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The Effect of Temporary Cutaneous Diversion on Ultimate Bladder Function

1995; Lippincott Williams & Wilkins; Volume: 154; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(01)67196-9

1527-3792

Venkata R. Jayanthi, Gordon A. McLorie, Antoine E. Khoury, Bernard M. Churchill,

Urinary Tract Infections Management

No AccessJournal of UrologyAugmentation/Diversion1 Aug 1995The Effect of Temporary Cutaneous Diversion on Ultimate Bladder Function Venkata R. Jayanthi, Gordon A. McLorie, Antoine E. Khoury, and Bernard M. Churchill Venkata R. JayanthiVenkata R. Jayanthi , Gordon A. McLorieGordon A. McLorie , Antoine E. KhouryAntoine E. Khoury , and Bernard M. ChurchillBernard M. Churchill View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67196-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail We evaluated the effect of temporary cutaneous diversion on bladder function in cases of various congenital uropathies. The clinical courses of patients who underwent reversal of vesicostomy or pyelostomy/ureterostomy in a 7-year period were reviewed. Indications for diversion included azotemia, massive hydronephrosis, high grade reflux and/or incomplete bladder emptying. Mean age at diversion was 15 weeks. Overall 75 cases were evaluated (posterior urethral valves in 31, neurogenic bladder in 16, reflux in 14, the syndrome of vertebral defects, anal atresia, tracheoesophageal fistula with esophageal atresia, and radial and renal anomalies in 8 and other in 6).Of 55 patients who underwent undiversion by direct closure only 2 required later augmentation for bladder/renal deterioration. Excluding the myelomeningocele patients on clean intermittent catheterization 45 of 46 who underwent direct closure were able to void spontaneously with acceptable post-void residuals. Urodynamics in 22 cases revealed normal bladder capacity at pressures below 30 cm. water in 19 (86 percent) after direct closure. We conclude that after a period of defunctionalization approximately 75 percent of children will have essentially normal bladder function. The frequency of bladder augmentation varied from 54 percent in patients with myelomeningocele to 14 percent in those with vesicoureteral reflux. This observation suggests that the need for bladder augmentation in the remaining patients is more related to the effect of the primary pathological condition on the detrusor rather than the diversion itself. References 1 : Vesicostomy for the temporary diversion of the urine in small children. J. Urol.1980; 123: 929. Link, Google Scholar 2 : Cutaneous vesicostomy: a useful form of temporary diversion in children. J. Urol.1980; 123: 927. Link, Google Scholar 3 : Emergency treatment and long-term follow-up of posterior urethral valves. Urol. Clin. N. Amer.1990; 17: 343. Google Scholar 4 : Accuracy of bladder volume determinations in children using a suprapubic ultrasonic bi-planar technique. J. Urol.1989; 141: 900. Link, Google Scholar 5 : The management of vesicoureteral reflux in children with myelodysplasia. J. Urol.1982; 128: 102. Link, Google Scholar 6 : Cloacal anomalies: role of vesicostomy. J. Ped. Surg.1994; 29: 74. Google Scholar 7 : Cutaneous vesicostomy for temporary urinary diversion in infants with neurogenic bladder dysfunction. J. Urol.1978; 119: 120. Link, Google Scholar 8 : Cutaneous vesicostomy in the young child: indications and results. Urology1993; 41: 558. Google Scholar 9 : Cutaneous vesicostomy in infancy. J. Urol.1981; 126: 92. Link, Google Scholar 10 : The role of vesicostomy in the management of anterior urethral valves in neonates and infants. J. Urol.1987; 138: 107. Link, Google Scholar 11 : Twenty-year outcome of cutaneous vesicostomy. J. Urol.1980; 124: 326. Link, Google Scholar 12 : Vesicostomy for neurogenic bladder with spina bifida: followup. J. Urol.1983; 130: 724. Link, Google Scholar 13 : Factors influencing patient and graft survival in 300 cadaveric pediatric renal transplants. J. Urol., part 21988; 140: 1129. Abstract, Google Scholar 14 : Is lamina propria matrix responsible for normal bladder compliance?. J. Urol., part 21992; 148: 544. Abstract, Google Scholar 15 : Bladder wall abnormalities in myelodysplastic bladders: a computer assisted morphometric analysis. J. Urol.1991; 145: 1024. Link, Google Scholar 16 : What volume can a child normally store in the bladder at safe pressure?. J. Urol.1993; 149: 561. Abstract, Google Scholar Hospital for Sick Children, Toronto, Ontario, Canada.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byJalkanen J, Heikkilä J, Kyrklund K and Taskinen S (2016) Controlled Outcomes for Achievement of Urinary Continence among Boys Treated for Posterior Urethral ValvesJournal of Urology, VOL. 196, NO. 1, (213-218), Online publication date: 1-Jul-2016. (2011) Reply by AuthorsJournal of Urology, VOL. 185, NO. 6, (2434-2434), Online publication date: 1-Jun-2011.Liu G, Lin Y, Li M, Xiao N and Daneshgari F (2010) Temporal Morphological and Functional Impact of Complete Urinary Diversion on the Bladder: A Model of Bladder Disuse in RatsJournal of Urology, VOL. 184, NO. 5, (2179-2185), Online publication date: 1-Nov-2010.Wei W, Howard P, Kogan B and Macarak E (2007) Altered Extracellular Matrix Expression in the Diverted Fetal Sheep BladderJournal of Urology, VOL. 178, NO. 3, (1104-1107), Online publication date: 1-Sep-2007.Kitchens D, DeFoor W, Minevich E, Reddy P, Polsky E, McGregor A and Sheldon C (2018) End Cutaneous Ureterostomy for the Management of Severe HydronephrosisJournal of Urology, VOL. 177, NO. 4, (1501-1504), Online publication date: 1-Apr-2007.MATSUMOTO S, KOGAN B, LEVIN R, HOWARD P and MACARAK E (2018) Response of the Fetal Sheep Bladder to Urinary DiversionJournal of Urology, VOL. 169, NO. 2, (735-739), Online publication date: 1-Feb-2003.GLASSBERG K (2018) THE VALVE BLADDER SYNDROME: 20 YEARS LATERJournal of Urology, VOL. 166, NO. 4, (1406-1414), Online publication date: 1-Oct-2001.JAUREGUIZAR E, LOPEZ PEREIRA P, MARTINEZ URRUTIA M, ESPINOSA L and LOBATO R (2018) DOES NEONATAL PYELOURETEROSTOMY WORSEN BLADDER FUNCTION IN CHILDREN WITH POSTERIOR URETHRAL VALVES?Journal of Urology, VOL. 164, NO. 3 Part 2, (1031-1034), Online publication date: 1-Sep-2000.MACHADO M, YOO J and ATALA A (2018) DEFUNCTIONALIZED BLADDERS: EFFECTS BEFORE AND AFTER REFUNCTIONALIZATION IN AN ANIMAL MODELJournal of Urology, VOL. 164, NO. 3 Part 2, (1002-1007), Online publication date: 1-Sep-2000.LIARD A, SEGUIER-LIPSZYC E and MITROFANOFF P (2018) TEMPORARY HIGH DIVERSION FOR POSTERIOR URETHRAL VALVESJournal of Urology, VOL. 164, NO. 1, (145-148), Online publication date: 1-Jul-2000.HABERSTROH K, KAEFER M, RETIK A, FREEMAN M and BIZIOS R (2018) THE EFFECTS OF SUSTAINED HYDROSTATIC PRESSURE ON SELECT BLADDER SMOOTH MUSCLE CELL FUNCTIONSJournal of Urology, VOL. 162, NO. 6, (2114-2118), Online publication date: 1-Dec-1999.INDUDHARA R, JOSEPH D, PEREZ L and DIETHELM A (2018) RENAL TRANSPLANTATION IN CHILDREN WITH POSTERIOR URETHRAL VALVES REVISITED: A 10-YEAR FOLLOWUPJournal of Urology, VOL. 160, NO. 3 Part 2, (1201-1203), Online publication date: 1-Sep-1998. (2018) EDITORIAL COMMENTJournal of Urology, VOL. 157, NO. 3, (988-988), Online publication date: 1-Mar-1997. Volume 154Issue 2August 1995Page: 889-892 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Venkata R. Jayanthi More articles by this author Gordon A. McLorie More articles by this author Antoine E. Khoury More articles by this author Bernard M. Churchill More articles by this author Expand All Advertisement PDF downloadLoading ...