Augmentation cystoplasty in neuropathic bladder

Abstract

In this series, we review 51 consecutive patients undergoing the same operation over a 10-year period from 2004 to 2014 in the same single unit. Outcome measures: Demographic data were collected to include patient age, condition, and previous treatments. Pre-and post-operative details included sphincter insertions, renal function, continence rates, and complications. Results: Despite an increase in the number of patients seen at the unit, there were considerably fewer cystoplasty procedures performed in the current series (51 vs. 78 in the 1982-1992 series). There were also significantly fewer patients with spina bifida and fewer concomitant sphincter insertions in the latter series (eight patients vs. 52 in the 82/92 series). Nevertheless, similar outcomes are observed between the current and 1982-1992 series, with continence rates of 93.7 and 93.6%, respectively and low numbers of reported adverse events for both retrospective cohorts. Conclusions: Cystoplasty remains a safe and effective option for the management of neuropathic bladder in a carefully selected group of patients.

The concerns of mechanical upper urinary tract obstruction in neurogenic lower urinary tract dysfunction: Beyond augmentation cystoplasty

“…Previously, urologists focused only on reconstruction of the bladder and elimination of VUR for NLUTD patients ( 5 , 6 ). However, many patients have severe UUTD without VUR.…”

“…Augmentation cystoplasty (AC) and/or ureteral anti-reflux reimplantation (UARI) is a widely accepted reconstructive procedure used when conservative treatment fails (5)(6)(7)(8). Previously, urologists mainly focused on the amelioration of bladder function and the elimination of vesicoureteral reflux (VUR) (9,10).…”

Interventional management and surgery of neurogenic lower urinary tract dysfunction in patients with chronic spinal cord injury: A urologist's perspective

“…Urinary continence can be achieved in 93.6% of patients with SCI. 70 Supratrigonal cystectomy and augmentation ileocystoplasty can achieve renal function protection, adequate bladder capacity, and low detrusor pressure in patients with refractory NLUTD. 71 Moreover, AE with an ileal segment is effective and safe in patients with chronic SCI exhibiting a severely contracted bladder, obstructive uropathy, and severe urinary incontinence with or without VUR.…”

“…In a recent series, augmentation cystoplasty remained a safe and effective treatment option for neuropathic bladder in a carefully selected group of patients. Urinary continence can be achieved in 93.6% of patients with SCI 70 . Supratrigonal cystectomy and augmentation ileocystoplasty can achieve renal function protection, adequate bladder capacity, and low detrusor pressure in patients with refractory NLUTD 71 …”