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• W2009558659 abstract "No AccessJournal of UrologyPediatric Urology1 Mar 2010Teapot Ureterocystoplasty and Ureteral Mitrofanoff Channel for Bilateral Megaureters: Technical Points and Surgical Results of Neurogenic Bladder Abdol-Mohammad Kajbafzadeh, Yasin Farrokhi-Khajeh-Pasha, Mohammad Reza Ostovaneh, Behtash Ghazi Nezami, and Asal Hojjat Abdol-Mohammad KajbafzadehAbdol-Mohammad Kajbafzadeh More articles by this author , Yasin Farrokhi-Khajeh-PashaYasin Farrokhi-Khajeh-Pasha More articles by this author , Mohammad Reza OstovanehMohammad Reza Ostovaneh More articles by this author , Behtash Ghazi NezamiBehtash Ghazi Nezami More articles by this author , and Asal HojjatAsal Hojjat More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.11.052AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We present the long-term results of simultaneous “teapot” ureterocystoplasty and ureteral Mitrofanoff in patients with bilateral megaureters due to neurogenic bladder, and compare urodynamic results before and after the procedure. Materials and Methods: We treated 13 children (mean age 7.3 years) with end stage neurogenic bladder and refluxing megaureters (mean diameter 5.5 cm) with simultaneous teapot ureterocystoplasty and Mitrofanoff appendicovesicostomy between April 1995 and May 2001. The larger ureter was used for teapot bladder augmentation while keeping its distal 2 cm tubularized. The Mitrofanoff channel was then created using the opposite ureter. Results: Followup ranged from 109 to 169 months (median 121). At the end of the followup period all patients were dry with clean intermittent catheterization and/or voiding. No repeat augmentation was needed and there were no bladder calculi during followup. Median postoperative bladder capacity was 430 ml (IQR 380 to 477), which was increased significantly compared to preoperative evaluations (210 ml, IQR 181 to 230, p = 0.001). During followup bladder compliance also improved significantly (p = 0.001) and serum creatinine level decreased (p = 0.021). Conclusions: Although neurogenic bladder and high grade reflux are poor prognostic factors for ureterocystoplasty, the present modification resulted in enduring bladder augmentation with no calculus formation. Bladders remained compliant with good capacity, presumably because sufficient tissue and blood supply were provided for the augmented flap. References 1 : Augmentation cystoplasty. BJU Int2001; 88: 511. Google Scholar 2 : Further observations on self-catheterization. J Urol1976; 116: 169. Link, Google Scholar 3 : Trans-appendicular continent cystostomy in the management of the neurogenic bladder. Chir Pediatr1980; 21: 297. Google Scholar 4 : Malignancies in bladder augmentations and intestinal conduits. J Urol1990; 143: 671. Link, Google Scholar 5 : Ureterocystoplasty: indications for a successful augmentation. J Urol2004; 171: 376. Link, Google Scholar 6 : Tandem ureterocystoplasty. Aust N Z J Surg1998; 68: 203. 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Link, Google Scholar 29 : Urinary tract reconstruction in children. In: Campbell-Walsh Urology. Edited by . Burlington, Massachusetts: Elsevier Health Sciences2007: 3656. Google Scholar 30 : A high easy-to-treat complication rate is the price for a continent stoma. BJU Int2002; 90: 240. Google Scholar Pediatric Urology Research Center, Department of Urology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 3March 2010Page: 1168-1176 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Keywordsurinary bladderureterurinary reservoirsneurogenicreconstructive surgical procedurescontinenturodynamicsMetricsAuthor Information Abdol-Mohammad Kajbafzadeh More articles by this author Yasin Farrokhi-Khajeh-Pasha More articles by this author Mohammad Reza Ostovaneh More articles by this author Behtash Ghazi Nezami More articles by this author Asal Hojjat More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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