Long-Term Followup of Augmentation Enterocystoplasty and Continent Diversion in Patients With Benign Disease

Blaivas, Jerry G.; Weiss, Jeffrey P.; Desai, Pretik; Flisser, Adam J.; Stember, Doron S.; Stahl, Peter J.

doi:10.1097/01.ju.0000154891.40110.08

Cited by 91 publications

(57 citation statements)

References 19 publications

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“…Many papers reported that augmentation enterocystoplasty provides benefits of urodynamic parameters in patients with neurogenic bladder. 4,5,7 In the present study, postoperative V-UDS showed a significant improvement after the surgery in bladder capacity, bladder compliance and detrusor overactivity. In addition, preoperative VUR were resolved or improved in all, and none had febrile UTI after the augmentation cystoplasty.…”

Section: Discussionmentioning

confidence: 65%

“…Augmentation enterocystoplasty is a procedure suitable for these MMC patients in whom conservative medical therapies have failed. 4,5 Although many papers revealed excellent clinical results of augmentation enteroplasty in patients with neurogenic bladder refractory to conservative therapies, [4][5][6][7] there have been few studies describing urodynamic results of augmentation enterocystoplasty and long-term satisfaction with bowel and urinary condition at postsurgery. In fact, as augmentation enterocystoplasty involves the incorporation of a bowel segment into the bladder, MMC patients may suffer from unstable bowel function after the surgery despite of a significant improvement of urinary condition such as urinary incontinence and UTI.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of lower urinary and bowel function in meningomyelocele patients with augmentation enterocystoplasty

et al. 2008

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Objectives: We evaluated the outcomes of augmentation ileocystoplasty in video-urodynamics (V-UDS) and questionnaires related to bowel and urinary function. Methods: In 22 meningomyelocele (MMC) patients (11 male and 11 female, a mean age at surgery 14.4 years) who underwent augmentation ileocystoplasties, V-UDS was performed before and at a median of 15 months (6-120 months) after the surgery and the questionnaires were answered at a median of 7.1 years (1.1-14.5 years) after surgery. Results: Concomitant procedures of urethral sling in four, cecostomy in four and ureteral reimplantation in two were performed at augmentation ileocystoplasty. V-UDS showed a significant improvement after the surgery in bladder capacity, bladder compliance and detrusor overactivity. Vesicoureteral reflux (VUR) disappeared after the surgery in 16 of 19 ureters with VUR. Although questionnaire for urinary condition using International Consultation on Incontinence QuestionnaireShort Form demonstrated that 80% of patients were completely free from urinary incontinence after surgery, more than a half of patients had persistent or deteriorated bowel function such as urgency of bowel movement and fecal incontinence in questionnaires for bowel function. Even with complaints in bowel function, more than 80% of MMC patients had a high level of satisfaction with augmentation enterocystoplasty in overall quality of life (QOL). Conclusions: Benefits of augmentation ileocystoplasty were maintained in urodynamic parameters as well as urinary continence. Although augmentation ileocystoplasty generally provides high QOL for MMC patients refractory to conservative therapies, an advance of fecal management can make MMC patients' QOL superior to a current state.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Outcomes of lower urinary and bowel function in meningomyelocele patients with augmentation enterocystoplasty

et al. 2008

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“…verbessert [26,29]. Allerdings muss das Risiko-Nutzen-Verhältnis für den individuellen Patienten vor der Entscheidung zu einer solchen Operation sorgfältig abgewogen werden, da es trotz einer insgesamt geringen Mortalität zu relevanten perioperativen und langzeitlichen Nebenwirkungen/Komplikationen kommen kann [7,24,64,71].…”

Section: Inkontinente Und Kontinente Harnableitungenunclassified

Neurourologische Funktionsstörungen des unteren Harntraktes bei Erkrankungen des ZNS

Mehnert

Nehiba

2012

Urologe

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The lower urinary tract (LUT) is regulated by a complex neural network that is subject to supraspinal control. Neurological disorders, especially of the central nervous system (CNS), can rapidly lead to disruption of this control. Multiple sclerosis, Parkinson's disease, multiple system atrophy, and stroke are neurological disorders which quite frequently cause dysfunction of the LUT. With respect to the pathophysiology of bladder dysfunction in CNS diseases there are various hypotheses regarding the individual disorders: disturbances of neural communication between the frontal cortex and pontine micturition center, between the pontine micturition center and the lumbosacral parts of the spinal cord, and between the basal ganglia, thalamus, and anterior cingulate gyrus appear to play a pivotal role in the development of bladder dysfunction. The symptoms and urodynamic presentation of LUT dysfunction can vary considerably depending on the disease and disease progression and can change in the course of the disease. The incidence and prevalence of LUT dysfunctions rise with increasing progression of the underlying neurological disease.Various conservative, minimally invasive, and open surgical procedures are available to prevent harmful sequelae and to improve the quality of life of these patients. As yet, however, few data exist on most of the treatment options in cases of the above-mentioned CNS diseases. Intermittent self-catheterization and antimuscarinic medications are among the most important conservative treatment options. Injection of botulinum neurotoxin type A into the detrusor muscle and increasingly sacral or pudendal neuromodulation are among the most important minimally invasive treatment options. Surgical methods include reconstructive continent or incontinent urinary diversion.When planning therapy the patient's current needs and neurological limitations as well as possible disease progression must be taken into consideration. It is often advisable to consult with and enlist the cooperation of the attending neurologist when planning treatment.

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“…Retraction, stomal prolapse, parastomal hernia, and stenosis are the most frequent. Stenosis occurs in up to 33% of patients and is considered one of the major complications [39][40][41][42][43]. Stomal stenosis can result from a combination of factors, including ischemia, fascial contraction, retraction, local skin alterations, and stoma placement [37,39].…”

Section: Surgical Complications and Treatment Optionsmentioning

confidence: 99%

Continent Urinary Diversions in Non Oncologic Situations: Alternatives and Complications

Miyaoka¹,

Aguiar²

2012

Urinary Incontinence

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Long-Term Followup of Augmentation Enterocystoplasty and Continent Diversion in Patients With Benign Disease

Abstract: AC and urinary diversion provide a safe and effective long-term therapy in patients with refractory neurogenic bladder but stomal problems in patients with continent diversion continue to be a source of complications.

Cited by 91 publications

References 19 publications

Outcomes of lower urinary and bowel function in meningomyelocele patients with augmentation enterocystoplasty

Outcomes of lower urinary and bowel function in meningomyelocele patients with augmentation enterocystoplasty

Neurourologische Funktionsstörungen des unteren Harntraktes bei Erkrankungen des ZNS

Continent Urinary Diversions in Non Oncologic Situations: Alternatives and Complications

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