Is continent urinary diversion feasible in children under five years of age?
OBJECTIVE
To review our clinical experience with urinary continent catheterizable reservoir in children under five years of age.


METHODS
A total of 23 patients (16 males, 7 females) with a median age of 3.64 years were evaluated. Among these, 6 (26.08%) had a posterior urethral valve, 9 (39.13%) myelomeningocele, 4 (17.39%) bladder exstrophy, 2 (8.69%) genitourinary rabdomyosarcoma, 1 (4.34%) had spinal tumor and 1 (4.34%) an ano-rectal anomaly.


RESULTS
Perioperative complications were observed in four patients consisting of one febrile urinary tract infection, one partial operative wound dehiscence, one partial stomal dehiscence and one vesico-cutaneous fistula after a secondary exstrophy repair. The overall long-term complications rate was 40.90% and consisted of two stomal stenoses (9.09%), one neobladder mucosal extrusion (4.54%), three neobladder calculi (13.63%) and persistence of urinary incontinence in three patients (13.63%). The overall surgical revision was 36.36% and final continence rate was 95.45% with mean follow-up of 39.95 months


CONCLUSIONS
Continent urinary diversion is technically feasible even in small children, with acceptable rates of complications.
Barbosa
Luiz L
LL
Division of Urology, Federal University of Sao Paulo, Sao Paulo, Brazil.
Liguori
Riberto
R
Ottoni
Sergio L
SL
Barroso
Ubirajara
U
Ortiz
Valdemar
V
Macedo
Antonio
A
D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods*; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects