neovaginal reconstruction, 250
Nephrology evaluation, 383
Nerve locator probe, 148
Neurovascular bundle, 148
Nonadherence, 249
Non-dipping, 387
Normal development, bladder exstrophy, 4–7
Nutrition, 251, 252
O
Obstetric care, 442–443
Oligohydramnios, 20
Omphalocele, 34, 38, 41, 45, 51, 248
Omphalocele-exstrophy imperforated anus
spinal anomaly (OEIS), 1–3, 7–9,
19, 41, 61, 241
Open bladder neck, 152
Open bladder plate, anatomical details of, 151
Orthopedic care, bladder exstrophy, 398, 399
Osteotomies, 114, 162, 164, 205, 210, 279
in BE reconstruction, 201–203
bladder capacity, 170
complications of, 118
corporal-urethral separation, 163, 164
cosmetic outcome, 170
follow-up, 168
immediate postoperative
complications, 169
intraoperative complications, 169
Index
471
ischiopubic osteotomy, 162
late complications, 169, 170
postoperative management, 168
reconstruction, 164, 166
3-D CT pelvis, trapezoid-shaped urogenital
diaphragm on, 169
transverse innominate osteotomy, 163
upper tracts, 170
ureteral reimplantation, 169
urinary continence, 170
Outlet obstruction, 282
Outpatient nursing care, 395
P
p63, 9–11
Pain control, BE, 397
p53 apoptosis effector related to PMP-22
(PERP), 10
Paraexstrophy, 282
Parental counseling, 16
Parental teaching, bladder exstrophy, 399
Patho-anatomy of pelvis, bladder exstrophy-
epispadias complex, 200, 201
Pathophysiology, bladder exstrophy, 8–9
Patient advocacy, 450
Patient-Advisory Councils, 460
Patient-Directed Research, 460
Pearson-type chi-squared test, 27
Pediatric psychology, 413, 414
Pediatric urology, 457
Peer support, 452
advocacy, 453
Pelvic and lower extremity immobilization
techniques, 117
Pelvic anomalies, bladder exstrophy-
epispadias complex, 201
Pelvic cavity, 402
Pelvic oor, 105, 106, 402
Pelvic oor 3D-CT imaging, 106
Pelvic immobilization, 306
Pelvic organ prolapse, gynecology, 436, 437
Pelvic osteotomy, 107, 116, 176–182,
202, 203
Pelvic reconstruction, 111
Pelvis, magnitude of external rotation of, 145
Penile disassembly, 264–265
Penile perception score (PPS), 124
Penile reconstructive techniques,
182–183, 426
Penile shaft skin coverage, 92
Penile skin dartos complex, 150
Penile skin reconstruction, 136, 137, 182, 183
Penis release, 133, 134
Penopubic epispadias, 257, 265
Penoscrotal angle, 166
Peritoneum, 156
Physical therapy, BEEC, 401
continence, 328
developmental timeline, 403
evaluation, 403
activity, 405
impairment, 405, 406
participation, 404
intervention, 407
constipation, 410
day vs night, 409, 410
post toilet training, 408, 409
pre toilet training, 407
toilet training, 408
muscular differences, 403
Polygalactin, 166
Posterior iliac osteotomies, 204–207
Posterior urethral obstruction, 120
Postnatal imaging ndings
musculoskeletal system, 57–60
spine, 61–62
urinary system, 53–60
Postoperative immobilization, 206
bladder exstrophy-epispadias complex, 218
Post-operative vaginal stenosis, 435
Postpartum, 443
Postponing surgery, 74
Preconception, 442
Pregnancy, 423
Prenatal counseling, 15, 18–20
Prenatal detection, of bladder exstrophy, 2
Prenatal diagnosis, BEEC, 15,
Prenatal imaging, 16–18
bladder exstrophy, 34–36, 38, 40–44
cloacal exstrophy, 41–46, 48–50
exstrophy variants, 46, 51, 53
isolated epispadias, 46, 51
Prenatal management, 21
Pressure, 110
Primary penile disassembly technique, 66
Prophylactic antibiotics, 176
Proteinuria, 387
Proximal defects, 258
Pseudoexstrophy, 46
Psychological impact, BE
with parents, 77
with patient, 77
Puberty, 433, 434
Pubic bones, 167, 228
closure
female exstrophy repair, 96
male exstrophy repair, 91–92
16
472
Index
Pubic diastasis, 200
assessment, 58
Pubic symphysis diastasis reduction, 206, 211
anterior bilateral superior pubic rami
osteotomies, 216
Puborectalis, 402
Pudendal artery, 153
Pudendal neurovascular bundle
Kelly procedure, 132, 133
Pudendal vein, 133
Pyelonephritis, 307
Q
Quadratus lumborum (QL), 305
Quality of life (QOL), 239, 332
R
Radical corporal detachment, 159
Radical soft tissue mobilization
(RSTM), 67, 77
Range of motion, 406
Reconstruction, osteotomy, 164–168
Rectal diversion, 239
Rectus, 132
Rectus abdominis muscle (RAM) ap, 361
failed exstrophy repair, 291, 292
Recurrent urinary tract infection, 169
Redo exstrophy repair, 287
failed exstrophy repair, 294
augmentation cystoplasty, 295
ureterosigmoidostomy, 294
Reimplantation, 386
Relaxin, 66
Renal continence, 250, 251
Renal function, male epispadias, 271
Reproductive and sexual health, 423
females
reproductive outcomes, 423–425
