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Ureterosigmoidostomy: an outdated approach to bladder exstrophy?

M Stöckle1, E Becht, G Voges

  • 1Department of Urology, Medical School, University of Mainz, Federal Republic of Germany.

The Journal of Urology
|April 1, 1990
PubMed
Summary
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Ureterosigmoidostomy in children offers excellent long-term continence and preserves renal function. This study shows high success rates for urinary tract reconstruction, with minimal complications in long-term follow-up.

Area of Science:

  • Pediatric Urology
  • Surgical Reconstruction
  • Long-term Outcomes

Background:

  • Ureterosigmoidostomy is a surgical procedure for urinary diversion.
  • Indications include bladder exstrophy, epispadias, and neurogenic bladder.
  • Previous reconstructions may fail, necessitating diversion.

Purpose of the Study:

  • To report long-term results of ureterosigmoidostomy in pediatric patients.
  • To evaluate continence rates and renal function after the procedure.
  • To assess the incidence of complications, including bowel neoplasia.

Main Methods:

  • Retrospective analysis of 46 children undergoing ureterosigmoidostomy.
  • Follow-up averaged 14.7 years.
  • Assessment of continence, renal function, and complications.

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Main Results:

  • 39 of 46 patients had functioning ureterosigmoidostomy at long-term follow-up.
  • Daytime continence rate was 97.4%; complete continence was 92.3%.
  • No renal insufficiency was observed in living patients; one tubular adenoma was successfully removed.

Conclusions:

  • Ureterosigmoidostomy provides durable and effective urinary diversion in children.
  • The procedure is associated with high rates of continence and preservation of renal function.
  • Long-term surveillance is important for early detection of potential complications.