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Ileal nipple for continence in cloacal exstrophy
1Department of Surgery, Children's Hospital, Boston, Massachusetts.
The Journal of Urology
|August 1, 1992
Summary
A catheterizable bowel nipple can help children with cloacal exstrophy achieve urinary continence. This surgical option offers a solution when local tissues are insufficient for bladder neck and urethra creation.
Area of Science:
- Pediatric Urology
- Surgical Reconstruction
- Congenital Abnormalities
Background:
- Cloacal exstrophy presents significant challenges in urinary tract reconstruction.
- Urinary incontinence is a common complication requiring innovative surgical solutions.
Observation:
- Seven patients (2-17 years) with cloacal exstrophy underwent bladder augmentation and creation of a small bowel nipple.
- Augmentation utilized small bowel, gastric tissue, or both, with evolving techniques over time.
Findings:
- Six out of seven patients achieved complete dryness and managed bladder emptying via intermittent self-catheterization.
- One case failed due to nipple infarction, necessitating reoperation.
Implications:
- A reversed, catheterizable bowel nipple is a viable option for bladder outlet reconstruction in cloacal exstrophy.
- This technique addresses cases with insufficient local tissue for bladder neck and urethra formation.
- Further evaluation and potential reoperation are considered for treatment failures.