Risk factors for spontaneous bladder perforation after augmentation cystoplasty
| Autor: | Leslie D. Tackett, Curtis A. Sheldon, William DeFoor, Eugene Minevich, Jeffrey Wacksman |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Colon Urology medicine.medical_treatment Urinary Bladder Perforation (oil well) Spontaneous Perforation Urinary catheterization Postoperative Complications Ileum Risk Factors Colon surgery Humans Medicine Child Retrospective Studies Postoperative Care Rupture Urinary bladder Rupture Spontaneous business.industry Incidence Anastomosis Surgical Stomach Urinary Bladder Diseases Infant Bladder Perforation medicine.disease Surgery Cystostomy Neck of urinary bladder medicine.anatomical_structure Child Preschool Female Urinary Catheterization business Urinary bladder disease Follow-Up Studies |
| Zdroj: | Urology. 62:737-741 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/s0090-4295(03)00678-2 |
| Popis: | Objectives To present our experience with the use of stomach, ileum, and colon for augmentation cystoplasty to examine the incidence of, and risk factors for, spontaneous perforation. Spontaneous bladder perforation is a potentially life-threatening complication of augmentation cystoplasty with a reported incidence of up to 13%. Methods A retrospective review of medical records from 1988 to 2001 identified 107 children (57 males and 50 females) who underwent augmentation cystoplasty at our institution. The etiology for bladder dysfunction included myelomeningocele, VATER (vertebral defects, imperforate anus, tracheoesophageal fistula, radial and renal dysplasia) syndrome, bladder and cloacal exstrophy, posterior urethral valves, and pelvic malignancy. Thirteen patients also had end-stage renal disease. Results The median follow-up was 7.4 years. Gastrocystoplasty was performed in 50 children (47%), ileocystoplasty in 37 (35%), colocystoplasty in 18 (17%), and gastric-ileal composite neobladder in 2 (2%). Augmentation cystoplasty procedures were performed using a standard technique that included a two-layer anastomosis. Additional procedures at the time of reconstruction included Mitrofanoff neourethra in 66 patients (62%) and bladder neck repair in 44 (41%). Postoperatively, most patients started a strict incremental catheterization regimen. The overall incidence of bladder perforation was 5%, with one traumatic (1%) and four spontaneous (4%) perforations. All patients recovered uneventfully after exploratory laparotomy. Conclusions We believe that the relatively low incidence of spontaneous bladder perforation encountered in this series may be explained by the large number of patients with gastrocystoplasty, as well as our strict adherence to a postoperative incremental catheterization program. |
| Databáze: | OpenAIRE |
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