Blasenaugmentation und -ersatz bei Kindern und Jugendlichen

• Verfasst von: Stein, Raimund [VerfasserIn]
• Verfasst von: Wessel, Lucas [VerfasserIn]
• Verfasst von: Michel, Maurice Stephan [VerfasserIn]
• Titel: Blasenaugmentation und -ersatz bei Kindern und Jugendlichen
• Paralleltitel: Bladder augmentation and urinary diversion in children and adolescents
• Verf.angabe: R. Stein, L. Wessel, M.S. Michel
• Jahr: 2016
• Jahr des Originals: 2015
• Umfang: 9 S.
• Fussnoten: Gesehen am 22.01.2019 ; Online publiziert:11. Dezember 2015
• Titel Quelle: Enthalten in: Der Urologe
• Ort Quelle: [Berlin : Springer Medizin, 2005
• Jahr Quelle: 2016
• Band/Heft Quelle: 55(2016), 1, Seite 44-52
• DOI: doi:10.1007/s00120-015-0006-0
• Datenträger: Online-Ressource
• Sprache: ger
• Sach-SW: Anal diversion
• Sach-SW: anale
• Sach-SW: Bladder
• Sach-SW: Blase
• Sach-SW: Children and adolescent
• Sach-SW: Continent cutaneous diversion
• Sach-SW: Harnableitung
• Sach-SW: Kinder und Jugendliche
• Sach-SW: kleinkapazitäre
• Sach-SW: kontinente kutane
• Sach-SW: small capacity
• Sach-SW: Sphincter defects
• Sach-SW: Sphinkterdefekt
• K10plus-PPN: 1586485407

Abstract

Background: In children and adolescents, the indication for continent urinary diversion or bladder augmentation is rare. Today, for most patients with a neurogenic bladder, conservative treatment (clean intermittent catheterization [CIC] and pharmacotherapy) is the method of choice, while for patients with bladder exstrophy-epispadias complex (BEEC), primary reconstruction is recommended. Only after failure of conservative treatment or primary reconstruction should bladder augmentation or urinary diversion be considered. Other rare indications include patients with malignant tumor involving the lower urinary tract (e. g., rhabdomyosarcoma). Discussion: In patients with a hyperreflexive, small capacity, and/or low compliance bladder with a normal upper urinary tract, bladder augmentation (bowel segments/ureter) is an option. For those unable to perform CIC via the urethra, a continent cutaneous stoma should be offered. In patients with irreparable sphincter defects and normal renal function, a continent cutaneous diversion is an option and in those with a competent anal sphincter the rectosigmoid pouch can be offered. Conclusion: In this review, surgical options with their advantages and disadvantages are discussed.