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Related Experiment Videos

[Bladder exstrophy: a neonatal emergency. II: Urinary diversion].

G Belloli1, P Campobasso, L Musi

  • 1Divisione di Chirurgia Pediatrica, Sezione di Urologia, Ospedale Regionale di Vicenza, Italia.

La Pediatria Medica E Chirurgica : Medical and Surgical Pediatrics
|March 1, 1989
PubMed
Summary

Ureterosigmoidostomy offers an excellent long-term solution for bladder exstrophy when primary closure fails. This therapy effectively achieves urinary continence and preserves renal function, significantly improving quality of life for affected children.

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Area of Science:

  • Pediatric Urology
  • Surgical Reconstruction
  • Bladder Exstrophy Management

Background:

  • Bladder exstrophy presents significant challenges in achieving urinary continence and preserving renal function.
  • Primary bladder closure is the ideal treatment, but alternative methods are necessary when primary closure is impossible or unsuccessful.

Purpose of the Study:

  • To evaluate the long-term efficacy and outcomes of ureterosigmoidostomy in selected pediatric patients with bladder exstrophy.
  • To assess urinary continence, renal function, and quality of life following ureterosigmoidostomy.

Main Methods:

  • A cohort of 15 pediatric patients with bladder exstrophy underwent ureterosigmoidostomy.
  • Patients were followed for an average of 8 years and 9 months (range: 18 months to 19 years).

Related Experiment Videos

  • Renal function, upper urinary tract status, fecal and urinary continence, and radiological/manometric studies were assessed.

    • Main Results:

    • All patients maintained normal renal function.
    • Upper urinary tracts were normal in 13 patients; two had moderate ureteral dilatation.
    • Complete fecal and urinary continence was achieved in 13 patients; acceptable continence in two.

    Conclusions:

    • Ureterosigmoidostomy provides excellent long-term results for selected bladder exstrophy patients.
    • Success hinges on correct patient selection, meticulous surgical technique (long submucosal tunnel, direct ureter-bowel anastomosis), and diligent post-operative care.