title: Efficacy of bladder irrigation and surveillance program in prevention of urinary tract infections and bladder calculi in children with an ileocystoplasty and bladder neck repair.
abstract: OBJECTIVE
  In children with bladder augmentation and particularly in those with bladder neck repair (BNR), urinary tract infections (UTI) and bladder calculi are a recognised problem. Bladder irrigation potentially prevents these complications. Our aim was to investigate the efficacy of bladder irrigation supported by a surveillance program in prevention of UTI and bladder calculi in these children.
  
  
  METHODS
  A cohort of children subjected to ileocystoplasty with a stoma for clean intermittent self catheterisation with or without BNR was retrospectively analysed. The children were subjected to bladder irrigation and monitored by Clinical Nurse Specialists (CNS) according to a protocol. Patients' demographics, treatment methods and postoperative management were reviewed. Compliance to bladder irrigation was assessed with questionnaires. UTI recurrence and bladder calculi during follow-up were assessed.
  
  
  RESULTS
  28 children were included in this study. The median follow-up was 48 months (range 6-87). Compliance could be assessed in all children, except in one child (3.5%). There was no recurrent UTI reported, bladder calculi occurred in two children (7%).
  
  
  CONCLUSIONS
  Our bladder irrigation regime resulted in a low incidence of calculi by preventing recurrent UTI. The surveillance program resulted in high compliance rates in children with an augmented bladder with or without BNR.
authors.affiliation: Department of Paediatric Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Marleen
authors.initials: M
authors.lastname: van den Heijkant
authors.forename: Nadeem
authors.initials: N
authors.lastname: Haider
authors.forename: Craig
authors.initials: C
authors.lastname: Taylor
authors.forename: Ramnath
authors.initials: R
authors.lastname: Subramaniam
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000379:methods*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D001744:Urinary Bladder Calculi / Q000209:etiology / Q000517:prevention & control*; D014547:Urinary Diversion / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control*