There are several conditions that require urinary tract reconstruction. You should investigate a surgeon's experience specifically with children with ARM, as urinary tract reconstruction in children with ARM is very different from a standard reimplant surgery or even a reconstruction in a child with spina bifada.
Vesicoureteral Reflux (VUR):
In the child with ARM, vesicoureteral reflux can be a sign of neurogenic bladder. If this is the case, there is high likelihood that the reflux will improve with bladder management alone. It is crucial that no attempt at surgery is made until it is proven that the bladder is normal.
Hydronephrosis (swelling of the kidney):
Obstruction of the kidneys is rare in the patient with ARM. Often, it is due to a primary bladder problem. Hydronephrosis after ureteral reimplant surgery may be the result of an undiagnosed or inadequately treated bladder problem.
In the child with ARM, urinary incontinence could be caused by a weak urinary sphincter or because of a flawed bladder. Urodynamic studies performed by your surgeon will help identify the true cause.
Continent Urinary Tract Reconstruction:
There are several different surgeries that may be performed if your child has a urinary tract problem requiring operation. Urodynamic studies and evaluation by a urologist familiar with ARM issues can help determine whether your child is a candidate for bladder augmentation, bladder neck reconstruction, a Mitrofanoff procedure or a Malone procedure.
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At Nationwide Children’s, every child diagnosed with a colorectal condition is handled with an individualized treatment plan. For more information or to request an appointment, please contact us.