sexual function, 424
males
ejaculatory function, 427
erectile function, 427
outcomes, 425
sexual function, 425–427
recommendations, 428
Residual curvature, 269
Respiratory patterns, 406
Retro-pubic dissection, 192
Retropubic drain, 166
Reverse Byars aps, 263
Right lower quadrant (RLQ), 441
Routine gynecologic care, 438
S
Sacral fusion abnormality, 26
Scrotal skin, 168
Scrotoperineal approach, 146
Second/third trimester, 442
Sensory integration, 406
Serum cystatin C, 386
Sexual function, 251, 271, 424
in men with BEEC, 425–427
Sexual health, 124, 432, 435,
Sigma-rectum pouch (SRP), 237, 238
Single cloacal membrane, 4, 8
Single institution, Toronto approach, 184, 185
Single stage repair, 66
Skin coverage, 166, 262–263
Skin integrity, 406
Soft tissue closure, 108–111
Soft tissue reconstruction, 112
Sonic Hedgehog (SHH), 9, 11
Spina bida, 16, 17, 20, 21
Spinal dysraphism, 19, 20, 45
Spine, 61–62
Sporadic bladder exstrophy, 26
Staged reconstruction, 66
Stomal incontinence, 347
Subfascial plane, 165
Summer camps, BEEC, 454
Superior vesical artery, 151
Suprapubic catheter, 180, 361
Surgical disease, burden of, 314
Symphyseal pubic band, 192
T
Tegaderm, 394
Tension free bladder neck construction, 135
Test menstruation, 433
Tissue expansion (TE), 124
Toronto approach, 173, 175
bilateral ureteral advancement
reimplantation, 177
bladder neck tailoring and repair and
bladder closure, 177, 180
challenges and limitations, 185
continence enhancement, 183, 184
cosmetic and functional renements, 184
epispadias repair, 182
pelvic osteotomy, 180
penile skin reconstruction, 182, 183
preoperative assessment and planning, 176
preoperative testosterone
administration, 182
rationale and strategic pillars, 175
single institution experience with, 184, 185
436
Index
473
surgical intervention, lateral dissection and
approach, 176
Touhy needle, 304
Transplantation, 388, 389
Transpubic midline incision, 272
Transverse innominate osteotomy, 163
Transverse island pedicle ap, 267
Transversus abdominis plane (TAP), 305
Triangular mucosal patch, 165
Tunica vaginalis ap, 119
U
Ultrane straight vessels, 151
Umbilicoplasty, 86, 93, 155, 176–182, 229
female exstrophy repair, 97
ap, 157, 166
male exstrophy repair, 93
Ureteral reimplantation, 169, 176–182,
223, 224
cephalo-trigonal technique, 224, 225
into colon segment of donut, 368
cross-trigonal technique, 224, 226
outcomes, 226, 227
Ureteric catheters, 361
Uretero-colic implantation, 367
Ureterosigmoidostomy (US), 236, 294–295
Ureterovesical junction, 258
Urethra, 266
Urethral plate
disassembly, 134–135
dissection, female exstrophy repair, 95
female exstrophy repair, 94
male exstrophy repair, 88
Urethral reconstruction, 136
Urethral stricture, 269
Urethral tubularization, 265
Urethrocutaneous stula, 269
Urethroplasty, 182
female exstrophy repair, 95
Urinary bladder, location in, 34
Urinary continence, 66, 72, 74, 76, 78, 79,
121, 122, 170, 195, 235, 250,
270, 271
Urinary incontinence
social consequences of, 331
social problem of, 333
Urinary reconstruction
bladder augmentation by donut, 368–369
into bladder plate/colon segment of donut,
366, 367
cloth catheter bag, 376
exstrophy, management protocol, 360
operative technique
bladder neck closure, 365
bladder turn in and epispadias repair
with rectus abdominis muscle
ap, 360–362
nal reconstruction, 363, 364
outcome of reconstruction, 372
pre-op cystogram, 373
Urinary system, 53–60
Urinary tract dilatation, 380
Urinary tract infections (UTIs), 323
kidney function and prevention,
79–80
Urogenital diaphragm, 147
anatomy of, 145–148
exposure of, 156–159
bers, 109
Urologic reconstruction procedures, 20
Urology psychology, 414
Uroplakins, 11
Urorectal septum, 5, 8, 11
U.S.-based Initiatives- Policy and
Legislation, 455–456
Uterovaginal abnormality, 432
UTIs, see Urinary tract infections
V
Vaginal procedures, 124, 431, 436
Ventral penoscrotal junction, 268
Vertebral segmentation anomalies, 45, 61
Verumontanum, 258
Vesicocutaneous stulae, 282, 293
Vesicoureteral reux (VUR), 79, 190, 195
Vesicoureteric reux, 297
Voiding, 324
Volitional voiding, 195, 249
W
Wedge effect, 7
Weightbearing, 407
WNT5A gene, 11
World Health Organization (WHO), 313
Wound and tube assessments, bladder
exstrophy, 397, 398
Wound closure, 136, 137
Wound dehiscence, 307
Wound tension, post operative sources, 280
Y
Young–Dees bladder neck repair, 339
Younge-Dees-Leadbetter (YDL) procedure,
195, 196
bladder neck plasty, 364–365, 374
Y-V vaginoplasty, 95, 96