Abstract
Background: Chronic retention in infancy and childhood is induced secondary to lower urinary tract obstruction or dysfunction. Objectives: To evaluate the outcomes of temporary vesicostomy in children with voiding dysfunction, and to assess the possible predictors of morphological and functional improvement of upper urinary tract. Patients and Methods: This retrospective study included 69 patients who underwent cutaneous vesicostomy during the period from January 2014 to December 2019 at Al-Azhar University hospitals (Al-Hussein and Sayed Galal) Cairo; Egypt. Patients were evaluated by clinical history, examination, urine analysis, s.creatinine, ultrasonography, voiding cystourethrogram, magnetic resonance urography and renal scan before and 12 months after vesicostomy. Results: There was significant clinical, morphological and functional improvement. The mean serum creatinine before vesicostomy was 1.75±1.12mg/dl and improved gradually to 0.97 ±0.63 mg/dl after 12 months. Number of pus cells decreased gradually from 44.35±33.23 cell/ HPF to 2.65±1.74 cell/ HPF. The mean glomerular filtration rate (GFR) was 25.0±11.5 and 50.8±21.7ml/ minute pre and 12 months after vesicostomy respectively. Forty four (63.8%) cases were not complicated, 7 (10.1%) cases (5 male and 2 females) were complicated with prolapse, 8 (11.6%) cases complicated with stenosis and all of them were males, and 10 (14.5%) cases complicated with peristomal dermatitis and all of them were males. Conclusion: Vesicostomy is a simple urinary diversion, showing encouraging results towards safeguard of kidney function and morphology. Furthermore, the procedure has received rave reviews from the caregivers, and therefore, it has become a viable choice for children with neurological or other voiding dysfunctions or those that do not respond to conservative treatment.
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