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Delayed linear growth in children with enterocystoplasties
K E Wagstaff1, C R Woodhouse, P G Duffy
1Academic Unit, Institute of Urology, London.
Insights
Urologic reconstruction using bowel segments can impact pediatric growth. Some children experienced delayed height and weight gain, suggesting potential bone development alterations after surgery.
Area of Science:
- Pediatric Surgery
- Growth and Development
- Urology
Background:
- Urinary diversion using intestinal segments is a complex surgical procedure.
- Assessing the long-term effects on pediatric growth is crucial for patient management.
Purpose of the Study:
- To evaluate the impact of urinary pouches constructed from bowel on height and weight growth in children.
- To identify patterns of growth disturbances following this type of reconstructive surgery.
Main Methods:
- Retrospective review of 60 children undergoing urinary pouch creation from bowel.
- Inclusion criteria required at least two pre- and post-operative measurements of height and weight.
- Minimum follow-up duration of 2.5 years was mandated.
Main Results:
- Delayed linear growth (height) occurred in 20% of patients, with a mean percentile loss of 25 points.
- Delayed growth in both height and weight was observed in 4 patients.
- Accelerated growth was noted in height alone (2), weight alone (7), and both (7).
- No significant differences in laboratory data were found between growth groups.
Conclusions:
- Delayed linear growth in isolation is an uncommon but concerning outcome following bowel-derived urinary pouch creation.
- This finding may indicate significant alterations in bone development.
- Further investigation into the mechanisms affecting bone development in these patients is warranted.
Abstract:
A series of 60 children whose urine was stored in pouches formed in whole or in part from bowel were reviewed to establish the effect on growth in height and weight. The mean age at operation was 7.8 years (range 0.9-14.1). Patients were included only if there were at least 2 measurements of both parameters pre-operatively and 2 post-operatively over a minimum follow-up of 2.5 years. Delayed growth in height alone occurred in 12 children (20%), with a mean loss of 25 percentile points (range 10-50). Delayed growth in height and weight occurred in 4. Accelerated growth in height alone, weight alone and in both occurred in 2, 7 and 7 respectively. There was no difference in a wide range of laboratory data between any of these groups. Although changes in growth rate (for better or worse) may occur for a variety of reasons after major surgery, delayed linear growth in isolation is an unusual and worrying finding that suggests a major alteration in bone development.