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Experiences with urinary undiversion in children with neurogenic bladder
Transactions of the American Association of Genito-Urinary Surgeons
|January 1, 1979
Summary
Urinary undiversion is a viable option for children with neurogenic bladder dysfunction, offering continence for most patients. This reconstructive surgery provides an alternative to revision of ileal conduits.
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.