[Bladder augmentation cystoplasty with continent urinary diversion by ileo-caeco-appendicular graft in children].

Objective: Description of augmentation cystoplasty combined with continent urinary diversion using an ileo-caeco-appendicular graft in children.

Material And Method: Augmentation cystoplasty combined with Mitrofanoff appendicostomy and reimplantation of the ureters into the ileal stump was performed during a single operation in two patients (a 3-year-old girl and an 8-year-old boy). The indications were a pseudoneurogenic bladder with major dilatation of the upper tract due to high-grade reflux in one case and a small scarred bladder after repeated failure of repeated surgery for duplicated ureterocele in another case.

Results: A bladder capacity of about 300 ml was obtained in the 2 children. Incontinence was managed by intermittent catheterization via the abdominal stoma. Upper urinary tract dilatation had resolved after one year.

Conclusion: This technique is useful in certain complex urological situations combining a small, poorly compliant bladder, destruction of continence and severe upper tract dilatation. In these situations, it constitutes a conservative alternative to salvage diversion.