Ileal conduit urinary diversion in children: computer analysis of followup from 2 to 16 years.
A 2 to 16-year followup of 96 ileal conduit urinary diversions in children is discussed. To assess the effect of time on renal function and structure we divided the patients into recent and remote operative groups. Patients with a longer followup (average 11.3 years) had a significantly greater incidence of pyelographic deterioration, particularly from preoperative normal status, compared to patients in the short followup group (average 4.5 years). Preoperative pyelonephritis was associated with a small but significant percentage of patients who progressed to poor renal function. Three potentially preventable and correctable late complications--stomal stenosis, excessive conduit length and ureteroileal obstruction--were associated with significant long-term deterioration in either renal function or pyelographic appearance. By using ileal conduit urinary diversion in children we attempt to provide a lifelong solution to urologic and social problems. The pyelographic deterioration rates would suggest that the solution is not perfect. Alternative forms of treatment need similar assessment for comparison. Patients who have ileal conduit urinary diversion need vigilant lifelong followup with accurate assessment of renal function, infection and pyelographic status to prevent or arrest renal deterioration.
D001806:Blood Urea Nitrogen; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D007415:Intestinal Obstruction / Q000453:epidemiology; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology; D007677:Kidney Function Tests; D011183:Postoperative Complications / Q000453:epidemiology; D011704:Pyelonephritis / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D011859:Radiography; D001745:Urinary Bladder Diseases / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000601:surgery; D014547:Urinary Diversion / Q000009:adverse effects