A real‐world experience with augmentation enterocystoplasty—High patient satisfaction with high complication rates

Wu, Shu-Yu; Kuo, Hann‐Chorng

doi:10.1002/nau.23339

Cited by 19 publications

(18 citation statements)

References 23 publications

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“…The median age at the moment of surgery was 15 years (5-39). The median follow-up was 20 years (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). No patient was lost to follow-up.…”

Section: Resultsmentioning

confidence: 99%

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Long‐term effectiveness and safety of bladder augmentation in spina bifida patients

Romero‐Maroto

Martínez-Cayuelas

Pérez

et al. 2021

Neurourology and Urodynamics

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To establish the long-term efficacy and safety of bladder augmentation in spina bifida patients. Material and Methods: Sixteen patients were operated on using the Bramble technique. Preoperative and postoperative evaluation included clinical history, blood tests, urine cultures, cystography, pyelography, ultrasound, and filling cystometry. In the final review a standardized quality of life questionnaire was applied. Results: Median follow-up was 20 years (15-26). Kidney function was stabilized except for one case that required a kidney transplant. Hydronephrosis disappeared or improved (p = 0.03). Vesicoureteral reflux grades I-II was cured without reimplantation and grades III-IV responded better with reimplantation than without (p = 0.03). Quality of life improved in all patients, with all stating they would undergo the procedure again. After surgery, 94% of the patients exhibited diurnal continence but 25% exhibited nocturnal incontinence. Pressure at capacity decreased and bladder capacity increased (p < 0.001). One patient presented ureteral fistula with another presenting hemorrhage. Both required immediate surgical review. Late complications included urinary sphincter cuff erosion, renal lithiasis, four instances of bladder lithiasis and repeated pyelonephritis in one 24-year-old patient. All required surgery. The mean of urinary infections fell, from 2.5 per year (0.7) to 1 (0.5) (p = 0.03). Conclusion:Augmentation cystoplasty (AC) maintains its efficacy and improves quality of life in the long term. However, serious surgical complications can ensue, along with minor or major subsequent complications. This should be considered before surgery and makes lifelong monitoring of patients necessary.

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“…The median age at the moment of surgery was 15 years (5-39). The median follow-up was 20 years (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). No patient was lost to follow-up.…”

Section: Resultsmentioning

confidence: 99%

“…One study showed recurrent bacteriuria rate of 75%, but only a 20% incidence of troublesome UTI, 13 while another article reported 42% of UTI. 15 Antibiotic prophylaxis causes multi-resistant bacteria and there is no evidence that it reduces UTI episodes. 23 Research is needed to determine the best practice for dealing with UTIs.…”

Section: Resultsmentioning

confidence: 99%

Long‐term effectiveness and safety of bladder augmentation in spina bifida patients

Romero‐Maroto

Martínez-Cayuelas

Pérez

et al. 2021

Neurourology and Urodynamics

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“…However, although some patients were able to void spontaneously with the Crede maneuver, 76% of the patients were completely dependent on CIC. Thus, patients might ultimately opt for an indwelling urethral catheter or cystostomy for convenience of bladder emptying [97].…”

Section: Quality Of Life Comparison Between Repeated Detrusor Botulinum Toxin a Injections And Augmentation Enterocystoplasty In Patientsmentioning

confidence: 99%

Frontiers in the Clinical Applications of Botulinum Toxin A as Treatment for Neurogenic Lower Urinary Tract Dysfunction

Jiang

Chen

2020

Int Neurourol J

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Patients with neurogenic lower urinary tract dysfunction (NLUTD) experience urinary incontinence with or without difficult urination, which might promote recurrent urinary tract infection (UTI) and exacerbate upper urinary tract function. Nonetheless, appropriate bladder management has been shown to reduce urological complications and improve quality of life. In addition to pharmacological therapy and surgical intervention, botulinum toxin A (BoNT-A) has been widely utilized in NLUTD. The therapeutic efficacy of detrusor BoNT-A injections for neurogenic detrusor overactivity due to spinal cord injury (SCI), multiple sclerosis, or other central nervous system lesions, such as cerebrovascular accident, Parkinson disease, early dementia, and pediatric NLUTD due to myelomeningocele, has been well established, with repeated BoNT-A injections every 6 to 9 months being necessary to maintain its therapeutic effects. Urethral BoNT-A injection can decrease urethral sphincter resistance and facilitate efficient voiding in patients with NLUTD who wish to preserve self-voiding. Detrusor BoNT-A injection can also decrease the occurrence of autonomic dysreflexia in patients with SCI, even after failed augmentation enterocystoplasty, with additional benefits including reduced UTI episodes and preserved renal function with repeated injections. However, this treatment does have some side effects. Complete informed consent for BoNT-A injection therapy with full disclosure of its potential complications should therefore be obtained before this procedure is undertaken.

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“…(F) Affected urethral wall with stricture lesion can be replaced by an electrospun scaffold through onlay or inlay fashion. Veeratterapillay et al, 2013;Wu and Kuo, 2018). Therefore, clinicians and basic scientists have investigated alternate therapeutic methods through the recruitment of modern technologies.…”

Section: Bladder Tissue Engineeringmentioning

confidence: 99%

Electrospinning: Application and Prospects for Urologic Tissue Engineering

Zamani

Shakhssalim

Ramakrishna

et al. 2020

Front. Bioeng. Biotechnol.

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Functional disorders and injuries of urinary bladder, urethra, and ureter may necessitate the application of urologic reconstructive surgeries to recover normal urine passage, prevent progressive damages of these organs and upstream structures, and improve the quality of life of patients. Reconstructive surgeries are generally very invasive procedures that utilize autologous tissues. In addition to imperfect functional outcomes, these procedures are associated with significant complications owing to long-term contact of urine with unspecific tissues, donor site morbidity, and lack of sufficient tissue for vast reconstructions. Thanks to the extensive advancements in tissue engineering strategies, reconstruction of the diseased urologic organs through tissue engineering have provided promising vistas during the last two decades. Several biomaterials and fabrication methods have been utilized for reconstruction of the urinary tract in animal models and human subjects; however, limited success has been reported, which inspires the application of new methods and biomaterials. Electrospinning is the primary method for the production of nanofibers from a broad array of natural and synthetic biomaterials. The biomimetic structure of electrospun scaffolds provides an ECM-like matrix that can modulate cells' function. In addition, electrospinning is a versatile technique for the incorporation of drugs, biomolecules, and living cells into the constructed scaffolds. This method can also be integrated with other fabrication procedures to achieve hybrid smart constructs with improved performance. Herein, we reviewed the application and outcomes of electrospun scaffolds in tissue engineering of bladder, urethra, and ureter. First, we presented the current status of tissue engineering in each organ, then reviewed electrospun scaffolds from the simplest to the most intricate designs, and summarized the outcomes of preclinical (animal) studies in this area.

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A real‐world experience with augmentation enterocystoplasty—High patient satisfaction with high complication rates

Abstract: AE is a procedure with long-term durability and high rates of patient satisfaction. However, several bothersome complications affecting life quality may occur. Both patients and doctors thus need to consider possible outcomes carefully before the operation.

Cited by 19 publications

References 23 publications

Long‐term effectiveness and safety of bladder augmentation in spina bifida patients

Long‐term effectiveness and safety of bladder augmentation in spina bifida patients

Frontiers in the Clinical Applications of Botulinum Toxin A as Treatment for Neurogenic Lower Urinary Tract Dysfunction

Electrospinning: Application and Prospects for Urologic Tissue Engineering

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