[Bladder exstrophy: a neonatal emergency. II: Urinary diversion].
The goal of the therapy involving the children with exstrophy of bladder must include urinary continence, protection of renal function and a good quality of life. Primary closure of the bladder would seem to be the ideal solution, but when it is impossible or fails, ureterosigmoidostomy can provide satisfactory solution. We have treated 15 selected exstrophied patients with ureterosigmoidostomy. The average length of follow up was 8 years and 9 months (range is from 19 years to 18 months). All patients have normal renal function; in 13 patients upper urinary tract is normal and two have a moderate ureteral dilatation. In 13 patients the fecal and urinary continence is complete, in two it's acceptable. We report radiological and manometric studies of the rectum and sigma after ureterosigmoidostomy. The long term results are excellent; it is mandatory to have correct indications, meticulous care in the operative technique producing a long submucosal tunnel with direct anastomosis of the ureter to the bowel, post operative management and follow up care.
Divisione di Chirurgia Pediatrica, Sezione di Urologia, Ospedale Regionale di Vicenza, Italia.
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Belloli
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Campobasso
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Musi
D000293:Adolescent; D001746:Bladder Exstrophy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery; D004630:Emergencies; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008365:Manometry; D011859:Radiography; D012007:Rectum / Q000000981:diagnostic imaging / Q000502:physiology; D014547:Urinary Diversion
L'estrofia vescicale: una urgenza neonatale. Parte II: Le derivazioni urinarie.