TY - JOUR
T1 - Long-term complications of continent catheterizable channels
T2 - A problem for transitional urologists
AU - Hampson, Lindsay A.
AU - Baradaran, Nima
AU - Elliott, Sean P.
N1 - Publisher Copyright:
©Translational Andrology and Urology.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - A majority of the transitional urology patient population have neurogenic bladder and many of these patients have undergone creation of continent catheterizable channels (CCCs) to facilitate bladder emptying. Transitional urologists will be faced with revision of these channels due to a variety of possible complications. We performed a comprehensive literature review to the data regarding the incidence, timing, and predisposing factors that lead to complications of CCCs as well as surgical revision techniques and their outcomes. Long-term channel complications and related revisions are common (25-30%) and likely underestimated. While many predictors for revision have been posited, the only predictor that has been significant in robust multivariable analysis is channel type, with appendicovesicostomies having a lower chance of requiring revision compared to Monti channels. Channels created in adults have high likelihood of requiring revision, even within a relatively short follow-up period. We review techniques for management of channel complications and their outcomes. As patients with congenital urologic conditions requiring CCCs are gaining longer lifespans, transitional urologists will be faced with revision and/or replacement of these channels. While some of these patients may require supravesical diversion in the future, data show that revision is feasible with good outcomes. Longer-term follow-up data is needed to understand the life-span and best practices of new CCCs created among the transitional population.
AB - A majority of the transitional urology patient population have neurogenic bladder and many of these patients have undergone creation of continent catheterizable channels (CCCs) to facilitate bladder emptying. Transitional urologists will be faced with revision of these channels due to a variety of possible complications. We performed a comprehensive literature review to the data regarding the incidence, timing, and predisposing factors that lead to complications of CCCs as well as surgical revision techniques and their outcomes. Long-term channel complications and related revisions are common (25-30%) and likely underestimated. While many predictors for revision have been posited, the only predictor that has been significant in robust multivariable analysis is channel type, with appendicovesicostomies having a lower chance of requiring revision compared to Monti channels. Channels created in adults have high likelihood of requiring revision, even within a relatively short follow-up period. We review techniques for management of channel complications and their outcomes. As patients with congenital urologic conditions requiring CCCs are gaining longer lifespans, transitional urologists will be faced with revision and/or replacement of these channels. While some of these patients may require supravesical diversion in the future, data show that revision is feasible with good outcomes. Longer-term follow-up data is needed to understand the life-span and best practices of new CCCs created among the transitional population.
KW - Catheterizable channel
KW - Outcomes
KW - Reconstruction
KW - Transitional urology
UR - http://www.scopus.com/inward/record.url?scp=85051747292&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85051747292&partnerID=8YFLogxK
U2 - 10.21037/tau.2018.03.26
DO - 10.21037/tau.2018.03.26
M3 - Review article
C2 - 30211046
AN - SCOPUS:85051747292
SN - 2223-4683
VL - 7
SP - 558
EP - 566
JO - Translational Andrology and Urology
JF - Translational Andrology and Urology
IS - 4
ER -