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      Delivery after augmentation cystoplasty: Implications and precautions

      case-report

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          Abstract

          A young female with history of genitourinary tuberculosis with solitary functioning kidney became pregnant 1 year after augmentation cystoplasty (AC) with ureteric reimplantation. Throughout pregnancy she had two episode of febrile urinary tract infection. Her renal function remained normal. She was planned for cesarian section due to obstetric indications. Despite altered pelvic anatomy, we successfully did the lower segment cesarian section. We reviewed the literature regarding pregnancy in patients with AC to find that what the treating Urologist and Gynecologist should know about these rare cases. Various complications which should be anticipated and measures to prevent them are also discussed.

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          Most cited references11

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          Complications of enterocystoplasty.

          Bladder reconstruction, either by augmentation or substitution enterocystoplasty, is a safe alternative to supravesical urinary diversion providing careful attention to preoperative selection, surgical technique, and postoperative review is observed. However, under the most optimal conditions an untoward outcome may occur. We reviewed our series of 100 intestinocystoplasties to categorize the types of complications encountered, and to identify preoperative risk factors that could potentially develop into an unfavorable sequela. Twenty-seven patients required either early or late surgical intervention, while 30 were managed nonoperatively. In our review we identified two groups, those with myelodysplasia and those with a solitary functioning kidney, who are at a higher risk for an unfavorable outcome to develop.
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            Bladder augmentation techniques in women.

            Augmentation cystoplasty is performed in women for a variety of indications, including neurogenic bladder dysfunction, inflammatory diseases, small fibrosed bladders, idiopathic urge incontinence and enuresis. The preoperative evaluation, surgical techniques and postoperative management are reviewed. Complications of stone formation, urinary tract infections, mucus production, metabolic disturbances, hematuria and dysuria syndrome, tumors and perforations are addressed. In addition, alternative techniques such as ureterocystoplasty, autoaugmentation, seromuscular cystoplasty and the future of augmentation of the bladder utilizing techniques of tissue engineering are discussed. The management of pregnancy in women who have previously undergone augmentation cystoplasty is also reviewed.
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              Pregnancy and delivery in patients with a continent ileostomy.

              Patients undergoing surgical treatment for inflammatory disease of the intestine are often in their reproductive years. Therefore, it is highly relevant to study the influence of surgical treatment on later pregnancy and delivery. Reported herein are 28 patients with continent ileostomies who have carried 37 pregnancies to term. An increased urge to empty the ileostomy reservoir, especially in the late period of pregnancy, was noted by the majority of patients. About one-third of the patients reported some difficulties with intubation of the reservoir in late pregnancy but in only a few patients did these disturbances result in a revisional operation after delivery. Pregnancy was normal in most instances and only four premature childbirths occurred. All pregnancies resulted in live birth. Vaginal delivery was successful in the majority of the patients, cesarean section being chosen for obstetric reasons in nine instances. From this study, it is concluded that, in patients with a continent ileostomy, normal pregnancy and delivery can be expected. However, in a few instances, the ileostomy function may be disturbed, necessitating later revisional operations.
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                Author and article information

                Journal
                J Nat Sci Biol Med
                J Nat Sci Biol Med
                JNSBM
                Journal of Natural Science, Biology, and Medicine
                Medknow Publications & Media Pvt Ltd (India )
                0976-9668
                2229-7707
                Jan-Jun 2014
                : 5
                : 1
                : 206-209
                Affiliations
                [1] Department of Maternal and Reproductive Health, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
                [1 ] Department of Urology and Kidney Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
                [2 ] Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
                Author notes
                Address for correspondence: Dr. Deepa Kapoor, Department of Maternal and Reproductive Health, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. E-mail: rkapoor@ 123456sgpgi.ac.in
                Article
                JNSBM-5-206
                10.4103/0976-9668.127334
                3961938
                24678231
                5324914d-7ce1-4ec8-82ba-ad53543a068e
                Copyright: © Journal of Natural Science, Biology and Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Case Report

                Life sciences
                augmentation cystoplasty,cesarian section,delivery,pregnancy
                Life sciences
                augmentation cystoplasty, cesarian section, delivery, pregnancy

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