Complications of the Catheterizable Channel Following Continent Urinary Diversion: Their Nature and Timing

Abstract

Complications of the catheterizable channel are a frequent and challenging problem. They appear to occur throughout the life of the channel with most developing within the first 2 years. Further followup is required to assess the performance and durability of continent catheterizable channels in children as patients progress to adulthood.

Long-term outcomes of catheterizable continent urinary channels: What do you use, where you put it, and does it matter?

“…While we agree that most channel complications occur early, [8,10,20] they can occur throughout the channel lifetime. The last revision in our study occurred at 15.1 years.…”

“…[5] When comparing APV and Monti techniques, at least 10 small series reported similar short-term rates of subfascial revisions. [6][7][8][9][10][11][12][13][14][15] Our initial series of urinary channels demonstrated more complications among APV than Monti channels, but the APV group had much longer follow-up. [16] Despite several decades of use, no direct comparison of long-term results of APV and Monti channels exists.…”

“…[17] We identified 10 series reporting rates of complications and reoperations in APV and Monti channels to be similar. [6][7][8][9][10][11][12][13][14][15] Our initial report of short-term outcomes of 100 catheterizable channels noted higher complications in APV than Monti (21% vs. 10%), but the APV group had longer follow-up (2.5 vs. 0.8 years). [16] Similar to our initial report, previous studies presented short-term results at median follow-up of 2-4 years in a small number of channels, particularly Monti channels, and did not correct for differential follow-up time.…”

“…One group successfully managed 82% of channel complications with endoscopic or stomal procedures. [8] In addition, we did not capture patients who were lost to follow-up and possibly developed complications. While the absolute risk of subfascial complications may possibly change if those patients were included, we attempted to control for this through survival analysis.…”

Langetermijn follow-up van katheteriseerbare vesicostoma’s bij kinderen, een vergelijking van verschillende technieken

“…Zeer regelmatig is chirurgische revisie nodig vanwege stenosering, vorming van een fausse route, sacculatie of incontinentie. In de literatuur zijn complicaties beschreven van zowel Mitrofanoff-, Monti-als Boari-stoma's [7][8][9][10][11][12][13][14]. De complicaties die zich voordoen bij de verschillende technieken zijn echter nooit met elkaar vergeleken.…”