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Abstract : |
Mitrofanoff, in 1980, reported his experience with continent cystostomy and urine diversion to abdominal wall using cecal appendix, in patients with neurologic bladder. In the last decades the indications of this principle extended to other clinical situations, another than neurologic bladder. Autors report their experience regarding continent appendico-vesicostomy in cases with retentionist bladder. Materials and methods: From 2000 to 2002, this procedure was performed in 6 male patients, with age between 6 and 14 years, with retentionist bladder. The underlying clinical conditions were myelomeningocele, MEN II B syndrome, traumatic injuries of the posterior urethra, posterior urethral valves. It was used the classical procedure, but with the specification that we didn’t close the vesical neck. Results: In five cases (83.33%) the outcome is good, one patient died. In 2 cases the initial intermitent catheterization was difficult, but subsequentely the maneuvre becomes facile. Episodes of urinary tract infection decreased in frecvency and azothat retention remains stable. Social insertion is good; there is no urinary leackage and catheterization is performe for 5-6 times daily. It was 2 complications, one stenosis of stoma and one necrosis of the flap of the stoma. Conclusions: Continent appendico-vesicostomy is a good solution for cases of bladder that doesn’t evacuate correctly: posterior urethral valves, traumatic injuries of the posterior urethra with urinary blockage., |
