[The effect of enterocystoplasty in childhood on linear growth].
OBJECTIVE
The assumption that enterocystoplasty in children has a detrimental effect on linear growth has been based almost exclusively upon a chance finding in a retrospective study 10 years ago. We re-evaluated the same research question in a larger cohort and with a longer follow-up.


METHODS
Between 1982 and 1997, 242 children and adolescents underwent enterocystoplasty. Patients with conditions involving organ systems apart from the urinary tract, and those with myelomeningocele, malignant diseases, reduced glomerular filtration rate and incomplete notes were excluded. In the definitive study cohort (123; mean age at operation 8.6 years; mean age at investigation 16.8 years), enterocystoplasty had been undertaken using colon in 70, ileum in 37, a combination of both in 11, ileocaecal segments in three and stomach in two patients.


RESULTS
In all, 1215 height and weight measurements had been recorded. The distribution of percentile positions before and after enterocystoplasty showed a normal configuration, with 83 % and 80 % of patients growing within two standard deviations of the 50th percentile. After surgery, 85 % either remained the same or reached a higher percentile. Nineteen (15.5 %) were in a lower position, with a similar tendency in the weight percentile. A clinically relevant growth disorder was recognized in four patients with a complete endocrinological evaluation; in none of these was enterocystoplasty thought to be a causal factor.


CONCLUSIONS
It is very unlikely that loss of the preoperative percentile position on the growth curve in 15 % of children after enterocystoplasty is a consequence of that particular surgery. Rather, it is a non-specific phenomenon that has to be considered in any clinical population of the same size and age distribution after the same length of time.
Gerharz
E W
EW
Urologische Klinik der Bayerischen Julius-Maximilians-Universität Würzburg. elmar.gerharz@klinik.uni-wuerzburg.de
Preece
M
M
Duffy
P G
PG
Ransley
P G
PG
Leaver
R
R
Woodhouse
C R J
CR
D000293:Adolescent; D000328:Adult; D001746:Bladder Exstrophy / Q000601:surgery*; D001827:Body Height; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004842:Epispadias / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007422:Intestines / Q000637:transplantation; D007677:Kidney Function Tests; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology*; D013524:Surgical Flaps; D001743:Urinary Bladder / Q000601:surgery*; D016476:Urinary Reservoirs, Continent