Urodynamic and clinical follow-up of 28 children after gastrocystoplasty.
OBJECTIVE
To determine the efficacy of gastrocystoplasty in creating a large and compliant urinary reservoir.


METHODS
Twenty-eight children (14 boys, 14 girls), with a median age of 9 years (range 4-17), were evaluated before and for a median of 2 years and 5 months after gastrocystoplasty. Evaluation included urodynamic and renal function studies and a survey of their post-operative complications and their sense of well-being. Renal function was assessed by ultrasound and serum creatinine, and electrolytes were measured.


RESULTS
After gastrocystoplasty bladder size increased, compliance improved, hydronephrosis decreased or was stable, and renal function remained stable. There were minimal complications and the children's subjective impression of their well-being was markedly improved.


CONCLUSIONS
Gastrocystoplasty, using our surgical technique, is a reliable method of creating a large and compliant urinary reservoir. Advantages include the absence of clinical urinary tract infections, the absence of mucus and the preservation of renal function. Complications, such as haematuria, dysuria and hypochloraemic alkalosis, might be avoided by excluding the antrum from the gastrocystoplasty, maintaining the child on a normal salt-containing diet, employing catheterization or buffering the urine in children with normal urethral sensation.
Bogaert
G A
GA
Department of Urology, University of California School of Medicine, San Francisco.
Mevorach
R A
RA
Kogan
B A
BA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011312:Pressure; D013270:Stomach / Q000637:transplantation*; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000601:surgery; D016476:Urinary Reservoirs, Continent; D014563:Urodynamics; D014741:Video Recording