[Continent bladder augmentation in children]

ABSTRACT

Cutaneous continent bladder reconstruction is a challenging operation for the pediatric urologist. The aim of this study is to review the different procedures of bladder augmentation and to present our experience. Thirty one children [21 boys and 10 girls] with a mean age of 10 years [3-16 years] underwent this procedure between June 2004 and March 2007. Neurogenic bladder dysfunction represented the main indication. Bladder sphincter dyssenergia was present in another 7 cases. The ileum was used for the augmentation in 21 children, the ileocecal segment in 8 and the ureter in another 2 cases. The cutaneous continent mechanism was reconstructed from the appendix in 28 children and from the ileum [Monti procedure] in 3 children. The results of the majority of cases were encouraging and children could empty the bladder by self catheterization. In case of failure of all conservative measures, bladder augmentation represents the final solution for the management of advanced dysfunction of the lower urinary tract in order to preserve renal function and to improve quality of life