Long-Term Followup of Children with Colon Conduit Urinary Diversion and Ureterosigmoidostomy

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Abstract
Children (64) underwent colon conduit urinary diversion because of a neurogenic bladder owing to myelomeningocele and 39 children required a ureterosigmoidostomy because of bladder exstrophy. The average length of followup was 4.6 yr after colon conduit and 5.6 yr after ureterosigmoidostomy. Colon conduit diversion was secondary in 3 children and ureterosigmoidostomy was secondary in 5. Of the children with a colon conduit 9.4% and of those with ureterosigmoidostomy 12.8% had postoperative surgical complications. Late surgical complications were encountered after colon conduit in 14.5% and after ureterosigmoidostomy in 20%. Of the children with normal renal function preoperatively 8.3% showed late deterioration after colon conduit and 8.7% after ureterosigmoidostomy. Only 16.7% with impaired renal function preoperatively did not improve at long-term followup after colon conduit. Of the renoureteral units 91% were normal after colon conduit and 95.2% were normal after ureterosigmoidostomy. The colon conduit halted the preoperative pyelonephritis in 74% of 31 affected kidneys.