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Órgano Oficial de el Colegio Mexicano de Urología

2003, Number 3

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Bol Col Mex Urol 2003; 18 (3)

Augmentation cystoplasty in urinary reconstruction, experience in 79 pediatric patients

García TVX, García LGJM, Sánchez VG

Language: Spanish
References: 39
Page: 113-122
PDF size: 872.20 Kb.


ABSTRACT

Antecedents: Augmentation cystoplasty has been design for the reconstruction of the genitourinary tract with the goal to diminish the bladder pressure, increase its capacity, avoid renal damage and improve the continence. Seventy nine pediatric patients who underwent augmentation cystoplasty between the years 1991 trough 2001 were studied, the main pathologies were high-pressure bladder, low capacity and urinary incontinence. Objective: To investigate the diagnosis, bladder behavior, the tissue used in the surgery, surgeries related to the reconstruction, as well of the long term results and complications. Results: Seventy nine patients were studied, a mean follow up of 63 months (6-120), average age of 9 years (3-16), 50 females (63%) and 29 males (37.8%), the main diagnosis were mielodysplasia (65.5%), secondary to urethral valves (15.1%), Hinman syndrome (7.5%), bladder exstrophy (5%), sacrum agenesis (3.7%), and others (2.5%). For the reconstruction sigmoid was used in 51.6%, ileum 17.6%, cecal portion in 5%, ureter 20.1% and peritoneum in 5%. 44.1% needed continence surgery, 35.2% abdominal catheterizable stomas, 59 ureteral reimplantation were practice, 6 trans ureter ureter anastomosis, 11 nefrectomies and 2 pilostomies. The effectiveness was reported of 83% managing to diminish the bladder pressure to 35 cm, improve the capacity to 200% and continence for a period of 4 hours. The complications were reported as 22.6%. Conclusions: Augmentation cystoplasty is essential in the reconstruction of the urinary tract of patients with high bladder pressure. The segment used must be individualizing in every case. Its difficult to make a reasonable comparison between the segment used, but we do not observe reasonable difference among them when they are chosen for the right case, as well of the surgeries performed to accomplish and finish the urinary reconstruction.


REFERENCES

  1. Lapides J, Diokno A. Further observations on self-catheterization in the treatment of urinary tract disease. J Urol 1972; 107: 458.

  2. Mitchell M. Use of bowel in undiversion. Urol Clin North Am 1986; 13: 349.

  3. Arikan N, Turkolmez K, Budak M. Outcome of augmentation sigmoidocystoplasty in children with neurogenic bladder. Urol Int 2000; 64(2): 82-5.

  4. Herschorn S, Herwitt RJ. Patient perspective of long-term outcome of augmentation cystoplasty for neurogenic bladder. Urology 1998; 52(4): 672.

  5. Martínez M, López P, Martínez U, Jaureguizar M. Bladder augmentation in reconstruction of the urinary tract. Cir Paediatr 1999; 12(3): 94-8.

  6. Gill IS, Rackley RR, Meraney AM, Marcello PW. Laparoscopic enterocystoplasty. Urology 2000; 55(2): 178-81.

  7. Shekarriz B, Upadhyay J, González R. Surgical complications of bladder augmentation: comparison between various enterocystoplasties in 133 patients. Urology 2000; 55(1): 123-8.

  8. Macdougal WS. Metabolic complication of urinary intestinal diversion. J Urol 1992; 147: 1199.

  9. Bruce B, Snider HM. Litogenic properties of enterocystoplasty. J Urol 1996; 148: 575-9.

  10. Filmer RB, Spencer JR. Malignant in bladder augmentation and intestinal conduits. J Urol 1996; 143: 675.

  11. Shaw J, Lewis MA. Bladder augmentation surgery-what about the malignant risk? Eur J Pediatr 1999; 9 (Suppl 1): 39-40.

  12. Bogaert GA, Mevorach RA, Kim J. The physiology of gastrocystoplasty: once a stomach, always a stomach. J Urol 1995; 153: 1977-80.

  13. Kurzrock EA, Baskin LS, Kogan BA. Gastrocystoplasty: long term follow-up. J Urol 1998; 160 (6 pt 1): 2182-6.

  14. Bellinger MF. Ureterocystoplasty: unique method for vesical augmentation in children. J Urol 1993; 149: 811-13.

  15. Talic RF. Augmentation ureterocystoplasty with ipsilateral renal preservation in the management of patients with compromised renal function secondary to dysfunctional voiding. Int Urol Nephol 1999; 31(4): 463-70.

