Continent catheterizable tubes/stomas in adult neuro-urological patients: A systematic review

Abstract

CCS/T appears to be an effective treatment option in adult neuro-urological patients unable to perform intermittent self-catheterization through the urethra. However, the complication rate is meaningful and the quality of evidence is low, especially in terms of long-term outcomes including the impact on the quality-of-life.

Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury

“…There are several anti‐incontinence surgical modalities, such as bladder neck reconstruction, bladder neck sling, artificial urinary sphincter and bladder neck closure with abdominal continent catheterizable channel ( LoE 5, GoR C1 ) . The proper procedure depends on physical disabilities, comorbid diseases and characteristics of the lower urinary tract dysfunction, as evaluated by video‐UDS.…”

Intermittent catheterization: Clinical practice guidelines from Association Française d’Urologie (AFU), Groupe de Neuro-urologie de Langue Française (GENULF), Société Française de Médecine Physique et de Réadaptation (SOFMER) and Société Interdisciplinaire Francophone d’UroDynamique et de Pelvi-Périnéologie (SIFUD-PP)

“…La revue de la Cochrane de Jamison et al sur les modalités de drainage vésical à long terme des vessies neurologiques ne mentionne rien à ce sujet (13). Dans la revue systématique de la littérature du groupe de recommandations en neuro-urologie de l'association européenne d'urologie (45), la procédure de Mitrofanoff est la procédure la plus utilisée et la plus fiable. En l'absence d'appendice ou en cas de problème de longueur, un tube de Monti ou de Casale est réalisé.…”

Complications of Continent Cutaneous Catheterizable Channel in Adult

“…Mitrofanoff's concept is proposed to patients with a neurourological condition who are unable to execute CIC through native urethra due to difficulty reaching or detecting urethra, or urethral damage 5 .…”

“…The Mitrofanoff technique has showed reoperation rate of 8% for bleeding, anastomotic leak, conduit disintegration, intestinal obstruction, with the most prevalent long-term consequence being stomal stenosis, which causes difficult conduit catheterization. 7 Documented complications associated with the continent cutaneous channel in studies are stenosis (11.2%) 8 , postoperative incontinence (44.8%) 5 and surgical site infections (22.2%) 9 . Bladder augmentation is a simple idea for patients with overactive, small-capacity, and/or low compliance bladder and a normal upper urinary tract, as well as in situations with coupled sphincteric incompetence with supplementary sphincteric function support (e.g., a fascial sling surgery) 10 .…”