Techniques Used to Create Continent Catheterizable Channels: A Comparison of Long-term Results in Children

Polm, Pepijn D.; Kort, Laetitia M.O. de; Jong, Tom P.V.M. de; Dik, Pieter

doi:10.1016/j.urology.2017.08.030

Cited by 12 publications

(8 citation statements)

References 14 publications

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“…The incidence of the discussed complications varies widely depending on the series, the type of channel used, and the length of follow-up. In general, the incidence of stomal prolapse ranges from 2-5% while stomal incontinence 1-47%, difficulty in catheterization 5-32% and overall rates of surgical revision range from 18-58% [10][11][12][13]. We did not notice any mucosal prolapse and incontinence in our series but two patients (6.6%) had Mitrofanoff stomal stenosis and one patient (3.3%)had Malone stenosis.…”

Section: Discussionmentioning

confidence: 47%

Split Appendix Malone and Mitrofanoff for the Management of Neurogenic Bowel and Bladder

MI,

2022

austinjurol

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Purpose: To share our experience of neurogenic bowel and bladder management by creating Malone Antegrade Continent Enema (MACE) procedure and Continent Urinary Diversion (Mitrofanoff VQZ technique) at the same time by using split appendix. Material and Methods: Between July 2017 and December 2021, 30 patients; 5 to 15 years old (mean 9.54±2.65 years) underwent VQZ Mitrofanoff and MACE using split appendix with or without bladder augmentation forneurogenic bladder and bowel management secondary to myelomeningocele. Proximal part of appendix was used for MACE by taking 3 antireflux stitches by wrapping seromuscular layer of cecum around base of appendix whereas distal part of appendix is used for Mitrofanoff creating VQZ stoma. The average length of appendix taken was 9.5 cm (8-12 cm). Results: All the patients were kept clean and dry throughout and were followed up for an average of 15 months (12 to 30 months). Only one patient was reported with MACE stoma stenosis because she lost to follow up and didn’t use the stoma for a year, stoma revision was performed on her. Procedure time is also reduced in split appendix MACE and Mitrofanoff as compared to if monti tube or cecal flap is reconstructed for MACE. Conclusion: MACE and Mitrofanoff with or without bladder augmentation are very invaluable procedures for the management of neurogenic bowel and bladder. Split appendix is an ideal channel for both Mitrofanoff and MACE.

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Section: Discussionmentioning

confidence: 47%

Split Appendix Malone and Mitrofanoff for the Management of Neurogenic Bowel and Bladder

MI,

2022

austinjurol

View full text Add to dashboard Cite

show abstract

“…The incidence of these complications varies widely based on the series, the type of channel used, and the length of follow-up. In general, the incidence of stomal prolapse ranges from 2-5 %, stomal incontinence 1-47 %, difficulty catheterizing 5-32 % and overall rates of surgical revision range from 18-58 % [19][20][21][22]. We did not notice any mucosal proplase and stomal incontinence in our series but three patients had mitrofanoff stomal stenosis and one patient has Malone stenosis (22%) at one year follow up.…”

Section: Discussionmentioning

confidence: 48%

Augmentation Cystoplasty in Children: Institute of Kidney Diseases Peshawar Experience

Naeem¹,

Khan²,

Arsha³

et al. 2021

austinjurol

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Objective: The aim of this study is to share our single-center experience of Augmentation Cystoplasty (AC) in children regarding indications, bowel segment used, associated procedures, and its complications. Materials and Methods: We analyzed data of all pediatric patients who underwent AC at Institute of Kidney Diseases (IKD), Peshawar between July 2017 and March 2020. Results: A total of 18 pediatric patients are included in the study who underwent Bladder augmentation (BA) either isolated in 1 (5.5%), or along with other associated procedures like Mitrofanoff 17 (94.4%), Antegrade Continent Enema (ACE) 6 (33.3%), Bladder Neck Reconstruction (BNR) 5 (27.7%) and Bilateral ureteric Re-implantation (B/L UR) in 3 (16.6%). Indication for Bladder augmentation were Neurogenic bladder (NGB) 13 (72.2%), Exstrophy Epispadias Complex (EEC) 3 (16.6%) and Posterior urethral value with small functional capacity bladder 2 (11.1%). Small gut used in 15 (83.3%) and large gut in 3 (16.6%) for BA. For Mitrofanff associated with bladder augmentation, Appendix was used in 14 (82.35%) and small gut (Monti) in 3 (17.6%) cases. For ACE associated with BA, in 4 (66.6%) Appendix used as right-sided ACE and in 2 (33.3%) small gut (Monti) as left-sided ACE. No intraoperative complications noted, while early post-op complications, 2 wound infection and 1 urinary leakage from wound, were noted in 3(16.6%) cases and late post-op complications (stomal stenosis) in 4(22.2%) patients.

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“…Despite all efforts to improve the technique, stomal stenosis remains the most commonly reported complication in the literature, with a stenosis rate ranging from 6 to 39 percent [ 24 ]. However, in many cases, channel dilation or simple endoscopic procedures can be used to manage this conservatively [ 25 ], with complex revisions being sometimes required regardless of the conduct type (appendix, bowel, bladder flap), also taking into account that this type of surgery is aimed at growing bodies with changing pattern of body habits [ 26 , 27 ]. The findings are consistent with our research, which discovered a relatively high rate of complications such as stenosis, recurrent urinary tract infection, incontinence, and bladder stones.…”

Section: Discussionmentioning

confidence: 99%

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

Ciongradi

Benchia

Stupu

et al. 2022

IJERPH

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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.

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Techniques Used to Create Continent Catheterizable Channels: A Comparison of Long-term Results in Children

Cited by 12 publications

References 14 publications

Split Appendix Malone and Mitrofanoff for the Management of Neurogenic Bowel and Bladder

Split Appendix Malone and Mitrofanoff for the Management of Neurogenic Bowel and Bladder

Augmentation Cystoplasty in Children: Institute of Kidney Diseases Peshawar Experience

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

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