Elective appendicovesicostomy in association with Monfort abdominoplasty in the treatment of prune belly syndrome

• Published in: International Brazilian journal of urology 2006-12, Vol.32 (6), p.689-696
• Main Authors: Liguori, Riberto, Barroso, Jr, Ubirajara, Matos, Joao T, Ottoni, Sergio L, Garrone, Gilmar, Demarchi, Guilherme T, Ortiz, Valdemar, Macedo, Jr, Antonio
• Format: Article
• Language: English
• Subjects: Abdominal Muscles - surgery; Adolescent; Appendectomy - methods; bladder; Child; Child, Preschool; Elective Surgical Procedures; Humans; Infant; Male; Patient Satisfaction; Postoperative Complications; prune belly syndrome; Prune Belly Syndrome - surgery; Reconstructive Surgical Procedures; surgical procedures, operative; Urinary Catheterization; Urinary Diversion - methods; urinary tract infections; Urinary Tract Infections - prevention & control
• ISSN: 1677-5538; 1677-5538; 1677-6119
• DOI: 10.1590/s1677-55382006000600010

To evaluate the role of elective appendicovesicostomy in association with Monfort abdominoplasty to avoid urinary tract infection (UTI) and renal damage in the post-operative follow-up of patients with prune belly syndrome. We followed 4 patients operated in our institution (UNIFESP) (Monfort, orchidopexy and Mitrofanoff) and compared them to 2 patients treated similarly, but without an appendicovesicostomy, in a second institution (UFBA). We evaluated postoperative clinical complications, UTI and preservation of renal parenchyma. Patients were followed as outpatients with urinalysis, ultrasonography (US) and occasionally with renal scintigraphy. Mean follow-up was 23.5 months. Immediate post-operative course was uneventful. We observed that only one patient with the Mitrofanoff channel persisted with UTI, while the 2 patients used as controls persisted with recurrent pyelonephritis (> 2 UTI year). Our data suggest that no morbidity was added by the appendicovesicostomy to immediate postoperative surgical recovery and that this procedure may have a beneficial effect in reducing postoperative UTI events and their consequences by reducing the postvoid residuals in the early abdominoplasty follow-up. However, we recognize that the series is small and only a longer follow-up with a larger number of patients will allow us to confirm our suppositions. We could not make any statistically significant assumptions regarding differences in renal preservation due to the same limitations.