title: Evolution of impaired renal function after external continent urinary diversion (Mitrofanoff principle).
abstract: OBJECTIVE
  To study the evolution of impaired renal function after external continent urinary diversion (Mitrofanoff principle) (ECUD-M) associated with ileocystoplasty.
  
  
  METHODS
  Over 18 years from 1992 to 2009, ECUD-M with ileocystoplasty was performed in 120 patients with mean age of 25.5 years. Renal impairment was evident in 43 patients (17 children and 26 adults).
  
  
  RESULTS
  Ninety percent of patients demonstrated a neurologic bladder and mild to moderate renal failure. Initially, all patients underwent continuous bladder drainage for a mean of 3 weeks. Renal function improved in 35 patients, although with persistent mild renal insufficiency. The other patients demonstrated moderate persistent residual renal insufficiency. During a mean follow-up of 10 years (range, 1-18 years), renal function returned to normal in 13 patients, stabilized at lower values in 15, and remained moderate in 5. After a mean follow-up of 8 years (range, 6-12 years), renal failure gradually worsened, increasing to higher values in 6 patients and leading to hemodialysis in 4. One patient underwent living-donor kidney transplantation, with good evolution.
  
  
  CONCLUSIONS
  ECUD-M with ileocystoplasty can lead to normalization unless stabilizationof impaired residual renal function by eliminating the obstructive factor provides self-adequate management of the diversion. The procedure delays for the need forhemodialysis therapy, and enables patients to prepare for kidney transplantation into a previously reconstructed lower urinary tract.
authors: Department of Urology, H. Bourguiba Hospital, Sfax, Tunisia.
authors: M N
authors: MN
authors: Mhiri
authors: K
authors: K
authors: Chabchoub
authors: S
authors: S
authors: Fakhfakh
authors: I B
authors: IB
authors: Hmida
authors: M H
authors: MH
authors: Slimen
authors: A
authors: A
authors: Bahloul
authors: S
authors: S
authors: Yaiche
authors: K
authors: K
authors: Charfeddine
authors: J
authors: J
authors: Hachicha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007668:Kidney / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D001745:Urinary Bladder Diseases / Q000601:surgery* / Q000628:therapy; D014547:Urinary Diversion / Q000379:methods*; D014551:Urinary Tract / Q000473:pathology