lleocystoplasty in Children:
Assessing Safety and Success

Krishna, Anurag; Gough, D. C. S.; Fishwick, Janet; Bruce, J.

doi:10.1159/000475126

Cited by 39 publications

(17 citation statements)

References 16 publications

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“…Reported rates of bladder perforation following augmentation range between 6-13% (9,22,(46)(47)(48)(49). Perforation occurs due to increased intravesical pressure, which may result from chronic bladder over-distention, chronic infection, traumatic catheterization, and ischemic necrosis of the intestinal segment used for the augmentation (50)(51)(52)(53)(54)(55)(56).…”

Section: Perforationmentioning

confidence: 99%

Long-Term Sequela of Pediatric Bladder Reconstruction

Roth

Keenan

Cain

et al. 2015

Curr Bladder Dysfunct Rep

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Children with refractory neurogenic bladder (NGB) who have failed maximal medical management are presented with options for bladder reconstruction. It is critical to understand the long-term sequela of bladder augmentation and bladder neck reconstruction to properly counsel families regarding these procedures. Benefits may include preservation of renal function, continence, reduced risk of renal-related mortality and potential improvements in quality of life (QOL). However, these advantages must be balanced with the risks of bladder calculi, perforation, need for additional surgery, acid/base disturbances, vitamin B12 deficiency and malignancy. Therefore, careful patient selection and preoperative counseling are paramount for those undergoing bladder reconstruction which includes intestinal bladder augmentation, as these patients require lifelong vigilant follow-up. IntroductionChildren with neurogenic bladders (NGB) are initially managed with clean intermittent catheterization (CIC) and anticholinergic medications in order to maintain a sizable, continent, and compliant urinary reservoir. Despite early and aggressive intervention, some patients undergo lower urinary tract reconstruction (bladder augmentation, catheterizable channel and/or bladder neck reconstruction) to protect their upper tracts and achieve continence. In a few select patients with favorable urodynamics (UDS) and low outlet resistance, a bladder neck procedure (BNP) can be performed without bladder augmentation to achieve continence. Myelodysplasia, specifically spina bifida (SB), remains the most common etiology of NGB in the pediatric population. Due to medical advances, particularly in the realm of Urology, more SB patients with bladder reconstruction are surviving into adulthood. We review current literature regarding long-term sequela of bladder reconstruction in pediatric patients with neurogenic bladder, with a primary focus on bladder augmentations for refractory NGB secondary to SB.

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Section: Perforationmentioning

confidence: 99%

Long-Term Sequela of Pediatric Bladder Reconstruction

Roth

Keenan

Cain

et al. 2015

Curr Bladder Dysfunct Rep

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“…The length of time from surgery to perforation can vary from the first few days following surgery to 6 years post-operatively (Metcalfe et al, 2006). Research evidence has been unable to clearly demonstrate whether the section of GI tract influences Abes et al, 2003 Diverse sample diagnosis Ahmed et al, 2002 Bladder extrophy sample Arikan et al, 2000 Diverse sample diagnosis Bertschy et al, 2000 Diverse sample diagnosis Blackburn et al, 2012 Bladder extrophy sample Blavias et al, 2005 Bladder augmentation as adult Boylu et al, 2006 Diverse sample diagnosis Chen and Kuo, 2009 Bladder augmentation as adult Chartier-Kastler et al, 2000 Bladder augmentation as adult Daher et al, 2007 Diverse sample diagnosis Feng et al, 2002 Bladder extrophy sample Franke et al, 2011 Diverse sample diagnosis Gerharz et al, 2003 Myelomeningocele diagnosis excluded Hamid et al, 2009 Vast age range up to old age, varied diagnoses Hendren and Hendren, 1990 Diverse sample diagnosis Herschorn and Hewitt, 1998 Bladder augmentation as adult Husmann and Rathburn, 2008 Diverse sample diagnosis Kalloo et al, 1997 Small sample with varying diagnosis and limited statistical analysis Kilic et al, 1999 Extrophy, posterior urethral value and cloacal anomaly sample Kockum et al, 1999 Diverse sample diagnosis Krishna et al, 1995 Diverse sample diagnosis with limited statistical analysis Lima et al, 2004 Bladder augmentation as adult Lopez Pereira et al, 2008 Results not discussed in relation to diagnosis and limited statistical analysis Mast et al, 1995 Diverse sample diagnosis, age range at time of surgery up to 54 years Obermayr et al, 2011 Diverse sample diagnosis Quek and Ginsberg, 2003 Number of sample had bladder augmentation as an adult Rosenbaum et al, 2008 Sample diagnosis not provided Taskinen et al, 2008a Cloacal sample Taskinen et al, 2008b Cloacal sample…”

