Complications after bladder augmentation or substitution in children: a prospective study of 86 patients.
BJU Int
; 108(2): 282-9, 2011 Jul.
Article
em En
| MEDLINE
| ID: mdl-21070584
ABSTRACT
OBJECTIVE:
⢠To evaluate complications after urinary bladder augmentation or substitution in a prospective study in children. PATIENTS ANDMETHODS:
⢠Data of 86 patients who underwent urinary bladder augmentation (80 patients) or substitution (6 patients) between 1988 and 2008 at the authors' institute were analysed. ⢠Ileocystoplasty occurred in 32, colocystoplasty in 30 and gastrocystoplasty in 18. Urinary bladder substitution using the large bowel was performed in six patients. ⢠All patients empty their bladder by intermittent clean catheterization (ICC), 30 patients via their native urethra and 56 patients through continent abdominal stoma. Mean follow-up was 8.6 years. ⢠Rate of complications and frequency of surgical interventions were statistically analysed (two samples t-test for proportions) according to the type of gastrointestinal part used.RESULTS:
⢠In all, 30 patients had no complications. In 56 patients, there were a total of 105 complications (39 bladder stones, 16 stoma complications, 11 bowel obstructions, 5 reservoir perforations, 7 VUR recurrences, 1 ureteral obstruction, 4 vesico-urethral fistulae, 4 orchido-epididymitis, 4 haematuria-dysuria syndrome, 3 decreased bladder capacity/compliance, 3 pre-malignant histological changes, 1 small bowel bacterial overgrowth and 7 miscellaneous). ⢠In 25 patients, more than one complication occurred and required 91 subsequent surgical interventions. Patients with colocystoplasty had significantly more complications (P < 0.05), especially more stone formation rate (P < 0.001) and required more post- operative interventions (P < 0.05) than patients with gastrocystoplasty and ileocystoplasty.CONCLUSIONS:
⢠Urinary bladder augmentation or substitution is associated with a large number of complications, particularly after colocystoplasty. ⢠Careful patient selection, adequate preoperative information and life-long follow-up are essential for reduction, early detection and management of surgical and metabolic complications in patients with bladder augmentation or substitution.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Derivação Urinária
/
Incontinência Urinária
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Bexiga Urinária
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Coletores de Urina
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Risk_factors_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Humans
Idioma:
En
Revista:
BJU Int
Assunto da revista:
UROLOGIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Hungria