20 years experience with appendicovesicostomy in paediatric patients
Complications and their re-interventions
To evaluate the long-term outcome of appendicovesicostomies and to present the frequency and timing of complications needing re-intervention. Methods: In this retrospective study we included patients in whom an appendicovesicostomy was created at our institution between 1993 and 2011. Patients with a follow-up less than 1 year were excluded. Patient characteristics and conduit-related complications requiring re-intervention were collected. Results: One hundred and twenty-eight patients were included with mean age at initial surgery of 10.1±3.9 years. Two thirds of the children had underlying neurogenic disease. The mean follow-up was 10.1±4.8 years. All but one patient continued to use the catheterizable channel. Re-intervention for conduit-related complications was necessary in 32.0% of the patients. A second, third, and fourth re-intervention was required in respectively 10.9%, 2.3%, and 1.6%. The commonest complications were cutaneous/fascial stenosis in 14.8%, stenosis at conduit-bladder level in 9.4%, and stomal incontinence in 6.3% of the patients. The most performed re-interventions were stoma revision (in 16.4% of the patients), conduit revision (10.2%), and dilatation of a stenotic tract (4.7%). 63.3% of the re-interventions was superficial and/or endoscopic. The peak incidence of re-interventions was in the 1st year after conduit construction and decreased yearly. Conclusions: Our study gives an overview of patients and their conduits developing from prepubertal children to young adults. During a mean follow-up of 10.1 years, roughly one third of the patients needed a re-intervention. We conclude that an appendicovesicostomy is an effective and durable treatment for whom transurethral clean intermittent catheterization is not feasible.
|Keywords||Adolescence, Complications, Continent catheterizable conduit, Continent urinary reservoir, Long-term effects, Urinary diversion|
|Persistent URL||dx.doi.org/10.1002/nau.23045, hdl.handle.net/1765/106191|
|Journal||Neurourology and Urodynamics|
Reuvers-Verhoef, S.H.M, van den Hoek, J, Blok, B.F.M, De Oliveira Barbosa, T.C, Wolffenbuttel, K.P, & Scheepe, J.R. (2017). 20 years experience with appendicovesicostomy in paediatric patients. Neurourology and Urodynamics, 36(5), 1325–1329. doi:10.1002/nau.23045