Related Experiment Videos
The modified rectal bladder in children: long-term follow-up
M S Dawaba1, A Dawood, M A Ghoneim
1Urology and Nephrology Center, Mansoura, Egypt.
Insights
This study highlights the modified rectal bladder as a safe and effective urinary diversion for children. The procedure ensures daytime and nighttime continence and preserves upper tract function, making it ideal for long-term pediatric care.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Urinary Diversion Techniques
Background:
- Urinary diversion in children requires strict evaluation due to long life expectancy.
- The modified rectal bladder procedure offers a potential solution for long-term urinary diversion needs.
Purpose of the Study:
- To report the experience and outcomes of a modified rectal bladder procedure in pediatric patients.
- To evaluate the efficacy and safety of this technique for long-term urinary diversion.
Main Methods:
- A cohort of pediatric patients underwent a modified rectal bladder procedure.
- Follow-up included assessment of continence, upper tract function via urography, and metabolic/growth parameters.
Main Results:
- All patients achieved daytime and nighttime continence.
- Urography confirmed normal upper urinary tracts without reflux.
- Metabolic status and growth rates were within normal limits; renal pelvis urine samples were sterile.
Conclusions:
- The modified rectal bladder with an ileal intussusception valve is a highly effective urinary diversion for children.
- This technique demonstrates excellent long-term outcomes, including continence and preservation of renal function.
Abstract:
The criteria for evaluation of urinary diversion procedures in children must be strict since their life expectancy is long. Our experience with the modified rectal bladder in children with considerable follow-up periods is reported herein. All patients were continent by day and night. Urography studies revealed a normal upper tract in all cases. Three early complications were encountered among patients who had a submucous tunnel reimplantation. Reflux to the proximal colon or the kidneys was not demonstrated. The metabolic status and growth-rate patterns of these patients were within normal limits without alkaline therapy. All urine samples aspirated from the renal pelves were sterile. We conclude that a modified rectal bladder with a second ileal intussusception valve is the operation of choice whenever urinary diversion in children is indicated.