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SYNCHRONOUS BLADDER RECONSTRUCTION AND ANTEGRADE CONTINENCE ENEMA

2001; Lippincott Williams & Wilkins; Volume: 165; Issue: 6 Part 2 Linguagem: Inglês

10.1016/s0022-5347(05)66212-x

1527-3792

Andrew Wedderburn, R.S. LEE, A. DENNY, Henrik Steinbrecher, Martin A. Koyle, P.S. Malone,

Urologic and reproductive health conditions

No AccessJournal of UrologyMitranoff, Malone and Monti Principles1 Jun 2001SYNCHRONOUS BLADDER RECONSTRUCTION AND ANTEGRADE CONTINENCE ENEMA A. WEDDERBURN, R.S. LEE, A. DENNY, H.A. STEINBRECHER, M.A. KOYLE, and P.S. MALONE A. WEDDERBURNA. WEDDERBURN More articles by this author , R.S. LEER.S. LEE More articles by this author , A. DENNYA. DENNY More articles by this author , H.A. STEINBRECHERH.A. STEINBRECHER More articles by this author , M.A. KOYLEM.A. KOYLE More articles by this author , and P.S. MALONEP.S. MALONE More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66212-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assess the long-term outcome of synchronous bladder reconstruction and antegrade continence enema in a large series of patients. Materials and Methods: We retrospectively reviewed records of the last 50 consecutive patients treated at 1 unit in Southampton and 1 in Denver. Results: A total of 46 patients were available for analysis, including 24 from Southampton and 22 from Denver. Median patient age at operation was 12 years (range 4 to 30), median followup was 44 months (range 7 to 100), and 80% of patients had neuropathy and anorectal malformation. A variety of bladder reconstructive procedures were performed and 58% of patients underwent a simultaneous Mitrofanoff procedure. Fecal and urinary continence was achieved in 76% of patients but the rate of revision surgery was high. The most common complication was stomal stenosis (17%). Secondary procedures consisted of refashioning urethral length, closure of the bladder neck, bladder augmentation and conduit revision. Conclusions: It is now possible to produce double continence in some patients with synchronous combined surgery, a goal that was not achievable without colostomy before the development of the antegrade continence enema in 1990. However, the surgery is demanding with high revision rates and we emphasize that it should only be performed in patients who are highly motivated and have reasonable dexterity and intelligence. This careful patient selection is confirmed by the fact that surgery was performed on 2 to 3 patients a year at each unit. This surgery should only be performed at facilities which can provide long-term patient followup. References 1 : Preliminary report: the antegrade continence enema. Lancet1990; 336: 1217. Crossref, Medline, Google Scholar 2 : The MACE procedure experience in the United Kingdom. J Pediatr Surg1999; 34: 338. Crossref, Medline, Google Scholar 3 : Functional results following the antegrade continence enema procedure. Br J Surg1998; 85: 980. 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Crossref, Medline, Google Scholar From the Department of Paediatric Urology, Southampton University Hospitals NHS Trust, Southampton, United Kingdom, and Department of Pediatric Urology, The Children’s Hospital, Denver, Colorado© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by Quintanilla R, Galvez C, Nassau D, Suarez M, Babastro Y, Ransford A, Castellan M, Alam A and Gosalbez R (2022) Simultaneous placement of fecal and urinary continent channel stomas in the umbilicus: Single-center experienceJournal of Pediatric Urology, 10.1016/j.jpurol.2022.08.019, VOL. 18, NO. 5, (613.e1-613.e8), Online publication date: 1-Oct-2022. Skerritt C, DaJusta D, Fuchs M, Pohl H, Gomez-Lobo V and Hewitt G (2020) Long-term urologic and gynecologic follow-up and the importance of collaboration for patients with anorectal malformationsSeminars in Pediatric Surgery, 10.1016/j.sempedsurg.2020.150987, VOL. 29, NO. 6, (150987), Online publication date: 1-Dec-2020. Penna F and Koyle M (2019) The MACE (Malone Antegrade Continence Enema) Procedure Pediatric Surgery, 10.1007/978-3-662-56282-6_72, (629-636), . Peard L, Fox P, Andrews W, Chen R, McCraw C, Klaassen Z and Neal D (2016) Continent Catheterizable Vesicostomy: