PURPOSE We aimed to assess long-term use of continent catheterizable urinary channels (CCCs) and explore potential risk factors of disuse. MATERIALS AND METHODS People undergoing appendicovesicostomy and Monti procedures at our institution were retrospectively reviewed (1991-2023). The main outcome was CCC disuse (not intermittently catheterizing channels as the primary method of bladder emptying). Cox regression was used. RESULTS Five hundred sixty-one people (46% male, 57% shunted, 72% spina bifida) met inclusion criteria (244 appendicovesicostomy, 317 Monti; 69% right lower quadrant [RLQ]). Channels were created at a median age of 8 years (median follow-up: 11 years, 78% self-catheterized). Overall, 76 people disused their channels. The most common reasons for disuse were nonmechanical (64%). After disuse, 46% underwent incontinent diversion. After correcting for differential follow-up, 89% of people still used their channels at 10 years and 81% at 20 years. When analyzing all disused channels in patients reaching adulthood on multivariable analysis, channels catheterized by others had 3.78 times the risk of disuse compared with self-catheterized channels (P < .001); RLQ channels were 1.06 times more likely to be disused than umbilical channels (P = .02). For channels disused for nonmechanical reasons, catheterization by others, not attending transition clinic, and RLQ stoma were independently associated with disuse (P ≤ .04). No variables were associated with disuse for mechanical reasons (P ≥ .22). CONCLUSIONS Most people with CCCs use them on long-term follow-up. One percent stopped using them annually. People who never self-catheterized, never attended transition clinic, or never had RLQ stomas were at higher risk of channel disuse, particularly because of nonmechanical reasons.

中文翻译：

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使用和不使用可导尿通道作为排空神经性膀胱的主要方法：一项单一的机构队列研究。


目的 我们旨在评估大陆导尿通道 （CCC） 的长期使用情况，并探讨废弃的潜在危险因素。材料和方法 回顾性回顾了在我们机构接受阑尾膀胱造口术和 Monti 手术的患者 （1991-2023）。主要结局是 CCC 废用 （不是间歇性导管插入通道作为膀胱排空的主要方法）。使用 Cox 回归。结果 561 人 （46% 男性，57% 分流，72% 脊柱裂） 符合纳入标准 （244 例阑尾膀胱造口术，317 例 Monti;69% 右下腹 [RLQ]）。建立通道的中位年龄为 8 岁 （中位随访： 11 岁，78% 自行导尿）。总体而言，有 76 人停用了他们的频道。最常见的废弃原因是非机械的 （64%）。停用后，46% 接受了失禁分流。在校正差异随访后，89% 的人在 10 年时仍然使用他们的渠道，81% 的人在 20 年时仍然使用他们的渠道。在多变量分析中分析成年患者所有废弃的通道时，他人导尿通道的废弃风险是自导尿通道的 3.78 倍 （P < .001）;RLQ 通道被废弃的可能性是脐通道的 1.06 倍 （P = .02）。对于因非机械原因废弃的通道，他人置管、未参加过渡门诊和 RLQ 造口与废弃独立相关 （P ≤ .04）。由于机械原因，没有变量与废弃相关 （P ≥ .22）。结论 大多数 CCC 患者在长期随访中使用它们。每年有 1% 的人停止使用它们。 从未自行导尿、从未参加过过渡诊所或从未接受过 RLQ 造口的人患上通道废弃的风险更高，特别是由于非机械原因。