Continent Catheterisable Channels in Children: in search of prognostic factors for durable surgical success.

Authors

Fabrizio Vatta, Thomas Blanc, Ilona Alova, Aline Broch, Jules Kohaut, Mathilde Glenisson, Nicolas Vinit, Beatrice Montanaro, Kiarash Taghavi, Nathalie Botto, Henri Lottmann

Published in

Journal of pediatric surgery. Pages 163428. Aug 29, 2026. Epub Aug 29, 2026.

Abstract

This study evaluates a 27-year single-center experience with continent catheterisable channels (CCC) to identify factors influencing long-term outcomes.
Retrospective review (1998-2025) conducted on patients undergoing CCC placement. Data points analyzed included primary diagnosis, surgical indication, conduit type, stoma location, and postoperative complications.
The study included 175 children (99 males) with a total of 178 CCC procedures performed. Primary diagnoses included neuropathic bladder (53%), exstrophy-epispadias complex (21%), complex uropathy (12%), cloacal malformations (7%), and posterior urethral valves (7%). Median age at surgery was 11.3 years (IQR 7.8-14.7). Indications for CCC were concomitant bladder-outlet or reconstructive surgery (46%), difficult urethral catheterization (27%), desire for improved autonomy (21%), and redo surgery (3%). Conduits utilised were appendix (78%), ileum-Casale (9.6%), ileum-Monti (8.4%), and other - sigmoid, vesical flap, ureter (4%). Stoma sites included the right iliac fossa (51%), umbilicus (42%), and other locations (7%). At a median follow-up of 9 years (IQR 4-12), 97% of children maintained channel utility. Complications occurred in 28% of children (n=48), totalling 70 events: superficial stenosis (9%), suprafascial obstruction (10.7%), subfascial obstruction (7.3%), stomal incontinence (6.2%), and complete channel loss (6.2%). The use of the appendix was associated with lower complication rates (p=0.03). Stoma location did not significantly impact complication rates.
Continent catheterisable channels provides durable long-term benefits with high patient utilisation rates. Use of the appendix as a conduit is associated with superior outcomes and fewer complications. Stoma location does not significantly impact complication rates; therefore, site selection should be individualized.

PMID:
42667981
Bibliographic data and abstract were imported from PubMed on 30 Aug 2026.

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