An Alternative Surgical Modality for Pediatric Patients With Large Bladder CapacityUrology, 10.1016/j.urology.2016.03.018, VOL. 93, (217-222), Online publication date: 1-Jul-2016. Malone P (2015) Antegrade continence enema procedure in children Operative Surgery of the Colon, Rectum and Anus, Sixth Edition, 10.1201/b18337-34, (257-270), Online publication date: 28-May-2015. Bar-Yosef Y, Castellan M, Joshi D, Labbie A and Gosalbez R (2011) Total Continence Reconstruction Using the Artificial Urinary Sphincter and the Malone Antegrade Continence EnemaJournal of Urology, VOL. 185, NO. 4, (1444-1448), Online publication date: 1-Apr-2011. VanderBrink B, Cain M, Kaefer M, Meldrum K, Misseri R and Rink R (2011) Split-appendix technique for simultaneous appendicovesicostomy and appendicocecostomyJournal of Pediatric Surgery, 10.1016/j.jpedsurg.2010.08.001, VOL. 46, NO. 1, (259-262), Online publication date: 1-Jan-2011. Farrugia M and Malone P (2010) Educational article: The Mitrofanoff procedureJournal of Pediatric Urology, 10.1016/j.jpurol.2010.01.015, VOL. 6, NO. 4, (330-337), Online publication date: 1-Aug-2010. Malone P (2010) FECAL INCONTINENCE IN PEDIATRIC UROLOGY Pediatric Urology, 10.1016/B978-1-4160-3204-5.00061-X, (789-796), . Kajbafzadeh A, Mahboubi A and Payabvash S (2009) Concomitant repeated intravesical injections of botulinum toxin-type A and laparoscopic antegrade continence enema; a new solution for an old problemBJU International, 10.1111/j.1464-410X.2008.08287.x, VOL. 103, NO. 9, (1248-1254), Online publication date: 1-May-2009. (2008) Bladder augmentation: current and future techniques The Kelalis-King-Belman Textbook of Clinical Pediatric Urology Study Guide, 10.3109/9780203091760-55, (187-190) Rajimwale A and Malone P (2006) The Malone antegrade continence enema (MACE) procedure Pediatric Surgery and Urology, 10.1017/CBO9780511545757.034, (429-434) Casale A, Metcalfe P, Kaefer M, Dussinger A, Meldrum K, Cain M and Rink R (2018) Total Continence Reconstruction: A Comparison to Staged Reconstruction of Neuropathic Bowel and BladderJournal of Urology, VOL. 176, NO. 4S, (1712-1715), Online publication date: 1-Oct-2006. Marshall D, Steinbrecher H and Malone P The Antegrade Continence Enema Procedure: Long-Term Results Pediatric Neurogenic Bladder Dysfunction, 10.1007/3-540-30867-9_34, (263-270) Malone P The ACE (Antegrade Continence Enema) Procedure Pediatric Surgery, 10.1007/3-540-30258-1_59, (623-632) Pensabene L and Nurko S (2004) Management of fecal incontinence in children without functional fecal retentionCurrent Treatment Options in Gastroenterology, 10.1007/s11938-004-0051-z, VOL. 7, NO. 5, (381-390), Online publication date: 1-Oct-2004. Gross M and Boone T (2003) Continent and Incontinent Bladder Augmentation and DiversionJournal of Pelvic Medicine and Surgery, 10.1097/01.SPV.0000074200.12380.d2, VOL. 9, NO. 2, (91-99), Online publication date: 1-Mar-2003. Teichman J, Zabihi N, Kraus S, Harris J and Barber D (2003) Long-term results for malone antegrade continence enema for adults with neurogenic bowel diseaseUrology, 10.1016/S0090-4295(02)02282-3, VOL. 61, NO. 3, (502-506), Online publication date: 1-Mar-2003. Harper M, Andrich D and Fowler C (2003) Neurogenic Disorders of Micturition, Defecation, and Sexual Function Neurological Disorders, 10.1016/B978-012125831-3/50299-9, (1479-1493), . González R and Schimke C (2002) Strategies in urological reconstruction in myelomeningoceleCurrent Opinion in Urology, 10.1097/00042307-200211000-00007, VOL. 12, NO. 6, (485-490), Online publication date: 1-Nov-2002. Lowe J, Furness P, Barqawi A and Koyle M (2002) Surgical Management of the Neuropathic BladderSeminars in Pediatric Surgery, 10.1053/spsu.2002.31811, VOL. 11, NO. 2, (120-127), Online publication date: 1-May-2002. Volume 165Issue 6 Part 2June 2001Page: 2392-2393 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.KeywordsbladderabnormalitiesmethodsMetrics Author Information A. WEDDERBURN More articles by this author R.S. LEE More articles by this author A. DENNY More articles by this author H.A. STEINBRECHER More articles by this author M.A. KOYLE More articles by this author P.S. MALONE More articles by this author Expand All Advertisement PDF downloadLoading ...