FUNCTIONAL OUTCOME AND SPECIFIC COMPLICATIONS OF GASTROCYSTOPLASTY FOR FAILED BLADDER EXSTROPHY CLOSURE

No AccessJournal of UrologyExstrophy1 Sep 1998FUNCTIONAL OUTCOME AND SPECIFIC COMPLICATIONS OF GASTROCYSTOPLASTY FOR FAILED BLADDER EXSTROPHY CLOSURE ALAA EL-GHONEIMI, CONRAD MULLER, JEAN M. GUYS, MICHEL COQUET, and GERARD MONFORT ALAA EL-GHONEIMIALAA EL-GHONEIMI More articles by this author , CONRAD MULLERCONRAD MULLER More articles by this author , JEAN M. GUYSJEAN M. GUYS More articles by this author , MICHEL COQUETMICHEL COQUET More articles by this author , and GERARD MONFORTGERARD MONFORT More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62735-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The encouraging initial results of gastrocystoplasty led us to perform it for failed bladder exstrophy closure. We assess the functional outcome of the augmented bladder and evaluate complications related directly to use of the stomach in this specific group of children. Materials and Methods: We performed gastrocystoplasty in 22 children an average of 9.5 years old with a small, poorly compliant bladder after staged reconstruction of bladder exstrophy failed. Followup ranged from 6 months to 6 years (mean 3 years). Results: Complete urinary continence was achieved in 14 children (64%). Voiding via the urethra was possible in 13 patients (60%) but post-voiding residual urine was significant in 12. Bladder capacity increased from a mean of 77 to 270 ml. Bladder capacity decreased during followup in 3 children, requiring repeat augmentation. Six children had isolated dysuria and 2 had dysuria with hematuria. Perforation of the gastric patch and a bleeding gastric ulcer occurred in 1 patient each. Conclusions: The disadvantages of gastrocystoplasty outnumber its advantages after failed bladder exstrophy closure. Urethral sensation makes dysuria a major discomfort. Safety is not optimal, since perforation may occur. Voiding is not efficient because gastrocystoplasty provides continence only when it is associated with intermittent catheterization. Bladder capacity is insufficiently augmented and inconsistent during followup. We believe that the use of gastrocystoplasty in cases of failed bladder exstrophy closure should be reconsidered. References 1 : Techniques to create continence in the failed bladder exstrophy closure patient. J. Urol.1993; 150: 441. Link, Google Scholar 2 : Gastrocystoplasty in the treatment of bladder exstrophy. Eur. J. Ped. Surg.1995; 5: 342. Google Scholar 3 : Urodynamics in normal infants and children. Scand. J. Urol. Nephrol.1988; 114: 20. Google Scholar 4 : Long-term results of ureterosigmoidostomy in children with bladder exstrophy. J. 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Link, Google Scholar From the Departments of Pediatric Urology, Hopital La Timone, Marseilles and Hopital Robert Debre, Paris, France© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byDeFOOR W, MINEVICH E, REEVES D, TACKETT L, WACKSMAN J and SHELDON C (2018) Gastrocystoplasty: Long-Term FollowupJournal of Urology, VOL. 170, NO. 4 Part 2, (1647-1650), Online publication date: 1-Oct-2003.MINGIN G, STOCK J and HANNA M (2018) GASTROCYSTOPLASTY: LONG-TERM COMPLICATIONS IN 22 PATIENTSJournal of Urology, VOL. 162, NO. 3 Part 2, (1122-1125), Online publication date: 1-Sep-1999.STEIN R, FISCH M, BLACK P and HOHENFELLNER R (2018) STRATEGIES FOR RECONSTRUCTION AFTER UNSUCCESSFUL OR UNSATISFACTORY PRIMARY TREATMENT OF PATIENTS WITH BLADDER EXSTROPHY OR INCONTINENT EPISPADIASJournal of Urology, VOL. 161, NO. 6, (1934-1941), Online publication date: 1-Jun-1999.KURZROCK E, BASKIN L and KOGAN B (2018) GASTROCYSTOPLASTY: LONG-TERM FOLLOWUPJournal of Urology, VOL. 160, NO. 6 Part 1, (2182-2186), Online publication date: 1-Dec-1998. Volume 160Issue 3 Part 2September 1998Page: 1186-1189 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information ALAA EL-GHONEIMI More articles by this author CONRAD MULLER More articles by this author JEAN M. GUYS More articles by this author MICHEL COQUET More articles by this author GERARD MONFORT More articles by this author Expand All Advertisement PDF downloadLoading ...