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Ureterosigmoidostomy in bladder exstrophy.

D H Frohneberg, R Hohenfellner, E Straub

    European Urology
    |January 1, 1983
    PubMed
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    Ureterosigmoidostomy with reflux prevention is an excellent choice for urinary diversion in bladder exstrophy cases. This technique shows great long-term results for the upper urinary tract, continence, and psychological well-being.

    Area of Science:

    • Pediatric Urology
    • Surgical Reconstruction

    Background:

    • Bladder exstrophy is a complex congenital anomaly requiring urinary diversion.
    • Ureterosigmoidostomy (US) is a potential surgical option, but concerns regarding reflux and long-term outcomes exist.

    Purpose of the Study:

    • To review the long-term outcomes of ureterosigmoidostomy (US) with a reflux prevention technique in patients with bladder exstrophy.
    • To evaluate the efficacy of this technique regarding upper urinary tract morphology, continence, and psychosocial development.

    Main Methods:

    • Retrospective review of 48 cases of bladder exstrophy.
    • 38 cases underwent ureterosigmoidostomy (US) with a reflux prevention technique.
    • Follow-up extended up to 14 years.

    Main Results:

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    • Excellent outcomes were observed in the upper urinary tract morphology.
    • Patients demonstrated good continence, psychological development, and social behavior.
    • Patients were considered healthy within their families.

    Conclusions:

    • Ureterosigmoidostomy (US) with reflux prevention is the preferred operation for urinary diversion in benign bladder exstrophy cases, ideally performed in the second year of life.
    • Annual sigmoidoscopy, alongside routine upper tract and metabolic monitoring, is recommended postoperatively.