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SHR Neuro Cancer Cardio Lipid Metab Microb
Kispal, Z; Balogh, D; Erdei, O; Kehl, D; Juhasz, Z; Vastyan, AM; Farkas, A; Pinter, AB; Vajda, P.
Complications after bladder augmentation or substitution in children: a prospective study of 86 patients.
BJU Int. 2011; 108(2): 282-289.
Doi: 10.1111/j.1464-410X.2010.09862.x
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- Leading authors Med Uni Graz
- Kispal Zoltan Farkas
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- Abstract:
- OBJECTIVE To evaluate complications after urinary bladder augmentation or substitution in a prospective study in children. PATIENTS AND METHODS 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 premalignant 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 postoperative 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.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Child -
- Child, Preschool -
- Epidemiologic Methods -
- Humans -
- Patient Selection -
- Postoperative Complications - etiology
- Urinary Bladder - surgery
- Urinary Catheterization -
- Urinary Diversion - adverse effects
- Urinary Incontinence - surgery
- Urinary Reservoirs, Continent - adverse effects
- Young Adult -
- Find related publications in this database (Keywords)
- urinary bladder augmentation
- substitution
- complication
- children
- adolescents