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Published on: January 7, 2019
Enterocystoplasty complications in children. A study of 30 cases
1Department of Paediatric Surgery, University Hospital Center of Charles Nicolle, Rouen, France.
Insights
Enterocystoplasty for small bladder capacity can lead to serious complications like infections and stones. This study highlights the risks associated with using intestinal segments for bladder augmentation, urging research into alternative tissues.
Area of Science:
- Urology
- Pediatric Surgery
- Gastroenterology
Background:
- Bladder augmentation is crucial for patients with small bladder capacity.
- Enterocystoplasty techniques, while beneficial, are associated with significant complication rates.
Purpose of the Study:
- To analyze the complications of enterocystoplasty techniques used for bladder augmentation.
- To evaluate the long-term outcomes of bladder augmentation using intestinal segments.
Main Methods:
- A retrospective analysis of 30 patients (16 girls, 14 boys) who underwent bladder augmentation or substitution between 1983 and 1997.
- Detailed review of surgical techniques, including the use of small bowel, ileum, caecum, and sigmoid colon.
- Documentation and categorization of all post-operative complications.
Main Results:
- High incidence of complications, including recurrent urinary infections (12 children) and bladder stone formation (5 children).
- Gastrointestinal complications such as intestinal volvulus (2 children) and caecal volvulus (1 child) were observed.
- Other serious complications included bladder perforation (2 children) and severe electrolyte disturbances (1 child).
Conclusions:
- Complications are frequently linked to the use of intestinal mucosa within the bladder.
- The study underscores the ongoing need for alternative tissues for bladder augmentation to minimize risks.
- Current enterocystoplasty methods necessitate careful patient selection and monitoring due to potential morbidity.
Background/Purpose:
Bladder augmentation for small vesical capacity represents an important aid to these patients, but the appearance of complications is not rare. We analysed the complications of the enterocystoplasty techniques used in our Department.
Methods:
From 1983 to 1997 sixteen girls and fourteen boys were treated. We performed 28 bladder augmentations (in 13 cases using small bowel, in one case using ileum and caecum and in 14 cases using sigmoid colon) and 2 bladder substitutions (in one case with ileum and sigmoid colon and in the second using a colonic segment).
Results:
Twelve children present recurrent urinary infections. In five children bladder stones were formed (among them a case of familial cystinuria-lysinuria). Two children presented intestinal volvulus and another one a caecal volvulus. In two children a perforation of the augmented bladder was treated operatively. An 11-years-old child presented severe electrolyte disturbances.
Conclusions:
The complications presented in our patients confirm the view that they are associated with intestinal mucosa in the bladder and our study proves, once more, the current necessity to seek alternative tissues for bladder augmentation.
