Urostomal ileal conduit complications in association with abdominal wall mesh implantation

Mesh implantation for hernia repair is one of the common surgical techniques. The goal of this review is to highlight the basic requirements of mesh in order to select the most appropriate hernia mesh considering mesh type, physical properties and mechanical properties. Textile warp-knitted synthetic meshes have significantly decreased recurrence rate of hernia. Polypropylene light weight mesh with antimicrobial coating is taking attention of researchers due to its improved compliance, infection resistance, hydrophobicity, inert nature and strong material. Composite meshes have better tissue incorporation, reduced shrinkage and improved mechanical properties. The mesh porosity is an important factor to predict the biocompatibility of all meshes. Usually, large pore size meshes are better than small pore size meshes because of their flexibility, decreased shrinkage, reduced scar bridging and increased tissue ingrowth. All synthetic and composite meshes have higher strength than the human abdominal wall. Mesh type, mesh structure, mechanical properties and mesh implantation techniques are important factors for hernia repair. It is critical to understand the physical structure and mechanical properties of mesh material in relation to human abdominal wall. Moreover, mesh surface functionalization and grafting with plasma is a new development technique to enhance the loading of antimicrobial agent for the prevention of mesh infection.

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A Response to “Major Complications Associated With Xenograft Biologic Mesh Implantation in Abdominal Wall Reconstruction” (Harth KC, Rosen MJ. Surg Innov. 2009;16:324-329) and Discussion of the MAUDE (Manufacturer and User Facility Device Experience) Database, FDA Regulation of Biologic Implants, and Evidence-Based Medicine

Surgical Innovation ◽

10.1177/1553350610371214 ◽

2010 ◽

Vol 17 (3) ◽

pp. 273-275 ◽

Cited By ~ 3

Author(s):

Ross David Segan

Keyword(s):

Abdominal Wall ◽

Evidence Based Medicine ◽

Abdominal Wall Reconstruction ◽

Biologic Mesh ◽

Evidence Based ◽

Mesh Implantation ◽

Major Complications ◽

User Facility ◽

Based Medicine

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634 Case Report: Large Perforating Ileal Conduit Stone as A Rare Cause of Abdominal Wall Abscess

British Journal of Surgery ◽

10.1093/bjs/znab259.310 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

H Satherley ◽

A Gowda ◽

F Nawaz ◽

G Caddeo ◽

R Stanford

Keyword(s):

Case Report ◽

Abdominal Wall ◽

Ileal Conduit ◽

Stone Formation ◽

Foley Catheter ◽

Fluid Collection ◽

Late Complications ◽

Abscess Cavity ◽

Urine Leak ◽

Abdominal Wall Abscess

Abstract Introduction Ileal conduits are common following cystectomy for benign or malignant disease of the bladder. They are associated with late complications such as parastomal hernias, strictures, infections and rarely conduit stone formation. We present a previously unreported case of a significant abdominal wall abscess secondary to a very large perforating conduit stone. Case Report A 59-year-old female with an established ileal conduit due to multiple sclerosis presented acutely with abdominal pain, peristomal mass and fever. A CT showed a large (40mm) calcification with a fluid collection adjacent to the conduit in the subcutaneous tissues. Emergency incision and drainage of the abscess revealed a large abscess cavity containing a stone. Conduitoscopy demonstrated a narrow stoma and a perforation between the abscess cavity and the lumen of the conduit suggesting extrusion of the stone through an eroded area in the wall of the conduit. A Foley catheter was inserted to bypass the perforation. The patient recovered well after the procedure with the addition of antibiotics. Subsequent conduitoscopy showed closure of the perforation with these measures. Conclusions Conduit stones are rare but have the potential to perforate the urinary conduit. We believe that the subcutaneous location of the perforation allowed it to go unnoticed and the stone to achieve a significant size before acting as a nidus for infection. A more proximal perforation would likely result in an intraperitoneal urine leak and earlier presentation with an acute abdomen.

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Hypothesis on Cadaveric Urinary Bladder Transplantation in a Radical Cystectomy, an alternative option of ileal conduit

10.31219/osf.io/ke8tj ◽

2020 ◽

Author(s):

Dattatreya Mukherjee

Keyword(s):

Urinary Bladder ◽

Adverse Effects ◽

Abdominal Wall ◽

Radical Cystectomy ◽

Urinary Diversion ◽

Ileal Conduit ◽

Research Work ◽

Neural Regeneration ◽

Alternative Option ◽

Genetic Techniques

In Radical Cystectomy the urinary bladder is fully resected and in ileal conduit the ureter is joined with a ileal part and drained outside the abdominal wall. It’s a technique of urinary diversion. This procedure has many adverse effects and its also tough for the patients to drain the urine through abdominal wall. So my hypothesis is to use a cadaveric bladder as a transplantation. Now the challenge will arise how to control urge of urination. For that artificial urinary bladder sphincter can be used with the neural regenerations procedure which is under research work. WNT/Beta pathway and Tissue genetic techniques have shown the peripheral neural regeneration.

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