Long-term functional results of urinary tract reconstruction in childhood.
When reviewing the important long-term parameters of urinary tract reconstruction in childhood, one must consider the protection of renal function, maintenance of social continence and freedom from urinary tract infection as paramount. The 3-year assessment of 25 patients who underwent urinary tract reconstruction for a variety of underlying conditions is presented in terms of renal function, social continence and urinary tract sterility. The underlying pathological condition in our patients was weighted toward children with obstructive uropathy rather than neurogenic vesical dysfunction, and the most common form of diversion was an ileal conduit. Maintenance of renal function was achieved in 21 of our 25 patients (84 per cent). All 8 children (100 per cent) who underwent reconstruction for neurogenic vesical dysfunction have maintained preoperative renal function, while only 12 of the 17 children originally diverted for obstructive uropathy (75 per cent) have done well with reconstruction. Social continence with or without intermittent catheterization has been achieved in 23 of the 25 patients (92 per cent) and sterile urine has been maintained in 22 of the 25 patients (88 per cent). Factors involved in the success or failure of reconstruction are discussed, and observations toward future selection are made from this data base.
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007668:Kidney / Q000002:abnormalities / Q000503:physiopathology; D008297:Male; D013997:Time Factors; D014521:Urethra / Q000002:abnormalities; D014524:Urethral Obstruction / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000601:surgery; D014547:Urinary Diversion; D014552:Urinary Tract Infections / Q000517:prevention & control; D014554:Urination; D014718:Vesico-Ureteral Reflux / Q000601:surgery