To present the results of technique of continent urinary diversion, described by Macedo, that allows the configuration of a tunnel with a flap of the ileal tube at the same segment created for the reservoir.
From January 2006 to November 2016, 29 patients were underwent a urinary diversion by Macedo's technique. Patients demographics, hospitalization time, surgical time, follow up, continence rate, reservoir capacity and postoperative complications were evaluated.
69% were male and the median age was 16.9 years. The main etiology was meningomyelocele (69.1%). The mean surgical time was 4.2 hours (SD 0.9 range 2.9-6.3). The median length of hospital stay was 10 days (IQR: 11.3 range 5-51). The mean follow up was 3.3 years (SD 2.2 range 0.3 - 9.8). Procedure in the bladder neck was performed in 12 patients (41.3%). A continence rate of the catheterizable conduit was 82.8%.The reservoir capacity increased from 134.4 to 364.4 ml (p <0.0001). The continence rate improved significantly (20 vs. 74%, p <0.0001). There was no change in glomerular filtration rates in the long term (143.1 vs. 147, p = 0.45). Morbidity rate was 58% (25 complications in 17 patients), 72% occurred within the first 60 days and 60% were classified as Clavien-Dindo I or II.
Except for publications from the original author, this is the first series described. The outcomes are similar, adding important data with respect to this technique. They show that the ileal reservoir is feasible, reproducible and with good results.
Urology. 2018 Jun 26 [Epub ahead of print]
Patric Machado Tavares, Guilherme Pereira Smaniotto, Tiago Bortolini, Nicolino Cesar Rosito, Brasil Silva Neto, Tiago Elias Rosito
Urology Department of Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil . Electronic address: ., Urology Department of Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil., Pediatric Surgery Department of Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.