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[Ureteral meatotomy associated with vesicostomy, a possible urinary derivation?].

AIM
To show our experience in urinary derivation by ureteral meatotomy associated with vesicostomy.


METHODS
We reviewed uni or bilateral ureteral meatotomy associated with vesicostomy carried out in our institution between 1989 and 2006. We report 20 patients (15 boys and 5 girls) with ages ranging from 1 month to 13-years-old (median 4,4-years-olds). Nine (45%) had neuropathic bladder, 6 (30%) posterior urethral valves and 5 (25%) vesicoureteral stenosis.


RESULTS
Improvement of the ureteral dilatation controlled by ultrasound was demonstrated in 100% of the patients. Improvement of the renal function was observed in the group of patients (5) with renal failure.


COMPLICATIONS
2 bladder prolapses, 1 calculus and 1 postoperative bladder bleeding.


CONCLUSIONS
Ureteral meatotomy associated with vesicostomy is an effective urinary derivation in children with obstructive urological conditions with an important dilatation in which ureteral reimplantation seems to be difficult. This derivation avoids bladder dysfunction and the management of the vesicostomy is comfortable by the use of a bag or the nappies.