Transappendicular continent cystostomy. Critical study apropos of 30 cases
Mollard, P.; Basset, T.; Mouriquand, P.
Chirurgie Pediatrique 27(3): 121-123
1986
ISSN/ISBN: 0180-5738 PMID: 3769109 Document Number: 282624
Continent vesicostomy using appendix has been performed in 30 incontinent children (myelo-meningocele). Surgical technique is described laying stress on the closure of the bladder neck and the appendix arrangement: appendix is implanted in the bladder with an antireflux sub-mucosal tunnel and the other end is hemmed to the skin. Self-catheterization is very easy. All patients are dry but the rate of complications was very high: 77%--8 leakage through the bladder neck imposing one or two re-operations. 10 uretero-hydronephrosis related to a small and hypertonic bladder: enterocystoplasty with good results--5 lithiasis--2 perforations. Success of this technique is closely linked to the construction of a large and low pressure bladder: 11 enterocystoplasty have been performed secondarily and 4 during the first operation. Actually 26/30 patients are well with normal kidneys and excellent comfort. 1 to 7 years.