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Related Experiment Videos

Synchronous bladder reconstruction and antegrade continence enema.

A Wedderburn1, R S Lee, A Denny

  • 1Department of Paediatric Urology, Southampton University Hospitals NHS Trust, Southampton, United Kingdom.

The Journal of Urology
|May 24, 2001
PubMed
Summary

Synchronous combined surgery for bladder reconstruction and antegrade continence enema can achieve double continence in select patients. However, this complex procedure requires careful patient selection and specialized long-term follow-up due to high revision rates.

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Area of Science:

  • Urology
  • Pediatric Surgery
  • Reconstructive Surgery

Background:

  • The development of antegrade continence enema (ACE) in 1990 enabled new surgical approaches.
  • Synchronous combined surgery aims to achieve fecal and urinary continence without a colostomy.

Purpose of the Study:

  • To assess the long-term outcomes of synchronous bladder reconstruction and ACE in a large patient cohort.
  • To evaluate the efficacy and complications associated with this combined surgical approach.

Main Methods:

  • Retrospective review of 50 consecutive patients from two specialized units.
  • Analysis of patient demographics, surgical procedures, continence rates, and complications.

Main Results:

  • 46 patients analyzed; median age 12 years, median follow-up 44 months.

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  • 76% achieved fecal and urinary continence, but revision surgery was common.
  • Stomal stenosis (17%) was the most frequent complication, requiring secondary procedures.

    • Conclusions:

    • Synchronous surgery can achieve double continence, a significant advancement.
    • High revision rates and surgical complexity necessitate careful patient selection (motivation, dexterity, intelligence).
    • This demanding procedure requires long-term follow-up and should be performed at experienced centers.