title: Long-term followup and time to event outcome analysis of continent catheterizable channels.
abstract: OBJECTIVE
  Creation of a continent catheterizable channel has facilitated the treatment of patients undergoing lower urinary tract reconstruction. We present outcomes and complications of a single center series of continent catheterizable channels followed out to 15 years.
  
  
  METHODS
  We retrospectively reviewed medical records of all children who underwent continent catheterizable channel (Mitrofanoff and Monti) between 1992 and 2007. Collected data included age, underlying diagnosis, associated procedures, stoma site, conduit type (appendix or reconfigured bowel), time to complications and need for subsequent surgical revisions.
  
  
  RESULTS
  We identified 71 girls and 98 boys who underwent surgery at a mean age of 7.5 years (range 6 months to 22 years) and were subsequently followed for a mean of 5.8 years (8 months to 15 years). Underlying diagnoses included neurogenic bladder (36% of patients), bladder exstrophy (25%), epispadias (6%) and posterior urethral valves (6%). Concurrent procedures were conducted in 71% of cases, including augmentation (35%) and bladder neck plasty (22%) or closure (8%). Surgical revision was performed in 39% of patients, including stomal revision (18%), redo operation (8%), bulking agent injection (8%) and prolapse correction (4%). Although an initial peak was followed by a relatively stable complication-free period, delayed problems were detected on long-term followup. No statistically significant differences in complication rates were noted when comparing use of appendix and reconfigured bowel or different stoma locations.
  
  
  CONCLUSIONS
  Despite an initial decrease in complications soon after continent catheterizable channel creation, late problems appeared on long-term evaluation. In our experience no specific factor predicted the likelihood of complications. Nevertheless, despite the need for surgical revision, good functional outcomes were evidenced in this series.
authors.affiliation: Division of Urology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Bruno
authors.initials: B
authors.lastname: Leslie
authors.forename: Armando J
authors.initials: AJ
authors.lastname: Lorenzo
authors.forename: Katherine
authors.initials: K
authors.lastname: Moore
authors.forename: Walid A
authors.initials: WA
authors.lastname: Farhat
authors.forename: Darius J
authors.initials: DJ
authors.lastname: Bägli
authors.forename: Joao L
authors.initials: JL
authors.lastname: Pippi Salle
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003559:Cystostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014546:Urinary Catheterization; D055815:Young Adult