Abstract: FR-PO645
Long-Term Complications and Outcomes of Augmentation Cystoplasty in Children with Neurogenic Bladder
Session Information
- Pediatric Nephrology - II
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Tsai, Hsin-Lin, Taipei Veterans General Hospital, Taipei, Taiwan
- Chang, Jei-Wen, Taipei Veterans General Hospital, Taipei, Taiwan
- Lin, Tzu-Ching, Taipei Veterans General Hospital, Taipei, Taiwan
Background
Controversy still exists regarding complications especially malignancy and long-term outcomes of augmentation cystoplasty (AC) in children with neurogenic bladder.
Methods
Pediatric patients <18 years underwent AC between 2000 and 2020 were enrolled. Early postoperative complications, long-term outcomes and histopathologic changes in mucosal biopsies of native bladder and the augmented intestine after AC were reviewed.
Results
Twenty-two patiients with mean age of 7.6±4.4 years were included. The ileum was used in 19 patients and the sigmoid colon in 3 patients. The length of hospital stay was 14.8±6.8 days. Post-operatively, urinary continence rate improved from 22.7% to 86.4% (p<0.001). Vesicoureteral reflux resolved in 16 (64.0 %) of the refluxing ureter units and was downgraded in 8 (32.0%). Hydronephrosis resolved in 17 of 19 patients. Grades of reflux and hydronephrosis significantly improved following AC (p<0.001). The estimated glomerular filtration rate also significantly increased (p=0.012). Formation of urinary tract stones was the most frequent late complication (in 8 patients, 36.4%). After a mean follow-up of 13.4±5.9 years, there were no cases of mortality, new-onset symptomatic metabolic acidosis, or effects on serum electrolytes. No cases of malignancy or metaplastic changes were identified in the native bladder or augmented bowel epithelium.
Conclusion
AC is a safe and effective procedure with low surgical and metabolic complication rates. AC provides a satisfactory continence rate and long-term protection of renal function, increases functional capacity, and regresses reflux and hydronephrosis. Individualized surveillance is recommended for the early identification of urolithiasis and metabolic disturbance.
Table 1 &2
Table 3 Renal and functional outcomes after augmentation cystoplasty
Funding
- Government Support – Non-U.S.