Bladder augmentation and continent catheterizable channel creation in children: surgical, functional, and renal outcomes

The aim of this study was to present our institutional experience with continent catheterizable channel creation, with or without bladder augmentation, and to evaluate the surgical, functional, and renal outcomes of these reconstructive procedures in pediatric patients. A retrospective review was conducted of pediatric patients who underwent CCC creation with or without concurrent BA between January 2019 and December 2024. Demographic characteristics, primary diagnoses, surgical details, postoperative complications, ultrasonographic findings, glomerular filtration rate (GFR), urinary tract infection history, and continence outcomes were evaluated. Hydronephrosis was graded according to the Society for Fetal Urology classification, and renal function was assessed using the Schwartz formula. A total of 40 patients were included in the study. Bladder augmentation combined with continent catheterizable channel (CCC) creation was performed in 27 patients, while 13 patients underwent CCC creation alone. In the augmentation group, the sigmoid colon was used in 16 cases and the ileum in 11 cases. Among patients undergoing bladder augmentation, mean bladder capacity increased from 51 ± 35.7 mL preoperatively to 328.5 ± 41.6 mL postoperatively. Continence was achieved in 36 of 40 patients during follow-up, and the frequency of symptomatic urinary tract infections decreased after reconstruction. Renal function and upper urinary tract status remained stable in most patients, with no significant deterioration in glomerular filtration rate or hydronephrosis grades. Procedure-related complications occurred in both groups and were mostly managed successfully with additional surgical intervention; one mortality related to superior mesenteric artery thrombosis was observed. No significant differences were observed in preoperative and postoperative GFR values or hydronephrosis grades between groups. Despite a considerable complication burden, lower urinary tract reconstruction with bladder augmentation and/or continent catheterizable channel creation remains a valuable option for selected pediatric patients, providing favorable functional outcomes and supporting short- to medium-term stabilization of renal and upper urinary tract function.