Continent Catheterizable Vesicostomy: An Alternative Surgical Modality for Pediatric Patients With Large Bladder Capacity

Peard, Leslie; Fox, Patrick J.; Andrews, William; Chen, Roger; McCraw, Casey O.; Klaassen, Zachary; Neal, Durwood E.

doi:10.1016/j.urology.2016.03.018

Cited by 4 publications

(1 citation statement)

References 20 publications

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“…In our institution, we suggest that parents use saline solution for more aggressive bladder irrigation once a day for preventing urolithiasis. The pathological condition with the largest number of complications was exstrophy-epispadias complex, which is different if compared to numerous other studies, where it was more common in patients with the posterior urethral valve or central nervous system anomalies [17,18].…”

Section: Discussioncontrasting

confidence: 63%

Long-term outcomes of catheterizable continent urinary diversion in children

et al. 2020

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Introduction/Objective The use of bladder augmentation and/or continent urinary diversion has gained wide acceptance, particularly in children with small, abnormally developed bladder or high-pressure bladder that poses great risk for renal deterioration and incontinence. We discuss indications, results, and complications with various types of continent vesicostomy (CV) in children. Methods Sixty-eight patients with CV are retrospectively reviewed (51 boys and 17 girls) 1987-2008. The median follow-up time was 17.8 years (3-22 years). CV included appendicovesicostomy in 31 (41.3%), vesicostomy with distal ureter in 27 (36.0%), and preputial CV in 10 (13.3%) patients. CV in patients with augmented bladder was in 18 (26.47%) children. The indications for performing CV were various types of neurogenic and myogenic dysfunctions of urine bladder with incontinence due to the following pathoanatomical substrates: anomalies of the brain-spine segment development (27), bladder exstrophy (10), posterior urethral valve (15), expansive processes (4), and other anatomical defects in 12 patients. Results Continence was achieved in 94.64% of the cases, without statistically significant difference between particular types of the stoma (p = 0.065). Early complications included stoma necrosis, stoma bleeding, peristomal infection in 5/68 (7.35%) patients, and late complications included calculosis, in 20/68 (29.4%), stomal stenosis, in 8/68 (11.5%), and difficulties of catheterization, in 3/68 patients (4.08%). Calculosis was predominant in appendicovesicostomy (p = 0.012). Conclusion CV is a safe procedure applied with the main purposes of achieving continence, preservation of renal function, and improvement of the quality of life, along with an acceptably low rate of complications.

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Section: Discussioncontrasting

confidence: 63%