Contraindications

Although ileal ureter replacement can be performed for almost any ureteric pathology, certain conditions of the bowel contraindicate this type of surgery. Among these are short bowel syndrome, inflammatory bowel disease, radiation damage to the bowel, and marked scarring of the mesentery (e.g., desmoid tumors).

Absorption of urinary metabolites occurs across the length of the ileal segment, and normal renal function is essential to avoid systemic metabolic derangement (hyper-chloremic metabolic acidosis).

It is generally recommended that segments of bowel not be placed within the urinary tract if the serum creatinine is 2.0 mg/dL or higher. Metabolic complications will occur in more than half of these patients (10).

Even in patients with normal renal function, the shortest length of ileum should be used to minimize absorption. Normal bladder function is an important consideration, and patients with neurogenic bladder dysfunction or decreased bladder capacity or compliance should be managed appropriately before surgery or concomitantly with ileal replacement.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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