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DOI: 10.1055/s-0029-1224654
© Georg Thieme Verlag Stuttgart ˙ New York
Ureterocystoplasty: An Ideal Method for Vesical Augmentation in Children
Ureterozystoplastie: Eine ideale Methode zur Harnblasenaugmentation bei KindernPublication History
Publication Date:
21 January 2010 (online)
Abstract
Background: Inadequate therapy endangers upper urinary tract function in children with low compliance bladders. We report our approach of increasing bladder compliance using the patients own (mega)-ureter for bladder augmentation. Patients: A total of 8 children underwent ureterocystoplasty. The etiology of bladder non-compliance and the need for augmentation was neurogenic in 5 children, posterior urethral valves in 2 children and in one child the situation after repeated antireflux surgery. In all patients the kidney of the used ureter was functionless. Surgery was done through a transperitoneal approach. After nephrectomy, the renal pelvis and the ureter were spatulated and sutured into the bladder incision. An additional MACE stoma was made in 3 patients, antireflux surgery for the contralateral kidney was necessary in 2 patients and one patient underwent stone removal in the remaining kidney. In 1 patient the ureter was used as a free transplant and was covered by an omental flap. In addition, a simultaneous living donor kidney transplant was performed (case 2). Results: Bladder capacity and compliance improved significantly in all patients. The function of the ureter which was used as a free transplant showed good clinical results. The longest follow-up is 8 years. Conclusion: Ureterocystoplasty is a useful and metabolically neutral alternative to bowel segments. In patients with only one functioning kidney and a contralateral megaureter, ureterocystoplasty is the treatment of choice in our institution.
Key words
ureterocystoplasty - bladder augmentation - ureter
References
- 1 Bellinger M F. Ureterocystoplasty update. World J Urol. 1998; 16 251-254
- 2 Bellinger M F. Ureterocystoplasty: a unique method for vesical augmentation in children. J Urol. 1993; 149 811-813
- 3 Carneiro P M, Binyamini J, Sofer M et al. Augmentation ureterocystoplasty: is it the preferred choice?. East Afr Med J. 2005; 82 247-249
- 4 Cartwright P C, Snow B W. Bladder autoaugmentation: early clinical experience. J Urol. 1989; 142 505-508 , discussion 520–501
- 5 Churchill B M, Aliabadi H, Landau E H et al. Ureteral bladder augmentation. J Urol. 1993; 150 716-720
- 6 Eckstein H BMM. Uretero-Cystoplastik. Aktuel Urol. 1973; 4 255-277
- 7 Gilbert S M, Hensle T W. Metabolic consequences and long-term complications of enterocystoplasty in children: a review. J Urol. 2005; 173 1080-1086
- 8 Gurocak S, De Gier R PE, Feitz W. Bladder augmentation without integration of intact bowel segments: critical review and future perspectives. The Journal of Urology. 2007; 177 839-844
- 9 Haferkamp A, Melchior D, Schumacher S et al. [Ureterocystoplasty: functional results and possible problem areas]. Urologe A. 2003; 42 954-959
- 10 Hinman F. Atlas of Urosurgical Anatomy. Oxford: W. B. Saunders; 1993
- 11 Husmann D A, Snodgrass W T, Koyle M A et al. Ureterocystoplasty: indications for a successful augmentation. J Urol. 2004; 171 376-380
- 12 Mills R D, Studer U E. Metabolic consequences of continent urinary diversion. J Urol. 1999; 161 1057-1066
- 13 Mitchell M E. Bladder augmentation in children: where have we been and where are we going?. BJU Int. 2003; 92 Suppl 1 29-34
- 14 Pascual L A, Sentagne L M, Vega-Perugorria J M et al. Single distal ureter for ureterocystoplasty: a safe first choice tissue for bladder augmentation. J Urol. 2001; 165 2256-2258
- 15 Perovic S V, Djordjevic M L, Kekic Z K et al. Bladder autoaugmentation with rectus muscle backing. J Urol. 2002; 168 1877-1880
- 16 Perovic S V, Djordjevic M L, Kekic Z K et al. Detrusorectomy with rectus muscle hitch and backing. J Pediatr Surg. 2003; 38 1637-1641
- 17 Podesta M, Barros D, Herrera M et al. Ureterocystoplasty: videourodynamic assessment. J Urol. 2006; 176 1721-1725
- 18 Wolf Jr J S, Turzan C W. Augmentation ureterocystoplasty. J Urol. 1993; 149 1095-1098
- 19 Zubieta R, de Badiola F, Escala J M et al. Clinical and urodynamic evaluation after ureterocystoplasty with different amounts of tissue. J Urol. 1999; 162 1129-1132
Prof. Dr. med. Dr. h. c. S. C. Müller
Klinik u. Poliklinik für Urologie · Universität Bonn
Sigmund-Freud-Str. 25
53105 Bonn
Phone: 02 28 / 2 87-1 41 80 und -1 41 81
Fax: 02 28 / 2 87-1 41 85
Email: Stefan.Mueller@ukb.uni-bonn.de