Intestinal Conduit Urinary Diversion in Children

SUMMARY A review of 66 intestinal conduit urinary diversions (62 ileal and 4 sigmoid conduits) done between 1956 and 1969 at the Montreal Children's Hospital is presented. Twenty‐one of these patients underwent other types of diversions prior to conduit formation. The most frequent indication for diversion has been neurogenic vesical dysfunction due to meningomyelocele followed by other congenital anomalies. There was an overall deterioration of 30 per cent of all upper tracts. When broken down, it was seen that 32 per cent of normal pre‐operative pyelograms deteriorated in the post‐operative period, whereas, 42 per cent of the severely hydronephrotic group improved after operation. The most frequent morbidity was associated with the ileostomy stoma and its appliances. Forty per cent of patients in our series needed at least one revision of stoma. Intestinal conduit operations are associated with a significant morbidity and require great care in planning the surgery, as well as careful long‐term follow‐up in the post‐operative period.