[Bladder augmentation cystoplasty with continent urinary diversion by ileo-caeco-appendicular graft in children].
OBJECTIVE
Description of augmentation cystoplasty combined with continent urinary diversion using an ileo-caeco-appendicular graft in children.


METHODS
Augmentation cystoplasty combined with Mitrofanoff appendicostomy and reimplantation of the ureters into the ileal stump was performed during a single operation in two patients (a 3-year-old girl and an 8-year-old boy). The indications were a pseudoneurogenic bladder with major dilatation of the upper tract due to high-grade reflux in one case and a small scarred bladder after repeated failure of repeated surgery for duplicated ureterocele in another case.


RESULTS
A bladder capacity of about 300 ml was obtained in the 2 children. Incontinence was managed by intermittent catheterization via the abdominal stoma. Upper urinary tract dilatation had resolved after one year.


CONCLUSIONS
This technique is useful in certain complex urological situations combining a small, poorly compliant bladder, destruction of continence and severe upper tract dilatation. In these situations, it constitutes a conservative alternative to salvage diversion.
Fotso Kamdem
Amaud
A
Service de Chirurgie Pédiatrique et Orthopédique, Hôpital Saint-Jacques, Besançon, France. afotso@chu-besancon.fr
Aubert
Didier
D
D001065:Appendix / Q000637:transplantation; D002432:Cecum / Q000637:transplantation; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000637:transplantation; D008297:Male; D001743:Urinary Bladder / Q000601:surgery*; D016476:Urinary Reservoirs, Continent; D013520:Urologic Surgical Procedures / Q000379:methods