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Sigmoid "tail" modification for bladder augmentation

R Mathews1, S Docimo, J P Gearhart

  • 1Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Urology
|April 1, 1997
PubMed
Summary
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This study introduces a modified sigmoid colon bladder augmentation technique for children, improving catheterizable stoma function. The sigmoid "tail" procedure enhances ease of catheterization and continence, with good patient outcomes.

Area of Science:

  • Pediatric Urology
  • Surgical Innovation
  • Bladder Reconstruction

Background:

  • The sigmoid colon is suitable for bladder augmentation, especially for ureteral reimplantation or Mitrofanoff valve procedures.
  • Existing techniques can be improved for better catheterization and reimplantation ease.

Purpose of the Study:

  • To present a modified sigmoid colon bladder augmentation technique (sigmoid "tail")
  • To enhance ease of catheterization and ureteral reimplantation.
  • To assess the durability and efficacy of the modified technique.

Main Methods:

  • Seven pediatric patients underwent sigmoid "tail" bladder augmentation.
  • A 3-5 cm nondetubularized sigmoid segment was used, fixed to the abdominal wall.
  • Appendix or tapered ileum created the catheterizable stoma.

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Main Results:

  • All patients achieved daytime and nighttime dryness with intermittent catheterization.
  • One patient experienced mild leakage managed with pseudoephedrine.
  • One patient developed postoperative bowel obstruction and abscess.

Conclusions:

  • The sigmoid "tail" modification is safe and effective for bladder augmentation.
  • Fixing the short sigmoid segment stabilizes the stoma, improving catheterization.
  • This technique does not appear to increase morbidity.