Evolution of Impaired Renal Function in Children After Continent Vesicostomy

Abstract

Abstract The aim of this study was to determine whether early commencement of clean intermittent catheterisation can improve impaired kidney function in children with continent vesicostomy as well as to analyse the effect of different types of continent vesicostomy and the observed outcome. All children with continent urinary derivation performed at the University Children’s Hospital in Belgrade, Serbia, during the period 1990-2016, were included in this retrospective-prospective study. The participants were divided into three groups with respect to type of continent vesicostomy (appendicovesicostomy, preputial continent vesicostomy, and vesicostomy using distal ureter). Clean Intermittent Catheterisation with continent vesicostomy, oxybutynin, and antibiotic prophylaxis were used in a standard way. Renal function was monitored by the value of glomerular filtration rate taken before the start of the therapy and three years afterward. The significance of differences was tested by the paired-samples t-test and ANOVA test. We analysed 74 patients aged 3 to 10 years (5.5-y average) of which 80% were boys. Renal function improved in 60.5% patients. A highly significant improvement in kidney function three years after the commencement of combined treatment was shown irrespective of the performed method of vesicostomy (p<0.01). Using the ANOVA test, we have proved that there is no difference in the efficiency of therapy between particular groups (p= 0,256). The timely started therapy lead to significant kidney function improvement. The type of continent vesicostomy did not affect kidney function.