Of 12 children who had undergone augmentation ileocystoplasty for treatment of neurogenic bladder, 3 developed bladder calculi 9 to 19 months after the operation. All these 3 children had simultaneously undergone procedure to ensure urinary continence together with ileocystoplasty, and postoperative persistent bacteriuria was found in these 3 children. Component of bladder calculi was magnesium-ammonium phosphate in 2 and calcium phosphate in the other child, and all were successfully removed by endoscopic lithotripsy. These data suggest that postoperative persistent bacteriuria as well as procedures to ensure urinary continence might play a role in the formation of bladder calculus after augmentation cystoplasty.
Preoperative water cystometrograms obtained from 437 patients with benign prostatic hyperplasia (BPH) were examined in a retrospective study. The cystometrographic results were analyzed regarding the preoperative clinical features: the patients' age, presence or absence of urinary incontinence, history of urinary retention, and rate of residual urine. Their prognostic value in terms of improvement in voiding difficulty and postoperative urinary incontinence was also analyzed at 1 and 6 months after elective transurethral resection of the prostate (TURP). Of these patients, 263 (60.2%) had detrusor instability (group I), whereas 174 did not (group II). Vesical denervation supersensitivity (Vds) to bethanecol chloride was noted in 47 (12.5%) of 375 patients. The observed difference in clinical features was significant between the two groups, with group I being older (P < 0.01) and showing a greater incidence of urinary incontinence (P < 0.001) and retention (P < 0.001). The difference seen between groups I and II in terms of mean bladder capacity (P < 0.01), compliance (P < 0.01), and a greater positive rate of Vds (P < 0.001) was also significant. The clinical and cystometrographic parameters studied worsened with advancing age of the patients. Although the majority of the patients (94.7%) were relieved of obstructive symptoms after TURP (6 months later), 113 (25.9%) showed no relief at 1 month.(ABSTRACT TRUNCATED AT 250 WORDS)
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