Methods: We performed a retrospective chart review over eight years of children presenting with lost access to a catheterizable channel for urinary or bowel drainage. Rates of successful re−establishment of access in IR and rates of future surgical revision were calculated.
Results: Twenty patients, ages one to 21 years, underwent attempts to re-establish lost access, some patients on multiple occasions. IR regained access via a minimally invasive technique with pigtail or foley catheter in 24 of 31 attempts (77%). None of these procedures required general anesthesia, and only four (13%) required conscious sedation. Of the 20 patients, eight (40%) never had to undergo eventual surgical revision to allow return to intermittent catheterization after a successful IR procedure. Eight (40%) did eventually require surgery, whether that entailed revision, endoscopy, or suprapubic tube placement, even after successful IR re-establishment of access. All four patients in whom IR access was unsuccessful required surgery.
Conclusion: Image−guided re-establishment of access for continent catheterizable channels in children is a useful and minimally−invasive treatment option to allow for resumption of self−catheterization and to obviate the need for surgical correction. This data is valuable in directing treatment course and in counseling families about potential clinical outcomes.