Section: Bladder Perforation Following Augmentationmentioning

confidence: 99%

Bladder augmentation in children and young adults: a review of published literature

Doyle

Carter

Bray

et al. 2015

Int J of Uro Nursing

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The objective of this study is to review published literature on bladder augmentation in children and young adults (C&YA) with a neuropathic bladder following a neural tube defect or spinal cord injury to inform nursing practice and patient education. Medline, Embase, CINAHL, PsycINFO and the British Nursing Index were systematically searched to identify studies. The papers reviewed were case studies and medical note review in single centres regarding outcome and post-operative complications. This limits the generalisability of the findings surrounding outcome and risk of bladder augmentation surgery in C&YA. Evidence suggests irrigation has a role in ongoing bladder management to reduce complications such as bladder calculi. However, data are sparse regarding both appropriate irrigation solutions and the frequency of irrigation necessary to minimise calculi formation. A statistically significant increase is noted in the risk of perforation following bladder augmentation when associated with bladder neck surgery at the time of primary surgery. Limited evidence exists regarding longer term systemic implications of bladder augmentation, such as malignancy or impact on bone mineral density. None of the studies demonstrated an overall improvement in health-related quality of life (HRQoL) following bladder augmentation. Discrepancies exist between parental and children's HRQoL scores. Bladder augmentation is clinically the standard surgical treatment used to manage refractory neuropathic bladder. However, current evidence demonstrates no improvements to HRQoL following surgery and also describes various complications. Future research in this area is necessary to explore standards of care and most importantly long-term outcome measures from the patient and professional perspective.

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“…Dans la grande majorité des cas, un cathétérisme intermittent pluriquotidien est à associer [24]. Toutes les études retrouvent une amélio-ration significative de la capacité et de la compliance [18,19,[29][30][31][32][33][34] ainsi qu'une amélioration significative de la qualité de vie [35,36]. La continence urinaire de jour et de nuit est obtenue dans 70 à 95 % des cas [24,27,[36][37][38][39][40].…”

Section: Entérocystoplastie D'agrandissementunclassified

Traitements chirurgicaux des hyperactivités vésicales neurologiques

Peyrat

2010

Lett Med Phys Readapt

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Les traitements chirurgicaux des hyperactivités vésicales neurologiques sont réservés aux échecs des traitements médicaux, conservateurs. Le but de ces interventions est d'obtenir un réservoir vésical de bonne capacité qui se remplit à basse pression. Cela permet de diminuer les symptômes, de préserver le haut appareil urinaire et de diminuer les complications des vessies neurologiques. Plusieurs options thérapeutiques sont à décrire : les méthodes chirurgicales de dénervation vésicale, la détrusoromyomectomie, les entérocystoplasties avec ou sans dérivation urinaire continente et enfin les dérivations urinaires non continentes. Nous ne parlerons pas de la neuromodulation sacrée qui fera l'objet spécifiquement d'un article.Mots clés Hyperactivité vésicale neurologique · Traitement chirurgical · Haut appareil urinaire · Vessie neurologique · Détrusoromyomectomie · Entérocystoplastie Abstract Surgical treatment of neurogenic bladder hyperactivity is reserved for cases where conservative medical treatment has failed. The objective of such surgery is to obtain a bladder of adequate capacity, which fills at low pressure. This minimises symptoms, protects the upper urinary tract and reduces the complications of neurogenic bladder. There is a range of therapeutic options: surgical techniques for bladder denervation, detrusor myomectomy, enterocystoplasties with or without continent urinary diversion and, finally, non-continent urinary diversion procedures. We shall not discuss the technique of sacral neuromodulation, which will form the object of a separate article.

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lleocystoplasty in Children: Assessing Safety and Success

Cited by 39 publications

References 16 publications

Long-Term Sequela of Pediatric Bladder Reconstruction

Long-Term Sequela of Pediatric Bladder Reconstruction

Bladder augmentation in children and young adults: a review of published literature

Traitements chirurgicaux des hyperactivités vésicales neurologiques

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