[Ureterocystoplasty in the treatment of "low-compliance" bladder in children].
In cases of inadequate or insufficient conservative treatment of non-compliant bladders the function of the upper urinary tract is jeopardized. We present our experience with ureterocystoplasty as one possible treatment option.A total of eight children underwent ureterocystoplasty. The etiology of bladder non-compliance and the need for augmentation was neurogenic in five children, posterior urethral valves in two children, and in one child after repeated antireflux surgery. In all patients the kidney of the used ureter was functionless. Surgery was done through a transperitoneal approach. Following nephrectomy, the renal pelvis and the ureter were spatulated and sutured into the bladder incision. An additional MACE procedure was performed in three patients, antireflux surgery for the contralateral kidney in two patients, and one patient underwent stone removal in the remaining kidney. In one patient the ureter was used as a free transplant and was covered by an omental flap. In addition a simultaneous living donor kidney transplant was performed. The storage function could be improved in all patients. The function of the ureter which was used as a free transplant showed good clinical results. The longest follow-up is 8 years. Ureterocystoplasty is a useful and metabolically neutral alternative to bowel segments. In patients with only one functioning kidney and a contralateral megaureter, ureterocystoplasty is the treatment of choice in our institution.
Hauser
S
S
Klinik und Poliklinik für Urologie, Universitätsklinikum, Sigmund-Freud-Strasse 25, Bonn, Germany. stefan.hauser@uni-bonn.de
Fisang
C
C
Fechner
F
F
Ellinger
J
J
Haferkamp
A
A
Müller
S C
SC
D000293:Adolescent; D002648:Child; D003187:Compliance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery; D007682:Kidney Pelvis / Q000601:surgery; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D009392:Nephrectomy; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology; D014718:Vesico-Ureteral Reflux / Q000601:surgery*