OBJECTIVE: To describe the urological and nephrological long-term outcome of patients born with classical bladder exstrophy treated with bilateral ureterosigmoidostomies in early childhood. PATIENTS AND METHOD: Out of 42 patients born with bladder exstrophy in Switzerland between 1937 and 1968, 25 participated in this study; seven had died, seven were lost to follow up and three refused consent. Assessment included chart review, clinical examination, and assessment of renal function and morphology. RESULTS: After a follow-up period of 37-69 years ((mean 50 years), 13 of the 25 participants (52%) had their ureterosigmoidostomy still in place. All others had different forms of urinary diversions. Fifteen (60%) patients had normal renal function or mild chronic kidney disease as assessed by estimated glomerular filtration rate. Three patients were on renal replacement therapy. MRI (n=16) showed 10 morphologically normal kidneys. One patient suffered from adenocarcinoma of the colon, five had benign colonic polyps, one urethral papillary carcinoma and 18 no evidence of tumor. CONCLUSION: The majority of our patients have normal or mildly impaired renal function and a well functioning ureterosigmoidostomy. This is remarkable, given the fact that ureterosigmoidostomies are considered to be refluxing high-pressure reservoirs at risk of renal injury and malignancy.
OBJECTIVE: To describe the urological and nephrological long-term outcome of patients born with classical bladder exstrophy treated with bilateral ureterosigmoidostomies in early childhood. PATIENTS AND METHOD: Out of 42 patients born with bladder exstrophy in Switzerland between 1937 and 1968, 25 participated in this study; seven had died, seven were lost to follow up and three refused consent. Assessment included chart review, clinical examination, and assessment of renal function and morphology. RESULTS: After a follow-up period of 37-69 years ((mean 50 years), 13 of the 25 participants (52%) had their ureterosigmoidostomy still in place. All others had different forms of urinary diversions. Fifteen (60%) patients had normal renal function or mild chronic kidney disease as assessed by estimated glomerular filtration rate. Three patients were on renal replacement therapy. MRI (n=16) showed 10 morphologically normal kidneys. One patient suffered from adenocarcinoma of the colon, five had benign colonic polyps, one urethral papillary carcinoma and 18 no evidence of tumor. CONCLUSION: The majority of our patients have normal or mildly impaired renal function and a well functioning ureterosigmoidostomy. This is remarkable, given the fact that ureterosigmoidostomies are considered to be refluxing high-pressure reservoirs at risk of renal injury and malignancy.
Authors: Anthony J Schaeffer; Andrew A Stec; Nima Baradaran; John P Gearhart; Ranjiv I Mathews Journal: J Pediatr Urol Date: 2012-02-24 Impact factor: 1.830
Authors: T Kälble; I Hofmann; J W Thüroff; R Stein; R Hautmann; H Riedmiller; D Vergho; L Hertle; C Wülfing; M Truß; S Roth; F C von Rundstedt; P Albers; J Gschwend; K Herkommer; U Humke; M Spahn; P Bader; J Steffens; R Harzmann; C G Stief; A Karl; S C Müller; M Waldner; J Noldus; K Kleinschmidt; P Alken; B Kopper; M Fisch; A Lampel; A Stenzel; J Fichtner; B Flath; H Rübben; K P Juenemann; S Hautmann; A Knipper; D Leusmann; W Strohmaier; W F Thon; S Miller; K Weingärtner; A Schilling; H Piechota; J E Becht; H Schwaibold; P Bub; S Conrad; U Wenderoth; W Merkle; W Rösch; T Otto; B Ulshöfer; M Westenfelder Journal: Urologe A Date: 2012-04 Impact factor: 0.639