Quality of Life in Pediatric Patients with Continent Urinary Diversion—A Single Center Experience

Abstract

Background and Objectives: The advancement of surgical strategies in various types of urological conditions has resulted in improved functional outcomes, but the issues of patient perception and life quality remain difficult to assess, particularly in pediatric populations. We aimed to critically analyze the outcomes of urinary continent diversion in pediatric patients treated in our institution for various bladder conditions. Materials and Methods: We conducted a cross-sectional study, reviewing the records of patients treated for bladder evacuation problems between 2003 and 2014, and analyzing the data of those with continent urinary diversion. We used two types of questionnaires to assess the impact on life quality: the Qualiveen-30 and the SF-36 Health Survey. Results: The study included one hundred thirty-four patients with bladder conditions, and eight underwent urinary diversion, at a median age of 6.5 years. Seven of them, aged 10–23 years, completed questionnaires, with all seven scoring high on physical functioning scale but low on the social functioning scale. Conclusions: Continent urinary diversion remains the treatment of choice in well selected patients, but the results must be considered both in terms of functional outcomes and the impact on these patients’ emotional and mental health.

Early colonic-preparation and salvage laparoscopic appendectomy (ECSLA)- innovative protocol for the management of magnets ingestion

“…Nevertheless, the disadvantages of amputating a healthy appendix as opposed to performing an enterotomy without bowel resection should be weighed against salvage appendectomy. Appendectomy should be avoided in children with anorectal malformations or other medical conditions that are associated with fecal or urinary incontinence, as the appendix may be needed in such children as a urinary conduit or as a conduit for antegrade enemas [ 22 , 23 ]. In addition, a number of recent studies suggest that the appendix has several significant physiological roles, such as production of mesenchymal stem cells [ 24 ] and functioning as a reservoir for commensal bacteria [ 25 ].…”

2023 Canadian Urological Association/ Pediatric Urologists of Canada guideline: Pediatric patients with neurogenic lower urinary tract dysfunction

“…Continent urinary diversion as an effective and durable treatment can be offered to well-selected older pediatric NLUTD for whom transurethral CIC is not feasible. 84 Recent reports and reviews described that patients on continent catheterizable channels have a good overall quality of life and associated patient satisfaction; [85][86][87] However, relatively common long-term reintervention rates and comorbidities may need to be discussed preoperatively with the patient and family to ensure an informed decision. 88 Congregated evidence generated by the NICE and SBA guidelines, as well as recent reports, has shown that augmentation cystoplasty improves bladder capacity and reduced detrusor pressure, decreasing the likelihood of incontinence, specifically in older pediatric patients with NLUTD.…”

Medical Image Despeckling Using the Invertible Sparse Fuzzy Wavelet Transform with Nature-Inspired Minibatch Water Wave Swarm Optimization

“…The suggested method estimates the anatomical structures by resolving a constrained optimization problem that combines wavelet-domain sparsity and total variation (wavelet-TV) regularization in order to preserve the edges of retinal layers and lessen artifacts brought on by pure wavelet thresholding. To accomplish the goal function outlined in [ 17 , 18 ], we use a brand-new hybrid approach called the Randomized FireFly (FF) update in Lion Algorithm (RFU-LA), which includes components of both the Lion Algorithm (LA) and the FireFly Algorithm (FF). By taking the mean of images that have been routinely median-filtered using different kernel sizes, the hybrid median-mean filter (HM2F) proposed in [ 19 ] is a one-shot image processing method for decreasing speckle noise.…”