Colonic conduit in children: protection of the upper urinary tract 16 years later?
OBJECTIVE
Complication rates of up to 86.6% have been reported after creation of an ileal conduit. In contrast to others, we construct an antirefluxing isoperistaltic colonic for incontinent diversion in children.


METHODS
Between 1968 and 1989 a colonic conduit was created in 105 patients up to age 20 years for neurogenic bladder (76), bladder exstrophy (16) and other reasons (13). Long-term followup (minimum 5 years, mean 16.3 years, range 5 to 26) was possible in 84 patients (159 renal units).


RESULTS
Early and late stenosis at the ureterocolic anastomosis, and stomal stenosis occurred in 7.6 and 15.5% of the cases, respectively. Renal calculi developed in 8.2% of the renal units. Eight kidneys without function after recurrent pyelonephritis, calculi or stenosis at the ureterocolic anastomosis were removed during followup. Compared to preoperative status 3 of the remaining 151 renal units had increased dilatation of the upper urinary tract at the last followup. A total of 31 patients had complications during followup and 18 underwent conversion to continent urinary diversion.


CONCLUSIONS
When incontinent urinary diversion is necessary in children, a colonic conduit with the option of continent conversion should be created before deterioration of the upper urinary tract.
Stein
R
R
Department of Urology, University of Mainz School of Medicine, Germany.
Fisch
M
M
Stöckle
M
M
Demirkesen
O
O
Hohenfellner
R
R
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D013997:Time Factors; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects*