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• W2019979684 abstract "No AccessJournal of UrologyPediatric Urology1 Jun 2015Long-Term Renal Functional Outcomes after Primary Gastrocystoplasty Katherine C. Hubert, Timothy Large, Jeffrey Leiser, Benjamin Judge, Konrad Szymanski, Benjamin Whittam, Martin Kaefer, Rosalia Misseri, Richard Rink, and Mark P. Cain Katherine C. HubertKatherine C. Hubert More articles by this author , Timothy LargeTimothy Large More articles by this author , Jeffrey LeiserJeffrey Leiser More articles by this author , Benjamin JudgeBenjamin Judge More articles by this author , Konrad SzymanskiKonrad Szymanski More articles by this author , Benjamin WhittamBenjamin Whittam More articles by this author , Martin KaeferMartin Kaefer More articles by this author , Rosalia MisseriRosalia Misseri More articles by this author , Richard RinkRichard Rink More articles by this author , and Mark P. CainMark P. Cain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.12.088AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed long-term renal function, morbidities and mortality in 50 patients who had undergone primary gastrocystoplasty at our institution. Materials and Methods: We retrospectively reviewed patients 21 years or younger who had undergone primary gastrocystoplasty between 1984 and 2004. Patients who underwent secondary gastrocystoplasty or primary composite augmentation or had cloacal exstrophy were excluded. Primary outcome was progression to end-stage renal disease. Secondary outcomes included mortality, bladder malignancy, hematuria-dysuria syndrome, electrolyte abnormalities and surgical revisions. Results: Of 50 patients who had undergone gastrocystoplasty 35 met inclusion criteria. Median age was 9.4 years and 60% of the patients were male. Median followup was 19 years (IQR 11 to 25). Of the 35 patients 15 (43%) had normal preoperative estimated glomerular filtration rate and 5 (14%) had stage 2, 10 (29%) stage 3 and 5 (14%) stage 4 chronic kidney disease. Five of the 15 patients with stage 3 or 4 chronic kidney disease improved to normal estimated glomerular filtration rate, 1 remained with stage 3 disease and 9 progressed to end-stage renal disease. In 1 patient with normal estimated glomerular filtration rate end-stage renal disease developed following an episode of septic shock due to osteomyelitis. Seven patients in the cohort (20%) died, with 1 each dying of ventriculoperitoneal shunt infection, pneumonia, end-stage renal disease, complications of pregnancy and unknown cause, and 2 patients dying of septic shock due to urinary tract infection. There were no bladder malignancies. Hematuria-dysuria syndrome developed in 9 patients (24%). Eight patients (23%) underwent surgical revision. Conclusions: The majority of patients had preserved or improved renal function after gastrocystoplasty. There were no deaths attributable to gastric augmentation and no bladder malignancies. Approximately a fourth of patients required surgical revision. References 1 : Gastrocystoplasty: an alternative solution to the problem of urological reconstruction in the severely compromised patient. J Urol1988; 140: 1152. Link, Google Scholar 2 : Gastrocystoplasty and colocystoplasty in canines: the metabolic consequences of acute saline and acid loading. J Urol1987; 138: 1009. Link, Google Scholar 3 : Tumor in bladder reservoir after gastrocystoplasty. J Urol2007; 178: 1771. Link, Google Scholar 4 : Gastrocystoplasty: long-term complications in 22 patients. J Urol1999; 162: 1122. Link, Google Scholar 5 : Metastatic adenocarcinoma after augmentation gastrocystoplasty. J Urol2008; 179: 1094. 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Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byRitchey M (2015) This Month in Pediatric UrologyJournal of Urology, VOL. 193, NO. 6, (1873-1874), Online publication date: 1-Jun-2015. Volume 193Issue 6June 2015Page: 2079-2085 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsurologic surgical proceduresfollow-up studiespediatricsrenal insufficiencyMetricsAuthor Information Katherine C. Hubert More articles by this author Timothy Large More articles by this author Jeffrey Leiser More articles by this author Benjamin Judge More articles by this author Konrad Szymanski More articles by this author Benjamin Whittam More articles by this author Martin Kaefer More articles by this author Rosalia Misseri More articles by this author Richard Rink More articles by this author Mark P. Cain More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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