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Is continent urinary diversion feasible in children under five years of age?

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Summary:Purpose: To review our clinical experience with urinary continent catheterizable reservoir in children under five years of age. Materials and Methods: A total of 23 patients (16 males, 7 females) with a median age of 3.64 years were evaluated. Among these, 6 (26.08%) had a posterior urethral valve, 9 (39.13%) myelomeningocele, 4 (17.39%) bladder exstrophy, 2 (8.69%) genitourinary rabdomyosarcoma, 1 (4.34%) had spinal tumor and 1 (4.34%) an ano-rectal anomaly. Results: Perioperative complications were observed in four patients consisting of one febrile urinary tract infection, one partial operative wound dehiscence, one partial stomal dehiscence and one vesico-cutaneous fistula after a secondary exstrophy repair. The overall long-term complications rate was 40.90% and consisted of two stomal stenoses (9.09%), one neobladder mucosal extrusion (4.54%), three neobladder calculi (13.63%) and persistence of urinary incontinence in three patients (13.63%). The overall surgical revision was 36.36% and final continence rate was 95.45% with mean follow-up of 39.95 months Conclusion: Continent urinary diversion is technically feasible even in small children, with acceptable rates of complications.
Main Authors:Barbosa,Luiz L.
Other Authors:Liguori,Riberto; Ottoni,Sergio L.; Barroso Jr,Ubirajara; Ortiz,Valdemar; Macedo Junior,Antonio
Subject:children congenital anomalies urinary diversion continence
Year:2009
Country:Brazil
Document type:article
Access type:open access
Associated institution:IBICT
Language:English
Origin:Oasisbr

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