A comparison of the Yang-Monti and appendix in the practice of the continent urinary diversion

Abstract

Objective To compare the outcomes of Yang-Monti channels and appendix in the practice of catheterizable continent urinary conduits. Methods Retrospective analyses were conducted in 27 cases with neurogenic bladder from July 2009 to December 2015, including 8 male and 19 female patients whose average age at surgery was 7.6 years old (range: 1.5-16 years). The average bladder volume is (203.8±126.0) ml. The bladder compliance values of 24 cases are lower than 20 ml/cm H2O. Seventeen cases had urinary infection combined with fever before surgery, while 6 cases had stress urinary incontinence and 17 cases had dysuria. Seven cases including 2 male patients underwent urinary diversion with Yang-Monti channels (YM group) and the average age at surgery for patients was 6.7 years old(range: 4-16 years). Twenty cases including 6 male patients underwent urinary diversion with appendix (AP group) and the average age at surgery for patients was 8.0 years old(range: 1.5-14 years). The 3-day urinary diaries were collected in all cases including their records of average catheterization interval, average catheterization volume, stoma stenosis and stoma leakage.The data between the two groups was compared and the statistical analysis was performed. Results Of the 7 patients undergoing Yang-Monti channels, 2 cases underwent open surgery and 5 cases underwent laparoscopic surgery in which 2 cases transferred to open surgery. The stoma stenosis occurred in 1 case and the stoma leakage occurred in 1 case. The average catheterization volume is (239.3±76.2) ml and the average catheterization interval is(2.8±0.9)h. Six patients in the group were followed up less than 3 years, of which the average catheterization interval is (2.6±0.8)h. Of the 20 patients undergoing appendix channels, 3 cases underwent open surgery and 17 cases underwent laparoscopic surgery in which 1 case transferred to open surgery. The stoma stenosis occurred in 1 case and the stoma leakage occurred in 2 cases. The average catheterization volume is (257.0±67.4)ml and the average catheterization interval is(3.9±0.9)h. Six patients in the group were followed up less than 3 years, of which the average catheterization interval is(3.5±1.0) h. There was no difference in stoma stenosis and stoma leakage and average catheterization volume between the two groups(P>0.05). There was no difference in average catheterization interval between the patients of two groups who were followed up less than 3 years (P>0.05). Conclusions Yang-Monti conduits are durable and reliable, which was similar with appendix conduits. Key words: Yang-Monti channels; Continence; Urinary diversion