Bladder replacement in children and young adults

Area of Science:

• Urology
• Surgical Reconstruction

Background:

• Review of 23 patients undergoing total and subtotal bladder replacement.
• Patients categorized by remaining bladder, bladder neck, or urethral function.
• Indications included urinary incontinence (13 cases) and prior urinary diversion (10 cases).

Observation:

• Colon segments (right or left) used for bladder reconstruction.
• Renal function remained stable in 20 patients, with 2 deteriorating and 1 improving.
• Functional outcomes: 14 patients dry day/night, 7 dry day/wet night, 2 wet day/night.

Findings:

• 15 of 23 patients experienced postoperative complications.
• Most common complication: loss of antireflux ileocecal mechanism (8 patients).
• Isolated bowel segment bladder replacement is feasible in selected patients.

Implications:

• Highlights key considerations for total and subtotal bladder replacement procedures.
• Demonstrates the viability of colon segments for bladder reconstruction.
• Emphasizes the importance of patient selection and managing potential complications.