Ten years' minimum follow-up with the ileal continent catheterizable reservoir: a test of time.
OBJECTIVE
To evaluate long-term efficacy of an original technique of catheterizable ileal reservoir designed for bladder augmentation and/or substitution, precluding the need to use a Yang-Monti channel or appendix.


METHODS
Our series comprised 19 patients, operated in 1998-2000, with a mean age of 10.1 years (1.6-30). Two were excluded from analysis because lost to follow-up after 1.5 and 7 years of surveillance. The primary disease was posterior urethral valves (9), myelomeningocele (4), anorectal malformation (1), rhabdomyosarcoma (1), medullary astrocytoma (1) and urethral stricture (1). Surgery consisted of creating a continent catheterizable ileum-based reservoir from a 35-cm ileum segment.


RESULTS
Mean follow-up was 11.2 years (10-12.4). All 16 patients eligible for final evaluation of the procedure were continent, excluding two lost of follow-up and one that underwent undiversion. Complications noted were: stomal stenosis (3), leakage associated with false passage (1) and false passage (1). One patient underwent a Bricker undiversion procedure, an appendicovesicostomy was performed in 2, and 1 patient received a Monti channel to replace the outlet conduit. The overall complication rate was 29.4% (5/17).


CONCLUSIONS
We have confirmed the long-term efficacy of the technique. The results are comparable to other 'gold standard' treatments, with the advantage of being simpler, faster and sparing the appendix for other uses (Malone antegrade continent enema), as well as precluding the need to create a Monti channel.
Federal University of São Paulo, Department of Urology, Escola Paulista de Medicina, São Paulo, Brazil. macedojr@usp.br
Antonio
A
Macedo
Eulálio
E
Damázio
Herick
H
Bacelar
Atila
A
Rondon
Sérgio
S
Ottoni
Riberto
R
Liguori
Gilmar
G
Garrone
Bruno
B
Leslie
Valdemar
V
Ortiz
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008591:Meningomyelocele / Q000601:surgery; D014521:Urethra / Q000002:abnormalities; D001743:Urinary Bladder / Q000601:surgery*; D014546:Urinary Catheterization / Q000379:methods*; D016476:Urinary Reservoirs, Continent; D055815:Young Adult