小儿失禁肠膀胱造口术：神经源性膀胱手术治疗的可行选择。

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-06-01 DOI:10.1016/j.urology.2025.04.021

Benjamin Press , Elizabeth Chu , Nahal Orak , Corey Weinstein , Edwin Smith , Andrew Kirsch , Shuvro De , Michael Garcia-Roig

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引用次数: 0

摘要

目的：报道一系列小儿肠梗阻造口术的结果。失禁肠膀胱造口术是小儿神经源性膀胱患者膀胱重建的可行方法，但该年龄组的临床结果数据很少。材料与方法：对26例神经源性膀胱患儿（女14例，男12例）行失禁肠膀胱造口术，中位年龄12.4岁（IQR: 6.4 ~ 14.0岁）。中位随访时间为18.99个月（IQR: 11.2-44.7个月），大多数患者（76.9%）的初步诊断为脊膜膨出。手术指征包括复发性尿路感染、尿道失禁和膀胱敌意。中位手术时间241.5分钟（IQR: 192 ~ 273分钟），中位住院时间5天。术后30天内，76.9%的患者无并发症发生。所有患者肾功能保持稳定，仅有1例患者肾积水恶化。结论：小肠膀胱造口术是一种安全、可行、有效的治疗小儿神经源性膀胱的手术选择。有效治疗膀胱敌意，保护上尿路功能，并发症发生率低。未来的研究应侧重于前瞻性的、多中心的研究，比较失禁膀胱造口术和膀胱隆胸成形术的长期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Incontinent Enterovesicostomy in the Pediatric Population: A Feasible Option for Surgical Management of Neurogenic Bladder

Objective

To report outcomes of a series of pediatric patients undergoing incontinent enterovesicostomy. Incontinent enterovesicostomy is a viable procedure for bladder reconstruction in pediatric patients with neurogenic bladder, but clinical outcomes data in this age group are scarce.

Materials and Methods

A retrospective chart review was conducted on pediatric patients (<18 years old) who underwent incontinent enterovesicostomy at a single institution between 2011 and 2024. Data were collected from electronic medical records and analyzed using descriptive statistics.

Results

A total of 26 pediatric patients (14 female, 12 male) with neurogenic bladder underwent incontinent enterovesicostomy at a median age of 12.4 years (IQR: 6.4-14.0 years). The median follow-up duration was 18.99 months (IQR: 11.2-44.7 months), and most patients (76.9%) had a primary diagnosis of myelomeningocele. Indications for surgery included recurrent urinary infections, urethral incontinence, and bladder hostility. The median operative time was 241.5 minutes (IQR: 192-273 minutes), and the median hospital stay was 5 days. Within 30 days postsurgery, 76.9% of patients experienced no complications. Renal function remained stable in all patients, and hydronephrosis status worsened in only 1 patient.

Conclusion

Enterovesicostomy is a safe, feasible, and effective surgical option for managing neurogenic bladder in pediatric patients. It reliably treats bladder hostility and protects upper urinary tract function with a low complication rate. Future research should focus on prospective, multicenter studies comparing long-term outcomes of incontinent enterovesicostomy with augmentation cystoplasty.

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.