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Published on: January 7, 2019
Ureterosigmoidostomy in childhood: the quality of life
Insights
Ureterosigmoidostomy in children offers acceptable urinary diversion, with most patients experiencing normal growth and a good quality of life. However, 39% required re-operation, often due to upper tract issues.
Area of Science:
- Pediatric Surgery
- Urology
- Reconstructive Surgery
Background:
- Ureterosigmoidostomy is a surgical procedure for urinary diversion.
- Long-term outcomes in pediatric patients are important to evaluate.
Purpose of the Study:
- To assess the long-term outcomes of ureterosigmoidostomy in children.
- To evaluate growth, quality of life, and complications in patients with ureterosigmoidostomy.
Main Methods:
- Retrospective review of 31 pediatric patients who underwent ureterosigmoidostomy between 1952 and 1974.
- Evaluation of 19 patients retaining the diversion for 3-22 years, including interviews and review of medical records.
Main Results:
- 39% of patients required re-diversion, primarily for upper tract deterioration.
- Nineteen patients retaining the diversion showed normal growth, with most reporting a good quality of life.
- Regular alkali supplementation was needed for 12 patients, and 3 required intermittent antibiotics.
Conclusions:
- Despite a significant re-diversion rate, ureterosigmoidostomy can be an acceptable long-term urinary diversion in children.
- Close follow-up and management of metabolic complications are crucial for successful outcomes.
Abstract:
Thirty-one patients in whom ureterosigmoidostomy had been performed between 1952 and 1974 for a variety of conditions are presented. Twelve patients, or 39%, were subsequently rediverted, mainly for upper tract deterioration. Nineteen patients retaining their ureterosigmoidostomy were evaluated after 3 to 22 yr. Growth was normal in all. Twelve patients required regular alkali and three intermittant antibiotics. In 14 patients, the I.V.U. remained perfect. Each patient was interviewed. Voiding was on average three hourly. Some urgency was common, but soiling was rare. Sleep was disturbed in nearly half the patients but this was usually around dawn. Lessons were rarely interrupted and nearly all took part in sports. The large majority felt no different from their peers. In spite of close initial supervision and significant rediversion rate, ureterosigmoidostomy can provide a very acceptable form of urinary diversion in children.
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