Evaluation of the functional significance of the colorectal valve used in rectal urinary diversion in children: a comparative study between cases with and without the valve.
OBJECTIVE
To study the long-term impact of functional isolation of rectal reservoirs on the blood chemistries and acid-base balance of children who underwent this type of urinary diversion.


METHODS
A retrospective evaluation of 63 children with rectal reservoirs was performed. Of these, 40 had a colorectal valve and 23 had double-folded rectal reservoirs without a functional isolation valve. Evaluation included serum chemistry and arterial blood sample analysis to verify the impact of the created valve on homeostasis.


RESULTS
There was a statistically significant difference between the two groups relative to the value of pH, P(CO2), bicarbonate, base excess, and chloride in favor of those having a colorectal valve. Reduction of the absorptive surface area of the colon is presumably the cause in view of the functional isolation created by the colorectal valve.


CONCLUSIONS
In children, the long life expectancy and the benign condition for which they have diversion require the incorporation of the colorectal valve in any form of continent rectal diversion. Prophylactic alkalinization with strict follow-up is a must in those having no valve.
Mahran
M R
MR
Urology and Neprology Centre, Mansoura University, Egypt.
Dawaba
M S
MS
Ghoneim
M A
MA
D000136:Acid-Base Equilibrium; D001784:Blood Gas Analysis; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000378:metabolism / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D012007:Rectum / Q000378:metabolism / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors; D016476:Urinary Reservoirs, Continent / Q000502:physiology*; D013520:Urologic Surgical Procedures / Q000379:methods