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[Augmentation cystoplasty for severe uropathy in children]
E Jaureguízar1, P López Pereira, J López Gutiérrez
1Unidad de Urología, Hospital Infantil La Paz, Madrid.
Insights
This study reports on seven pediatric patients undergoing bladder augmentation surgery. Most patients achieved normal renal function and urinary continence, demonstrating the effectiveness of various surgical techniques.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Reconstructive Surgery
Background:
- Bladder augmentation is a complex procedure for patients with dysfunctional bladders.
- Various techniques and intestinal segments are employed to improve bladder capacity and function.
- Outcomes depend on the underlying etiology, such as neurogenic bladder or bladder exstrophy.
Observation:
- Seven patients (3 boys, 4 girls) underwent bladder augmentation.
- Etiologies included neurogenic bladder, "nonneurogenic" neurogenic bladder, and bladder exstrophy.
- Surgical approaches involved rectocistoplasty, colon conduit diversion, and different intestinal segments (ileocecal, ileon, colon sigmoid).
Findings:
- Five patients maintained normal renal function post-augmentation, with one requiring a transplant.
- Six out of seven patients achieved full day and night urinary continence.
- Continence was managed with intermittent catheterization or anticholinergic drugs in some cases.
Implications:
- Bladder augmentation surgery can significantly improve renal function and urinary continence in pediatric patients.
- Tailoring surgical techniques and intestinal segments to specific bladder pathologies is crucial for successful outcomes.
- Further research can optimize surgical strategies for enhanced long-term results in reconstructive urology.
Abstract:
We present our experience in seven patients (three boys and four girls) with bladder augmentation. Two patients had a neurogenic bladder, two a "nonneurogenic" neurogenic bladder and three a bladder exstrophy. Between the exstrophy patients, two had a rectocistoplasty and one a colon conduit diversion. The rest of patients (two neurogenic bladders and two "nonneurogenic" neurogenic bladder) had a colon conduit diversion. The intestinal segment used for bladder augmentation were ileocecal sement (two patients), ileon (one patient) and colon sigmoid (four patients). Bladder augmentation were tubularized in four patients and detubularized in three. In the follow-up, five patients have a normal renal function (one transplanted), one patient his function is unchanged and other is waiting for the transplant. Of the seven patients, six are fully continente day and night (two with CI and one with anticholinergic drugs) and one has a diurnal continence no more than two hours.