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

Vainrib, Michael; Reyblat, Polina; Ginsberg, David A.

doi:10.1002/nau.22304

Cited by 16 publications

(12 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Augmentation cystoplasty can be combined with a continent catheterizable cutaneous urinary diversion to facilitate ISC in patients with limited dexterity. Recent long-term data confirm previous data on efficacy demonstrating sustained improvements in both, urodynamic parameters and symptoms [67][68][69][70].…”

Section: Augmentation Cystoplastysupporting

confidence: 79%

The management of urinary incontinence in the male neurological patient

Mehnert

Kessler

2014

Current Opinion in Urology

View full text Add to dashboard Cite

PURPOSE OF REVIEW: Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. RECENT FINDINGS: Intermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SUMMARY: Standard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in male neurological patients, well-designed, multicenter studies are warranted. Purpose of review Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. Recent findingsIntermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SummaryStandard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in mal...

show abstract

Section: Augmentation Cystoplastysupporting

confidence: 79%

The management of urinary incontinence in the male neurological patient

Mehnert

Kessler

2014

Current Opinion in Urology

View full text Add to dashboard Cite

show abstract

“…After duplicates removal (n = 100), 147 of 180 screened articles were excluded because they were not related to the neuro-urological follow-up. In all, 23 of 33 full-text articles were included in the quantitative synthesis [1][2][3][4][5][6][7][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Thus, 10 articles were excluded because they did not bring additional information on the neuro-urological follow-up (six review articles, two case-reports, one animal model, one cross-sectional study) [25][26][27][28][29][30][31][32][33][34].…”

Section: Resultsmentioning

confidence: 99%

“…Most studies were focused on SCI (13 articles), spinal dysraphism (threee articles), and MS (twoarticles). Main results are presented on Table 1 [9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Resultsmentioning

confidence: 99%

Follow‐up of the neuro‐urological patient: a systematic review

Averbeck

Madersbacher

2015

BJU International

View full text Add to dashboard Cite

ObjectivesTo systematically review the long-term urological follow-up strategies for patients with neurogenic lower urinary tract dysfunction (NLUTD), focusing on three main groups of neurological diseases: (i) spinal cord injuries, (ii) spinal dysraphism, and (iii) multiple sclerosis. Patients and MethodsData acquisition comprised electronic search on the Medical Literature Analysis and Retrieval System Online (MEDLINE) database and the EMBASE database in August 2014 to retrieve English language studies. MEDLINE and EMBASE search included the following medical subject heading (MeSH) terms: (i) neurogenic bladder and (ii) neurogenic bladder dysfunction. Each of these terms was crossed with (i) long-term care and (ii) long-term surveillance. Only studies related to NLUTD and urological follow-up were included. Studies were also identified by hand search of reference lists and review articles. ResultsInitial records identified through database searching included 265 articles. In all, 23 articles were included in the quantitative synthesis. The proposed time schedule of investigations as well as the amount and type of investigation were different according to specific neurological lesions. They depend on the dysfunctional pattern of the lower urinary tract (LUT) and its risk profile. However, there is a lack of high-evidence level studies to support an optimal long-term follow-up protocol. ConclusionsThe goal of neuro-urological management is the best possible preservation of upper urinary tract (UUT) and LUT function in relation to the individual neurological disorder. Regular and risk adapted controls ('urochecks') allow detection of risk-factors in time before irreversible changes of the LUT and UUT have occurred. With risk-and patient-oriented lifelong regular urological care an optimised quality of life and life-expectancy can be achieved, although there is a complete lack of high-evidence level studies on this topic.

show abstract

“…The use of reconfigured intestinal segments to increase bladder volume is effective (2, 3) but not without side effects (4, 5). Bringing urine in contact with functioning ileal or colonic mucosa can cause metabolic acidosis and intestinal mucus secretion into the urinary bladder may lead to difficult emptying and bladder lithiasis.…”

mentioning

confidence: 99%

“…Unfortunately the use of stomach had to be all but abandoned because of undesirable outcomes and side effects (3) in many patients (9). …”

mentioning

confidence: 99%

Alternatives to Conventional Enterocystoplasty in Children: A Critical Review of Urodynamic Outcomes

González¹,

Ludwikowski²

2013

Front. Pediatr.

View full text Add to dashboard Cite

Alternatives to conventional enterocystoplasty have been developed in order to avoid the most common complications derived from contact of the urine with intestinal mucosa. In this article critically we review the literature on the topics: ureterocystoplasty, detrusorectomy, detrusorotomy, seromuscular gastroenterocystoplasty, use of off the shelf biomaterials, and bladder augmentation by bioengineering. Recognizing the difficulty of deciding when a child with a history of posterior urethral valves requires and augmentation and that the development of a large megaureter in cases of neurogenic dysfunction represents a failure of initial treatment, we conclude that ureterocystoplasty can be useful in selected cases when a large dilated ureter is available. Seromuscular colocystoplasty lined with urothelium (SCLU) has been urodynamically effective in several series when the outlet resistance is high and no additional intravesical procedures are necessary. Seromuscular gastrocystoplasty lined with urothelium seems to offer no distinct advantages and involves a much more involved operation. The use of seromuscular segments without urothelial preservation, with or without the use of an intravesical balloon has been reported as successful in two centers but strict urodynamic evidence of its effectiveness is lacking. The published evidence argues strongly against the use of detrusorectomy or detrusorotomy alone because of the lack of significant urodynamic benefits. Two recent reports discourage the use of small intestinal submucosa patches because of a high failure rate. Finally, research into the development of a bioengineered bladder constructed with cell harvested from the same patient continues but is fraught with technical and conceptual problems. In conclusion of the methods reviewed, only ureterocystoplasty and SCLU have been proven urodynamically effective and reproducible.

show abstract

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

Cited by 16 publications

References 23 publications

The management of urinary incontinence in the male neurological patient

The management of urinary incontinence in the male neurological patient

Follow‐up of the neuro‐urological patient: a systematic review

Alternatives to Conventional Enterocystoplasty in Children: A Critical Review of Urodynamic Outcomes

Contact Info

Product

Resources

About