Augmentation ileocystoplasty in neuropathic bladder

Raezer, David M.; Evans, Robert J.; Shrom, Stanley H.

doi:10.1016/0090-4295(85)90557-6

Cited by 13 publications

(4 citation statements)

References 6 publications

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“…From a symptomatic standpoint, complete urinary continence was established in the majority of our patients after augmentation enterocystoplasty (72%). Our continence results are consistent with other studies in which continence rates range between 60% and 100% 7, 9, 10, 12–18, 20, 22–24. The primary reason patients continued to be incontinent post‐augmentation was due to an incompetent sphincter.…”

Section: Discussionsupporting

confidence: 90%

Differences in urodynamic study variables in adult patients with neurogenic bladder and myelomeningocele before and after augmentation enterocystoplasty

Vainrib

Reyblat

Ginsberg

2012

Neurourology and Urodynamics

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Most patients after augmentation maintain low bladder pressures for more than 10 years. Close long-term follow up should be maintained, especially in those patients that have not had prior augmentation. Urinary incontinence may be secondary to poor sphincteric function in patients with and without prior augmentation. Moreover, we should continue to follow patients after reconstruction as elevated detrusor pressures can still be seen. Strict follow up after LUT reconstruction still continues to be important.

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Section: Discussionsupporting

confidence: 90%

Differences in urodynamic study variables in adult patients with neurogenic bladder and myelomeningocele before and after augmentation enterocystoplasty

Vainrib

Reyblat

Ginsberg

2012

Neurourology and Urodynamics

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“…18,19 Ileum is the most commonly used bowel segment for augmentation in these patients, and the overall 'good result' rate is 77% (range: 55-88%) with 10-75% of these patients needing CISC. 8,14,15,[20][21][22][23][24][25] The 'clam' procedure introduced by Mundy and Stephenson 15 has produced good results, 14,19,[26][27][28] although the long-term results and follow-up are variable.…”

Section: Discussionmentioning

confidence: 99%

Single surgeon experience of augmentation ileocystoplasty in the management of refractory idiopathic detrusor overactivity

Pisipati

Khan

Kinder

2014

Journal of Clinical Urology

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Background: Until a decade ago, augmentation ileocystoplasty (AIC) was the only major advancement over antimuscarinics for intractable idiopathic detrusor overactivity (IDO). Clam ileocystoplasty has been proposed to restore continence and preserve urethral voiding. While intravesical botulinum and neuromodulation have revolutionised the treatment of this condition, arguably there remains a place for bladder augmentation in the surgical armamentarium. Objective: This study presents a single surgeon experience of clam ileocystoplasty performed for intractable IDO at our institution. Methods: A retrospective case-note review was performed over a 9-year period. Data on basic patient demographics, urodynamic findings, pre-operative treatments administered, post-operative complications and response to surgery were documented. Results: In total, 22 patients were identified with a median age of 42.4 years. The predominant symptoms were urgency (100%) and urge incontinence (96%). All our patients were incontinent pre-operatively with 59% using pads. Ambulatory cystometry was helpful in 27% patients in whom standard +/-video studies were inconclusive. Of the cohort, 100%, 82% and 55% had one, two and three anticholinergics, respectively. Only 18% received intravesical botulinum toxin A pre-operatively. Some 77% were cured of their storage symptoms and incontinence; 18% had residual incontinence. Of these, genuine urodynamic stress incontinence was demonstrated in 9% and improved with tension-free vaginal tape. Some 9% had Clavien 3b complications requiring laparotomy. Mortality was nil. Conclusion:In young patients with refractory IDO, clam ileocystoplasty serves as a permanent, effective technique for symptom reduction and restoration of continent urethral voiding with few complications.

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“…Augmentation ileocystoplasty has been used by several investigators as a last resort before urinary diversion to treat urge incontinence that was mainly secondary to an underlying neurogenic cause [ 14–20]. However, few studies have addressed the long‐term results, durability and complications in detail [ 19, 20, 27].…”

Section: Discussionmentioning

confidence: 99%

“…However, these procedures have their limitations, especially the need for repeated treatment [ 11, 12]. Augmentation ileocystoplasty has been used as a last resort before urinary diversion; the ‘clam’ procedure introduced by Mundy and Stephenson [ 13] has produced good results [ 14–18] although the long‐term results and follow‐up are variable. In most of these studies, the series included a significant proportion of neurogenic bladder dysfunctions, especially myelodysplasia [ 15–20].…”

Section: Introductionmentioning

confidence: 99%

Long‐term results and complications of augmentation ileocystoplasty for idiopathic urge incontinence in women

et al. 1998

British Journal of Urology

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Objective To assess the long‐term (3–9 years) results of augmentation ileocystoplasty for non‐neurogenic female urge incontinence in terms of continence, the need for intermittent self‐catheterization and the need for additional or auxiliary treatment, to define the long‐term complications and to assess the patients’ satisfaction with the outcome. Patients and methods The study comprised 51 women who underwent augmentation ileocystoplasty for non‐neurogenic urge incontinence between November 1987 and December 1993; 27 patients had associated interstitial cystitis. All patients had exhausted conservative methods, with an unsatisfactory outcome. All patients were interviewed about the results of the procedure, and their charts reviewed and updated with relevant information. Results Within a mean (range) follow‐up of 75.4 (36–109) months, 27 patients (53%) were completely continent, 13 (25%) had occasional leaks and nine (18%) continued to have disabling urge incontinence frequently requiring pads. Regular self‐catheterization was needed by 20 (39%) patients while the rest emptied adequately with no or minimal residual volumes. Additional pharmacotherapy had to be used by 12 (24%) patients. Three patients later developed stress urinary incontinence and were managed with fascial sling procedures. The patch was revised in two patients and excised from four others because they had high residual volumes and uncontrollable infections. Two patients had an ileal conduit diversion for persistent incontinence. The most common complication was recurrent urinary tract infections, seen in 22 patients using intermittent self‐catheterization. Mucus retention occurred regularly in 10 patients, six had chronic diarrhoea, four had latent bowel obstruction, one developed a bladder stone, one an incisional hernia and one developed patch necrosis and perforation. Twenty‐seven patients (53%) were happy with the outcome of the procedure while 20 (39%) were not; four patients were unsure whether a change had occurred. Conclusion Augmentation ileocystoplasty is a valuable alternative for women with intractable urge incontinence. However, these patients and their physicians should be aware of its limitations, specifically the possibility that incontinence may persist and the high probability of the need for self‐catheterization, with potential subsequent urinary tract infection.

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Augmentation ileocystoplasty in neuropathic bladder

Cited by 13 publications

References 6 publications

Differences in urodynamic study variables in adult patients with neurogenic bladder and myelomeningocele before and after augmentation enterocystoplasty

Differences in urodynamic study variables in adult patients with neurogenic bladder and myelomeningocele before and after augmentation enterocystoplasty

Single surgeon experience of augmentation ileocystoplasty in the management of refractory idiopathic detrusor overactivity

Long‐term results and complications of augmentation ileocystoplasty for idiopathic urge incontinence in women

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