Long-term followup of children with colon conduit urinary diversion and ureterosigmoidostomy.
Sixty-four children underwent colon conduit urinary diversion because of a neurogenic bladder owing to myelomeningocele and 39 children required a ureterosigmoidostomy because of bladder exstrophy. The average length of followup was 4.6 years after colon conduit and 5.6 years after ureterosigmoidostomy. Colon conduit diversion was secondary in 3 children and ureterosigmoidostomy was secondary in 5. Of the children with a colon conduit 9.4% and of those with ureterosigmoidostomy 12.8% had postoperative surgical complications. Late surgical complications were encountered after colon conduit in 14.5% and after ureterosigmoidostomy in 20%. Of the children with normal renal function preoperatively 8.3% showed late deterioration after colon conduit and 8.7% after ureterosigmoidostomy. Conversely, only 16.7% with impaired renal function preoperatively did not improve at long-term followup after colon conduit. Of the renoureteral units 91% were normal after colon conduit and 95.2% were normal after ureterosigmoidostomy. The colon conduit halted the preoperative pyelonephritis in 74% of 31 affected kidneys.
D000293:Adolescent; D001746:Bladder Exstrophy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000601:surgery; D012809:Colon, Sigmoid / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008591:Meningomyelocele / Q000150:complications; D011183:Postoperative Complications; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods