Lluna González J, Domínguez Hinarejos C, Estornell Moragues F, Martínez Verduch M, García Ibarra F
Unidad de Urología Pediátrica, Hospital Infantil La Fe, Valencia, España.
Arch Esp Urol. 1995 Dec;48(10):1023-6.
To evaluate the upper urinary tract morphology and function in children undergoing vesicostomy for different causes.
We report on 27 children aged 1 month to 12 years who had undergone a Blocksom vesicostomy procedure. Twenty had a neuropathic bladder and 3 had posterior urethral valves.
In the 20 children with neuropathic bladder, renal function improved in 95% and the associated vesicoureteral reflux improved in 56%. The morphology of the upper urinary tract returned to normal prior to the definitive operation in all cases. Only one of the patients with posterior urethral valves has preserved satisfactory renal function two years following vesicostomy. The most common complication was prolapse (14.8%).
In our view, vesicostomy is the best urinary diversion procedure in the cases described herein. Vesicostomy closure must be performed following definitive treatment of the underlying condition, except in those cases with neuropathic bladder who require augmentation cystoplasty to keep upper urinary tract pressures low.
评估因不同原因接受膀胱造瘘术的儿童上尿路形态及功能。
我们报告了27例年龄在1个月至12岁之间接受布洛克索姆膀胱造瘘术的儿童。其中20例患有神经源性膀胱，3例患有后尿道瓣膜症。
在20例神经源性膀胱患儿中，95%的患儿肾功能得到改善，56%的患儿相关膀胱输尿管反流得到改善。所有病例中上尿路形态在最终手术前均恢复正常。膀胱造瘘术后两年，后尿道瓣膜症患儿中只有1例肾功能保持良好。最常见的并发症是脱垂（14.8%）。
我们认为，膀胱造瘘术是本文所述病例中最佳的尿液转流手术。除了那些需要进行膀胱扩大成形术以保持上尿路压力较低的神经源性膀胱病例外，必须在对潜在疾病进行明确治疗后再进行膀胱造瘘术关闭。
