Long-Term Followup of Children with Colon Conduit Urinary Diversion and Ureterosigmoidostomy

Abstract

Sixty-four children underwent colon conduit urinary diversion because of a neurogenic bladder owing to myelomeningocele and 39 children required a ureterosigmoidostomy because of bladder exstrophy. The average length of followup was 4.6 years after colon conduit and 5.6 years after ureterosigmoidostomy. Colon conduit diversion was secondary in 3 children and ureterosigmoidostomy was secondary in 5. Of the children with a colon conduit 9.4 per cent and of those with ureterosigmoidostomy 12.8 per cent had postoperative surgical complications. Late surgical complications were encountered after colon conduit in 14.5 per cent and after ureterosigmoidostomy in 20 per cent. Of the children with normal renal function preoperatively 8.3 per cent showed late deterioration after colon conduit and 8.7 per cent after ureterosigmoidostomy. Conversely, only 16.7 per cent with impaired renal function preoperatively did not improve at long-term followup after colon conduit. Of the renoureteral units 91 per cent were normal after colon conduit and 95.2 per cent were normal after ureterosigmoidostomy. The colon conduit halted the preoperative pyelonephritis in 74 per cent of 31 affected kidneys.