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• W2081556908 abstract "No AccessJournal of UrologyClinical Research1 Oct 2008Complications of the Catheterizable Channel Following Continent Urinary Diversion: Their Nature and Timing Blayne K. Welk, Kourosh Afshar, Daniel Rapoport, and Andrew E. MacNeily Blayne K. WelkBlayne K. Welk More articles by this author , Kourosh AfsharKourosh Afshar More articles by this author , Daniel RapoportDaniel Rapoport More articles by this author , and Andrew E. MacNeilyAndrew E. MacNeily More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.03.093AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We reviewed the incidence, nature and timing of complications related to the catheterizable channel following continent urinary diversion. Materials and Methods: We retrospectively reviewed the records of 67 patients who underwent continent urinary diversion at British Columbia Children's Hospital from 2000 to 2006. Catheterizable channels included 54 Mitrofanoff appendicovesicostomies and 13 ileovesicostomies. Medical records were reviewed for predetermined complications and their timing, that is early—12 months or less, or late—more than 12 months. Results: At a median followup of 28 months (range 3 to 62) a total of 17 complications were identified in 14 patients (21%). Superficial cutaneous stenosis developed in 4 of 67 cases (6%) as an early and as a late complication. These cases were initially treated with operative dilation and surgical revision as necessary. Channel stricture, which developed in 4 of 67 patients (6%) as an early and as a late complication, was treated with operative revision in 2 and endoscopic resection in 2. Three patients (5%) had stomal prolapse, which was generally a late occurrence and required operative revision in all. Channel leakage developed in 6 of 67 patients, presenting as an early complication in 50%. Endoscopic injection of bulking agents was attempted in 4 of these patients and it was successful in 2. Overall 82% of complications were successfully managed by endoscopic or superficial procedures. Conclusions: Complications of the catheterizable channel are a frequent and challenging problem. They appear to occur throughout the life of the channel with most developing within the first 2 years. Further followup is required to assess the performance and durability of continent catheterizable channels in children as patients progress to adulthood. References 1 : Clean, intermittent self-catheterization in the treatment of urinary tract disease. J Urol1972; 107: 458. Abstract, Google Scholar 2 : Trans-appendicular continent cystostomy in the management of the neurogenic bladder. 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Google Scholar 9 : Outcomes of continent catheterizable stomas for urinary and fecal incontinence: comparison among different tissue options. BJU Int2005; 95: 1053. Google Scholar 10 : Continent catheterizable conduits: which stoma, which conduit and which reservoir?. BJU Int2002; 89: 86. Google Scholar 11 : The Mitrofanoff procedure: 20 years later. J Urol2001; 165: 2394. Link, Google Scholar 12 : The Yang-Monti ileovesicostomy: a problematic channel?. BJU Int2001; 87: 861. Crossref, Medline, Google Scholar 13 : Appendicovesicostomy: the Mitrofanoff procedure: a 15-year perspective. J Urol2000; 163: 1922. Link, Google Scholar 14 : Concealed umbilical stoma: long term evaluation of stomal stenosis. J Urol2001; 166: 1028. Link, Google Scholar 15 : Results of the Mitrofanoff procedure in urinary tract reconstruction in children. Br J Urol1997; 79: 279. Crossref, Medline, Google Scholar 16 : Continent catheterizable channels and the timing of their complications. J Urol2006; 176: 1816. Link, Google Scholar 17 : The challenge of pediatric continent urinary diversion. J Pediatr Surg2006; 41: 1113. Google Scholar 18 : Factors that influence outcomes of the Mitrofanoff and Malone antegrade continence enema reconstructive procedures in children. J Urol2002; 168: 1537. Link, Google Scholar 19 : The Mitrofanoff principle: expanding upon a versatile technique. Br J Urol1994; 74: 447. Crossref, Medline, Google Scholar 20 : The treatment of catheterizable stomal incontinence with endoscopic implantation of dextranomer/hyaluronic acid. J Urol2006; 175: 709. Link, Google Scholar Department of Pediatric Urological Sciences, University of British Columbia, Vancouver, British Columbia, Canada© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byO'Connor E, Foley C, Taylor C, Malde S, Raja L, Wood D, Hamid R, Ockrim J and Greenwell T (2019) Appendix or Ileum—Which is the Best Material for Mitrofanoff Channel Formation in Adults?Journal of Urology, VOL. 202, NO. 4, (757-762), Online publication date: 1-Oct-2019.Jacobson D, Thomas J, Pope J, Tanaka S, Clayton D, Brock J and Adams M (2016) Update on Continent Catheterizable Channels and the Timing of their ComplicationsJournal of Urology, VOL. 197, NO. 3 Part 2, (871-876), Online publication date: 1-Mar-2017.Kavanagh A, Afshar K, Scott H and MacNeily A (2012) Bladder Neck Closure in Conjunction with Enterocystoplasty and Mitrofanoff Diversion for Complex Incontinence: Closing the Door for GoodJournal of Urology, VOL. 188, NO. 4S, (1561-1566), Online publication date: 1-Oct-2012.Welk B, Herschorn S, Law C and Nam R (2012) Population Based Assessment of Enterocystoplasty Complications in AdultsJournal of Urology, VOL. 188, NO. 2, (464-469), Online publication date: 1-Aug-2012.Leslie B, Lorenzo A, Moore K, Farhat W, Bägli D and Pippi Salle J (2011) Long-Term Followup and Time to Event Outcome Analysis of Continent Catheterizable ChannelsJournal of Urology, VOL. 185, NO. 6, (2298-2302), Online publication date: 1-Jun-2011.Elshal A, Abol-Enein H, Sarhan O, Hafez A, Mosbah A, Abdel-Latif M, Ghaly A and Ghoneim M (2011) Catheterizable Serous Lined Urinary Outlet in Children and Adolescents: A Choice When Other Treatments FailJournal of Urology, VOL. 185, NO. 3, (1083-1087), Online publication date: 1-Mar-2011. Volume 180Issue 4SOctober 2008Page: 1856-1860 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsurinary diversionsurgical stomasurinary incontinencepostoperative complicationsmeningomyeloceleMetricsAuthor Information Blayne K. Welk More articles by this author Kourosh Afshar More articles by this author Daniel Rapoport More articles by this author Andrew E. MacNeily More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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