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Initial experience using a catheterizable ileovesicostomy (Monti procedure) in children
M P Cain1, A J Casale, R C Rink
1James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis 46202, USA.
Urology
|November 4, 1998
Summary
The Monti ileovesicostomy provides a reliable continent catheterizable stoma in children, preserving the appendix for other procedures. This technique offers an excellent alternative for pediatric reconstructive surgery.
Area of Science:
- Pediatric Urology
- Surgical Reconstruction
Background:
- Continent catheterizable stomas are crucial for managing bladder emptying in children with complex urological conditions.
- The traditional appendicovesicostomy has limitations, particularly when the appendix is unavailable or inadequate.
Purpose of the Study:
- To review the experience with the Monti ileovesicostomy as an alternative continent catheterizable stoma in pediatric patients.
- To evaluate the efficacy and safety of the Monti technique in reconstructive urology.
Main Methods:
- A cohort of 13 children underwent Monti ileovesicostomy between January and December 1997.
- Procedures included simultaneous bladder augmentation, bladder neck reconstruction, and Malone antegrade continent enema (MACE).
- Patient diagnoses included neurogenic bladder, cloacal exstrophy, and cloacal anomaly.
Main Results:
- All 13 patients achieved continent stomas with successful catheterization.
- Mean follow-up was 7 months, with no stomal complications or issues related to the ileal channel.
- The Monti technique allowed appendix preservation for MACE in suitable cases.
Conclusions:
- The Monti ileovesicostomy is a viable new technique for creating continent catheterizable stomas in children.
- It offers a valuable option for pediatric reconstructive surgery, especially when the appendix is compromised.
- Early outcomes indicate excellent results for this innovative approach.