We report the current status of patients who underwent augmentation cystoplasty (AC) at least 20years previously.
Surgical history, incidence of urinary tract infection (UTI) and bladder stones, vesicoureteral reflux (VUR), urine cytology, renal function, a colon cancer tumor marker (carcinoembryonic antigen: CEA), and patient outcomes were assessed.
Forty patients who underwent AC (mean age: 34.4years; mean follow-up time: 24.3years) were analyzed. Mean age at AC was 11years. Incidence of bladder stones was 30%. There were no incidences of carcinoma after AC, and CEA levels were not increased. Ureteral reimplantation (URI) was performed in 21 patients. URI performed at the same time as AC was successful in 14 cases (93%) and unsuccessful in 1 (7%) because of persistent VUR. UTI developed after AC in only 1 patient (2.5%) with persistent VUR. This patient required unilateral nephrectomy 18years after the AC because of repeated UTIs. Thirty-four patients (85%) were employed, and 4 (10%) were married. Two of the 19 female patients (11%) had experienced pregnancy and delivery. Five patients (13%) had mental disorders.
Ultra long-term follow-up suggests that AC is a safe procedure with manageable sequelae, although some mental health issues remain.
Case series with no comparison group.
Journal of pediatric surgery. 2017 Sep 02 [Epub]
Yutaka Hayashi, Emi Nishimura, Satoko Shimizu, Go Miyano, Manabu Okawada, Itsuro Nagae, Geoffrey J Lane, Kenji Katsumata, Atsuyuki Yamataka, Akihiko Tsuchida
Department of General and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan. Electronic address: ., Department of General and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan., Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.