  16. Zubieta R, Escala JM, Castellan M. Clinical and urodynamic evaluation after ureterocystoplasty with different amounts of tissue. J Urol 1999; 162 (3 pt 2): 1129-32.

  17. Gosalbez R Jr, Kim CO Jr. Ureterocystoplasty with preservation of ipsilateral renal function. Pediatr Surg 1996; 31(7): 970-5.

  18. Churchill BM, Aliabadi H. Ureteral bladder augmentation. J Urol 1993; 150: 716-20.

  19. Landau EH, Lanyanthi VR. Bladder augmentation: Ureterocystoplasty versus iliocystoplasty. J Urol 1994; 152: 7l6-19.

  20. Reimberg Y, Allen RC. Nefrectomy combined with lower abdominal extraperitoneal ureteral bladder augmentation in the treatment of children with the vesicoureteral reflux dysplasia syndrome. J Urol 1995; 153: 177-79.

  21. Wolf JS, Turson CW. Augmentation ureterocystoplasty. J Urol 1993; 150: 1095-98.

  22. García De León JM, Angulo A. Cistoplastía de aumento con uréter: Una alternativa. Col Mex Urol 1997; 14: 183-87.

  23. García De León JM, Angulo A. Versatilidad de la cistoplastía de aumento con segmentos ureterales en prensa. Bol Mex Urol

  24. Kilic N, Celayir S, Elicevik M. Bladder augmentation: Urodynamic findings and clinical outcome in different augmentation techniques. Eur J Pediatr Surg 1999; 9(1): 29-32.

  25. Weingarten JL, Cromie WJ. Augmentation myoperitoneocystoplasty. J Urol 1990; 144(1): 156-8.

  26. Oge O, Tekgul S, Ergen A. Urothelium preserving augmentation cystoplasty cover with a peritoneal flap. B J Urol Int 2000; 85(7): 802-5.

  27. Carr MC, Docim SG, Mitchell ME. Bladder augmentation with urothelial preservation. J Urol 1999; 162(3pt 2): 1133-6.

  28. Dayanc M, Kilciler M, Tan O. A new approach to bladder augmentation in children: Seromuscular enterocystoplasty. B J Urol Int 1999; 84(1): 103-7.

  29. Morioka A, Miyano T, Ando K. Management of vesicoureteral reflux secondary to neurogenic bladder. Pediatr Surg Int 1998; 13(8): 584-6.

  30. Cain MP, Casale AJ, King SJ. Appendecovesicostomy and newer alternatives for Mitrofanoff procedure: Results in the last 100 patients. J Urol 1999; 162(5): 1749-52.

  31. Castellan MA, Gosalbez R Jr. Clinical applications of Monty procedure as a continent catheterizable stoma. Urology 1999; 54(1): 152-6.

  32. Miller EA, Mayo M. Simultaneous augmentation cystoplasty and artificial urinary sphincter placement: Infection rates and voiding mechanisms. J Urol 1998; 160(3): 750-2.

  33. Clementson KC, Heilen I, Malmberg L. Pediatric urinary tract reconstruction using intestine. Scand J Urol Nephrol 1999; 33(1): 53-6.

  34. Tekgul S, Oge O, Boal K. Ureterocystoplasty: an alternative reconstructive procedure to enterocystoplasty in suitable cases. J Pediatric Surg 2000; 35(4): 577-9.

  35. Glassberg KI. The valve bladder syndrome: 20 years later. J Urol 2001; 166(4): 1406-14.

  36. Garignon C, Mure PY, Paparel P. Hinman’s syndrome. Presse Med 2001; 30(39-40 Pt 1): 1918-23.

  37. Flood HD, Malhotra SJ. Long term results and complications using augmentation cystoplasty in reconstructive urology. Neurol Urodyn 1995; 14(4): 297-309.

  38. Koo HP, Bunchman TE. Renal transplantation in children with severe urinary tract dysfunction. J Urol 1999; 161(1): 240-5.

  39. Yamazaki Y, Tanabe K. Renal transplantation into augmented bladders. Int J Urol 1998; 5(5): 423-7.




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