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The Catheterizable Content Urinary Stomas in Pediatric Population - our experince in 8 cases - Abstract

Iulia Straticiuc-Ciongradi, I. Sarbu, Elena Tarca, Doina Nedelcu, R. Russu, S. G. Aprodu

 

Abstract

Purpose: Continent appendicovesicostomy, described by Mitrofanoff in 1980, is widely used in patients with voiding dysfunction with indication for clean intermittent catheterization to provide an easier way. Our aim was to evaluate the outcome and complications of catheterizable continent urinary stomas.

Methods: Retrospective record review of all patients operated in our department with urinary continent stomas, within the last 8 years.

Results: 8 cases were operated during that time and they all received Mitrofanoff stomas, with the use of the appendix. The diagnoses were: posterior urethral valves (n=2), neurologic bladder (myelomeningoceles) (n=3), bladder exstrophy (n=1), severe posttraumatic urethral stenosis (n=1), neurogen-like bladder (n=1). The mean age at operation was 6.7 years. The implantation of urinary stomas was into the native bladder in 7 patients and into the intestinal segment of an augmented bladder in 1 case. The location of the stoma was umbilical in 2 cases and in the right lower quadrant of the abdomen in 6. When an extra-umbilical location was chosen, skin flaps were used. Excellent esthetic and functional results were achieved in 6 (75%) of the 8 stomas, which were continent and easy to catheterize. One of the children underwent a second surgical procedure on account of difficult catheterization due to umbilical stoma opening stenosis. One neurologic patient is still incontinent and will need further bladder neck surgery. All the cases have improved or maintained their renal function stable.

Conclusions: Catheterizable continent urinary stomas achieve the goals of urinary continence, renal function preservation and independence in most patients, with a low complication rate.

 

Key words: Mitrofanoff procedure, urinary stoma, urinary incontinence, appendicostomy

 

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