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Ileal conduit urinary diversion in children. A long term follow-up
Insights
Ileal conduit diversion for pediatric neuropathic bladders shows good long-term upper tract outcomes. In 85 children with myelomeningocele, 80% had preserved or improved kidney function after over ten years.
Area of Science:
- Pediatric Urology
- Nephrology
- Spinal Cord Medicine
Background:
- Ileal conduit diversion is used for neuropathic bladders in children with myelomeningocele.
- Concerns exist regarding long-term upper tract deterioration after this procedure.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of ileal conduit urinary diversion in children with myelomeningocele.
- To assess upper tract changes in patients with long-term follow-up.
Main Methods:
- Retrospective review of 144 ileal conduit urinary diversions in children with myelomeningocele.
- Analysis of upper tract status in 85 patients with over ten years of follow-up.
- Comparison with reported outcomes of colonic conduit diversions.
Main Results:
- 80% of patients with over ten years of follow-up showed improvement or preservation of upper tracts.
- Outcomes compare favorably with recently reported colonic conduit diversion series.
- Early and late complications were documented and strategies for minimization discussed.
Conclusions:
- Ileal conduit diversion remains a viable option for children with neuropathic bladders secondary to myelomeningocele.
- Long-term upper tract preservation is achievable with ileal conduit diversion.
- Careful patient selection and management can minimize complications.
Abstract:
In recent years ileal conduit diversion for children with neuropathic bladders secondary to myelomeningocele has been performed less frequently than previously, mainly because of reports of long term upper tract deterioration in these patients. The results of this series of 144 ileal conduit urinary diversions show that in the 85 children diverted for more than ten years, there has been improvement or preservation of their upper tracts in 80%. This compares favourably with the results of a recently reported series of colonic conduit diversions and consequently we feel that there is still a place for ileal conduit diversion in this group of patients. The early and late complications are described and means of minimising these are discussed.
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