There are several conditions that require restoration of the urinary system. You should study Dr. Angelo Gousse experience with children with MRA because urinary tract reconstruction in children with MRA is very different from standard reimplantation surgery or even reconstruction with a spinal cord.
Vesicoureteral Reflux - VUR
In children with MRA, vesicoureteric reflux may be a sign of neurogenic bladder. If so, reflux is improved by bladder administration alone. No surgery should be performed until the bladder has been proven to be normal.
Hydronephrosis - Swelling of the Kidney
Renal obstruction is rare in patients with MRA. Often this is due to a problem with the main bladder. Hydronephrosis after ureteral reimplantation surgery may be the result of an undiagnosed or poorly treated bladder.
Incontinence
Urinary incontinence in children with MRA may be due to the weakness of the urinary sphincter or bladder defect. Urodynamic studies performed by your surgeon can help determine the true cause.
Continent Urinary Tract Reconstruction
If your child has a urinary tract problem that requires surgery, there are several different surgeries that can be performed. Urodynamic studies and a urologist’s assessment, which are well versed in MRA problems, can help determine if your child is a candidate for bladder enlargement, bladder neck reconstruction, Mitrofanoff procedure, or Malone procedure.
Dr. Gousse will perform all types of urinary tract reconstructions and determine which procedure is best for you depending on your health, symptoms, and weight. Types of processes include.
Ureteral Reconstruction & Reimplantation
During ureteral reconstruction and reimplantation, your ureter is surgically removed, restored, and repositioned in its normal position. Bladder enlargement may also be necessary. This option is recommended for patients with a history of urinary tract trauma or ureteral cancer or another pathological process.
Bladder Enlargement
The bladder augmentation procedure involves the implantation of parts of the colon or small intestine to increase the size of the bladder. This option is recommended for patients with neurogenic bladder after spinal cord injury, Spinal Bifida, or multiple sclerosis (MS).
Urethral Reconstruction
Restoration of the urethra, technically called urethroplasty, involves enlarging the urethra with dilators, removing scar tissue, or placing a stent. This option is intended for patients with narrowing of the urinary tract.