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S22-14
(P)
LONG-TERM FOLLOW-UP OF CONTINENT CATHETERIZABLE CHANNELS IN
CHILDREN, A COMPARISON OF DIFFERENT TECHNIQUES
Pepijn POLM
1
, Laetitia DE KORT
1
, Tom DE JONG
2
and Pieter DIK
2
1) Univeristy Medical Centre Utrecht, Urology, Utrecht, NETHERLANDS - 2) University Children's Hospital UMC Utrecht,
Pediatric Urology, Utrecht, NETHERLANDS
INTRODUCTION
Since 1980 different techniques for creating a continent catheterizable channel (CCC) have been described. The
objective of this study was to compare long-term results of the different techniques used to create CCC's in a single
institution.
PATIENTS AND METHODS
Data of 112 children who had a CCC created between December 1995 and December 2013 was collected retrospectively.
All cases, with minimum follow-up of 12 months post-surgery, where appendix, bladder flap, or ileum was used, were
included. Primary outcomes were revision free survival, stenosis and incontinence.
RESULTS
A total of 117 CCC's (Appendix 67, Bladder flap 31, Ileum 19) with a median stoma follow-up of 85 months (range 3-
229) were analyzed. Underlying diagnosis was neurogenic bladder (77%), urethral pathology (11%), neuromuscular
disease (6%) and bladder exstrophy (6%). Surgical revision was required in 52% (Appendix 52%, Bladder flap 48%,
Ileum 58%). Laparotomy was required in 27% (Appendix 22%, Bladder flap 23%, Ileum 53%). Stenosis requiring
revision was seen in 33% (Appendix 40%, Bladder flap 29%, Ileum 16%). At the end of follow-up 12% was considered
incontinent (Appendix 12%, Bladder flap 3%, Ileum 32%). Differences in Kaplan-Meier survival analysis were not
significant.
CONCLUSIONS
A CCC is an elegant solution for children who experience problems with urethral catheterization. However, 52% requires
surgical revision. We found no significant differences in outcome between CCC's from appendix or bladder flap leading
us to conclude that a bladder flap CCC is a good alternative solution if the appendix is not available and bladder volume
is sufficient.