1. Nastanak i liječenje gigantskih kamenaca ileocekalnog urinskog spremnika u pacijenta liječenog cistektomijom zbog intersticijskog cistitisa: prikaz slučaja
- Author
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Matilda Crnić, Martin Kurosch, Robert Dotzauer, Dean Markić, Matilda Crnić, Martin Kurosch, Robert Dotzauer, and Dean Markić
- Abstract
Cilj: Cilj ovoga rada je prikazati pacijenta s intersticijskim cistitisom u kojega je došlo do stvaranja kamenaca u novoformiranom urinskom spremniku. Prikaz slučaja: Pacijent star 48 godina obrađivan je zbog recidivnih infekcija mokraćnog sustava. Prethodno mu je zbog intersticijskog cistitisa, koji je znatno utjecao na njegovu kvalitetu života, učinjena cistektomija uz oblikovanje urinskog spremnika (Mainz-pouch I). Urološkom obradom pronađena su u području urinskoga spremnika dva velika kamenca dimenzija 77 × 74 mm te 76 × 62 mm uz obostranu hidronefrozu. Kako bi se riješio uzrok rekurentnih urinarnih infekcija, učinjena mu je otvorenim pristupom ekstrakcija oba kamenca. Poslijeoperacijski tijek bio je uredan te je pacijent nastavio s provođenjem intermitentne samokateterizacije uz značajno poboljšanu kvalitetu života. Zaključak: U pacijenata s teškim oblikom intersticijskog cistitisa u obzir dolazi učiniti cistektomiju s urinarnom derivacijom. Pojava kamenaca u urinskome spremniku u takvih pacijenata nije česta, a liječenje ovisi o veličini litijaze (otvoreni odnosno endoskopski pristup)., Aim: The aim of this study is to present a patient with interstitial cystitis who has had a stone formation in a newly formed urinary reservoir. Case report: A 48-year-old patient was treated for recurrent urinary tract infections. Previously, due to interstitial cystitis, which significantly affected his quality of life, a cystectomy was performed with the formation of a urinary reservoir (Mainz-pouch I). Diagnostic evaluation revealed two large stones in the urinary reservoir whose dimensions were 77 × 74 mm and 76 × 62 mm with bilateral hydronephrosis. To resolve the cause of recurrent urinary infections, extraction of both stones was done by open access. The postoperative course was uneventful and the patient continued with the implementation of intermittent self-catheterization with a significantly improved quality of life. Conclusion: In patients with severe interstitial cystitis, cystectomy with urinary diversion must be considered. The occurrence of calculus in the urine reservoir is not common in such patients and treatment depends on the size of calculi (open or endoscopic approach).
- Published
- 2021