Abstract
We present the results of a new technique using a pedicled cutaneous flap for continent cystostomy. A total of 15 boys and 8 girls (mean +/- SD age 13.4 +/- 6.4 years) underwent continent cystostomy for neurogenic bladder (20), bladder exstrophy (2) and sequelae of hypospadias (1) between 1999 and 2008. In this procedure a rectangular pedicled flap is surgically elevated from a hairless area on the abdomen. The flap is tubularized and passed through the anterior abdominal wall directly into the bladder. A submucosal detrusor incision is made to expose the bladder mucosa, and the distal part of the flap is anastomosed to the bladder mucosa in a circular manner. The tube is positioned along the incised detrusor, which is closed over. Viability of the flap, self-catheterization management and continence status are then evaluated. Mean +/- SD followup was 4.5 +/- 3.1 years. There was 1 case of distal necrosis of the flap, which required a secondary surgery using the Mitrofanoff technique. The 22 remaining flaps were initially viable, although 2 patients were eventually lost to followup and 3 subsequently presented with false-passage incidents requiring a few days of calibration using a balloon catheter. Dryness was achieved immedia...Continue Reading
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Mar 9, 2012·Advances in Urology·Peter T Dorsher, Peter M McIntosh
Jun 1, 2012·Journal of Pediatric Urology·Antonio MacedoValdemar Ortiz
May 1, 2012·Journal of Pediatric Urology·Antonio MacedoValdemar Ortiz
Mar 27, 2012·Journal of Pediatric Urology·Antonio MacedoValdemar Ortiz
Mar 11, 2015·Ultrasonography·Yiu Shiobhon LukJennifer Lai San Khoo