A 22-Year Followup of Ileal Conduits in Children with a Neurogenic Bladder

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Abstract
The ileal conduit had previously been used in children for diversion of urine from the neurogenic bladder to prevent deterioration of the upper urinary tracts and to manage urinary incontinence. Long-term results after ileal conduits in children have revealed upper tract deterioration and a high complication rate. The complications and renal deterioration rates in 139 children with ileal conduits followed up to 22 yr were evaluated. Of 224 complications 114 required surgical correction. Upper urinary tract deterioration occurred in 16.5% of 50 children followed for 10 or more yr (mean 13.3 yr). The ileal conduit has been replaced by clean intermittent catheterization, ureteral reimplantation for reflux, the artificial sphincter and undiversion in the management of neurogenic bladders in children. Long-term followup will be necessary to compare the results of these procedures to the known long-term results of the ileal conduit to determine the appropriate role of the ileal conduit in the management of children with neurogenic bladders.