Harnableitung bei Kindern

Abstract

For reconstruction of the urinary tract almost all bowel segments have been used. Today ileal and colonic segments are used for bladder augmentation, substitution, continent or incontinent urinary diversion. In patients with a competent anal sphincter and normal renal function, the rectosigmoid pouch is an option. Urinary diversion in the paediatric age group is mostly performed in patients with dilated upper urinary tracts. Consequently the complication rate is increased with reoperation rates of up to 42%.Incorporation of bowel segments into the urinary tract can have metabolic consequences. Each bowel segment has its own characteristic and specific complications. These relate to the acid-base balance, absorption of vitamins and reabsorption of bile acids (causing diarrhoea) from the small bowel. Due to the risk of secondary malignancies, lifelong surveillance of the patients is mandatory, especially in those with continent anal diversion and after bladder augmentation.