You have accessJournal of UrologyPediatrics: Neuropathic Bladder/Reconstruction1 Apr 2013478 LOWER URINARY TRACT RECONSTRUCTION WITH CONCOMITANT CECOSTOMY BUTTON FOR ANTEGRADE ENEMA Chandra Singh, Daryl McLeod, Cheryl Baxter, Seth Alpert, and Venkata Jayanthi Chandra SinghChandra Singh Columbus, OH More articles by this author , Daryl McLeodDaryl McLeod Columbus, OH More articles by this author , Cheryl BaxterCheryl Baxter Columbus, OH More articles by this author , Seth AlpertSeth Alpert Columbus, OH More articles by this author , and Venkata JayanthiVenkata Jayanthi Columbus, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1870AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Procedures to enable antegrade enema improve the quality of life in children with intractable constipation related to neurogenic bowel and bladder dysfunction. Appendicocecostomy (AC) and Cecostomy button (CB) allow easy access for colonic wash-outs and help to achieve socially acceptable fecal continence. In children undergoing lower urinary tract reconstruction (LUTR), we have been offering concomitant CB to achieve total continence as an alternate to AC. This study aims to evaluate the outcome of LUTR with concomitant CB. METHODS We retrospectively reviewed the records of patients who underwent CB for intractable bowel dysfunction at the time of LUTR. Initial temporary cecostomy tubes were placed in the right iliac fossa during LUTR. After six weeks, this was exchanged for a Chait trapdoor CB. Subsequently, patients were scheduled for six month or annual exchange of the Chait tube by interventional radiology. Antegrade enema irrigation regimens varied and included water with or without additives. The outcome, follow up and complications were evaluated. RESULTS Between 2001 and 2011, a total of 110 patients underwent CB of whom 27 were performed at the time of LUTR, which included bladder outlet procedures, augmentations and abdominal catheterizable channels. There were 11 males and 16 females. The mean age at the time of surgery was 9.6 years (range 3.8–24.9). The mean follow was 29 months (range 1–115 months). Patients had an average of 4.2 (range 1–15) elective fluoroscopy guided tube changes during the study period. At studies end, 22 (81.5%) of patients continued to use their CB, reporting good functional results. Accidental removal of the CB occurred three times, and was managed by fluoroscopic replacement. Other self limiting complications included mucous discharge and pain around the tube. None of the patients required a visit to the operating room for complications related to CB. CONCLUSIONS Cecostomy button is a simple procedure for antegrade colonic enema administration. It can be combined with LUTR as an alternative to AC. By avoiding AC, the appendix can be spared for consideration during the LUTR, with minimal morbidity or complications noted in our study population. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e196 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chandra Singh Columbus, OH More articles by this author Daryl McLeod Columbus, OH More articles by this author Cheryl Baxter Columbus, OH More articles by this author Seth Alpert Columbus, OH More articles by this author Venkata Jayanthi Columbus, OH More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...