Experiences with urinary undiversion in children with neurogenic bladder

Area of Science:

• Pediatric Urology
• Reconstructive Surgery
• Neurogenic Bladder Management

Background:

• Supravesical diversion is a surgical option for managing neurogenic bladder dysfunction.
• Reconstruction aims to restore urinary tract continuity and improve bladder function.
• Long-term outcomes of urinary undiversion in pediatric patients require evaluation.

Observation:

• Six children underwent urinary tract reconstruction following supravesical diversion for neurogenic bladder.
• The time from initial diversion to reconstruction ranged from 14 months to 14 years.
• Patient follow-up extended to assess continence and renal status.

Findings:

• Five of six children achieved urinary continence post-reconstruction.
• Continence was managed via intermittent catheterization (4 patients) or complete voiding (1 patient).
• One patient experienced initial technical failure due to hydronephrosis but later underwent augmentation cystoplasty.

Implications:

• Urinary undiversion is a feasible alternative to ileal conduit revision in select pediatric cases.
• Successful undiversion requires adequate bladder storage capacity and low resting pressures.
• This approach can improve quality of life for children with neurogenic bladder dysfunction.