Keating M A, Rink R C, Adams M C
Department of Urology, Indiana University School of Medicine, Indianapolis.
J Urol. 1993 May;149(5):1091-4. doi: 10.1016/s0022-5347(17)36305-x.
Appendicovesicostomy is a useful adjunct to continent reconstruction of the bladder. During the last 3 years we have used this procedure in 14 children with difficult incontinence due to spina bifida (7), exstrophy/epispadias (5), imperforate anus (1) and urethral agenesis (1). In 4 patients in whom previous operations had failed to achieve continence the bladder neck was closed. In the remaining 10 children, all of whom had difficulty or discomfort catheterizing the native urethra, the bladder neck/urethra was preserved or reconstructed to serve as a vent for elevated bladder pressures. Continence was achieved in all 14 children with no complications related to the appendix. All children in whom the bladder neck/urethra was salvaged preferentially empty via the appendix and remain dry, except when the bladder is overly full.
阑尾膀胱造口术是膀胱可控性重建的一种有用辅助手段。在过去3年中，我们对14例因脊柱裂（7例）、膀胱外翻/尿道上裂（5例）、肛门闭锁（1例）和尿道发育不全（1例）导致排尿困难的儿童采用了该手术。在4例先前手术未能实现控尿的患者中，膀胱颈被关闭。其余10例儿童均存在经原尿道导尿困难或不适的情况，膀胱颈/尿道被保留或重建以作为膀胱内压升高时的一个出口。14例儿童均实现了控尿，且未出现与阑尾相关的并发症。所有膀胱颈/尿道得以保留的儿童，除膀胱过度充盈时外，优先通过阑尾排尿且保持干爽。
