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

• Published in: International Brazilian journal of urology 2009-08, Vol.35 (4), p.459-466
• Main Authors: Barbosa, Luiz L., Liguori, Riberto, Ottoni, Sergio L., Barroso Jr, Ubirajara, Ortiz, Valdemar, Macedo Junior, Antonio
• Format: Article
• Language: English
• Subjects: children; congenital anomalies; continence; urinary diversion
• ISSN: 1677-5538; 1677-5538; 1677-6119
• DOI: 10.1590/S1677-55382009000400010

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.