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Is bowel preparation required before cystoplasty in children?

Gundeti MS, Godbole PP, Wilcox DT

Evelina Children's Hospital (Guy's and St. Thomas') and Great Ormond Street Hospital for Children, NHS Trust, London, United Kingdom. gundemoh@aol.com

PURPOSE: We evaluated whether bowel preparation is required before augmentation cystoplasty in children. MATERIALS AND METHODS: A total of 46 consecutive children underwent cystoplasty using detubularized ileum between 1998 and 2004. Group 1 (24 patients) underwent standard mechanical bowel preparation with sodium picosulfate, a bowel enema (sodium phosphate) if required and clear fluids for 24 hours preoperatively. Group 2 (22 patients) received no bowel preparation and was on a normal diet preoperatively. One dose of parenteral triple antibiotics was administered at induction of anesthesia in both groups. The surgical technique was similar in both groups. Postoperatively, group 1 had a nasogastric tube in situ, while group 2 had no nasogastric tube. The main outcome measures were hospital stay (days), time to commencing fluids postoperatively (hours), incidence of urinary tract infection during hospitalization and incidence of wound infection. RESULTS: Median postoperative stay was 5 days (range 4 to 7) in group 1 and 4 days (3 to 6) in group 2. Median time to intake of oral fluids was 48 hours (range 24 to 72) in group 1 and 24 hours (12 to 48) in group 2. Three patients in group 1 and 2 in group 2 had a symptomatic urinary tract infection during the postoperative course. One patient in each group had a superficial wound infection. CONCLUSIONS: There were no significant differences in hospital stay or postoperative complications between the 2 groups. This series suggests that bowel preparation is unnecessary for children undergoing cystoplasty.

Published 5 September 2006 in J Urol, 176(4): 1574-6; discussion 1576-7.
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