Transvaginal Bladder Neck Closure With Posterior Urethral Flap for Devastated Urethra

Goudelocke, Colin; Gilchrist, Alienor; Лебед, Бретт

doi:10.1016/j.urology.2010.11.054

Cited by 24 publications

(11 citation statements)

References 11 publications

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“…Our case is unique with the usage of cadaveric pericardial tissue (CPT) to augment the closure and thereby reduce the risk of fistula formation. One study successfully combated the risk of fistula formation by using a posterior urethral flap to secure the suture line [5]. In our case, the decision was made to use CPT to help augment the native tissue repair secondary to the concern over the patient's medical comorbidities interfering with wound healing.…”

Section: Discussionmentioning

confidence: 99%

Use of Cadaveric Pericardial Tissue in the Surgical Treatment of Neurogenic Bladder

Caja

Lamonde

Barnard

et al. 2019

Case Reports in Urology

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The surgical treatments for neurogenic bladder are extremely variable. The lack of specific treatment guidelines makes this disease process even more challenging to treat. We present a case of a 55-year-old female with neurogenic bladder secondary to spinal cord injury (SCI). Her incontinence was conservatively managed with indwelling Foley drainage. Despite continued upsizing of the Foley catheters, the patient continued to have urinary leakage. The patient subsequently underwent a transvaginal bladder neck closure (BNC) with suprapubic bladder neck diversion (SPC). The urethra was successfully closed and uniquely supported with the use of cadaveric pericardial tissue (CPT). This surgical approach of neurogenic bladder provides durable continence with short operative times, minimal patient morbidity, decreased hospital length, and low risk of progressive renal dysfunction. BNC with SPC can provide an excellent management solution for neurogenic bladder from spinal cord injury refractory to conservative management.

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Section: Discussionmentioning

confidence: 99%

Use of Cadaveric Pericardial Tissue in the Surgical Treatment of Neurogenic Bladder

Caja

Lamonde

Barnard

et al. 2019

Case Reports in Urology

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“…30 Another report of 11 women who underwent urethral closure via a transvaginal approach reported on one failure at 6 weeks. 31 However, another series reported only 40% success from five transvaginal closures but 100% success from 10 combined abdominal and transvaginal closures. 32 Another stated that the retropubic approach to bladder neck closure in 26 patients had no complications when compared to the transvaginal approach, but only two underwent this method.…”

Section: Investigation and Managementmentioning

confidence: 99%

Urethral Complications in Spinal Cord Injury

Gordon¹,

Mangera²

2018

J Reconstr Urol

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rethral complications are recognised in patients post spinal cord injury (SCI) and can be challenging to manage. Our aim was to review the literature to identify the aetiology, incidence, risk factors and management for urethral complications in spinal cord injured patients. METHODSA search was carried out using the PubMed database for peer reviewed articles on 01/01/18. The following search terms were used: "spinal cord injury", "cauda equina", "neuropathic bladder" "neurogenic bladder" and were combined with "urethral complications", "urethral stricture", "urethral di- J Reconstr Urol 2018;8(1):21-7 21Urethral Complications in Spinal Cord Injury A AB BS S T TR RA AC CT T Spinal cord injury may pose a difficulty for the bladder to empty efficiently. In this scenario catheters are utilised, either in the form of clean intermittent catheterisation (CIC) or indwelling catheters. Little has been collated in the literature regarding the urethral complications associated with these methods of bladder drainage. We reviewed the literature of the published articles reporting on the urethral complications associated with catheter use in the spinal cord injured population. Long term, both methods carry a risk of urethral complications including tructuring, erosion, fistulation and diverticulum formation with less risk reported for CIC. Although reports of the management of these complications are limited in the literature, surgical repair forms the mainstay of management and in severe cases urinary diversion is required.K Ke ey yw wo or rd ds s: : Urethral complications; urethral erosion; urethral diverticulum; urethral stricture; urethral fistula; spinal cord injuries; clean intermittent catheterisation Ö ÖZ ZE ET T Spinal kord yaralanması, mesanenin etkin boşaltılmasında önemli güçlük çıkarabilir. Bu durumda "clean intermittent" kateterler (CIC) ve/veya "indwelling" kateterler kullanılabilir. Bu metotlarla mesanenin boşaltılmasına ilişkin üretral komplikasyonları ele alan literatürü gözden geçirdik. Spinal kord hasarı yaşamış popülasyonda kateter kullanımına ilişkin üretral komplikasyonları ele alan makaleleri derledik. Uzun dönemde, her iki kateter yönteminde de sık rastlanan komplikasyonlar erozyon, fistülasyon ve divertikulum formasyonu olmakla beraber, bu riskler CIC ile daha az rapor edilmiştir. Bu komplikasyonların yönetimine ilişkin makalelerin raporların sayısı az olmakla birlikte, bunların tedavisinde ana yöntem cerrahi onarım olmaktadır. Şiddetli olgularda üriner diversiyon gerekmektedir.A An na ah h t ta ar r K Ke e l li i m me e l le

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“…A well-known complication of this procedure is vesicourethral fistula formation, which has been reported in up to 24 % of patients [36]. Although less invasive, transvaginal bladder neck closure has been associated with higher rates of fistula formation than the transabdominal approach [40,41]. Several measures can be taken to avoid fistula complication.…”

Section: Bladder Neck Closurementioning

confidence: 99%

“…Several reports indicate that success rates to prevent fistulas are enhanced by tissue interposition between the bladder neck and the urethra [35,36,42]. Omentum is most often mobilized for this purpose; however, other available tissues have been used, including the rectus abdominis muscle, a posterior urethral flap, or a Martius flap [35,41,42]. Another common complication following bladder neck closure is stone formation, which may result from inadequate bladder emptying, retained staples, and mucous production by the bowel graft [35, 36, 38•, 39, 40].…”

Section: Bladder Neck Closurementioning

confidence: 99%

Evaluation and Management of Failed Bladder Reconstructions

Jordan¹,

Palmer

Kielb³

2015

Curr Bladder Dysfunct Rep

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Bladder reconstructions are commonly performed in patients with neurogenic bladders with a high rate of complications. We seek to help guide the evaluation and management of these complications by reviewing the available data. Augmentation cystoplasty and concomitant procedures such as continent catheterizable channels, bladder neck closure, and bladder neck sling can provide long-term solutions for patients with poorly compliant, high-pressure bladders or refractory detrusor overactivity. While these techniques improve symptoms and protect against upper tract deterioration, patients are exposed to new risks including bladder perforation, increased malignancy rates, urolithiasis, surgical failures, and persistent symptoms. The overall rate of reoperation is high. Evaluation with urodynamics and endoscopy, when indicated, remain critical tools to protect this patient population. Use of clean intermittent catheterization has helped popularize bladder reconstructive surgery, but a strict regimen is required to minimize postoperative risks in the long term. Additionally, various surgical techniques can be utilized to manage complications after bladder reconstruction, and concurrent use of anticholinergics and onabotulinum toxin injections can further mitigate these reconstructive failures. Bladder reconstruction can provide excellent long-term solutions, but patients are at a high risk of long-term complications. Appropriate patient counseling, close follow-up, and timely evaluation are crucial in managing the long-term complications of bladder reconstruction surgery.

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Transvaginal Bladder Neck Closure With Posterior Urethral Flap for Devastated Urethra

Cited by 24 publications

References 11 publications

Use of Cadaveric Pericardial Tissue in the Surgical Treatment of Neurogenic Bladder

Use of Cadaveric Pericardial Tissue in the Surgical Treatment of Neurogenic Bladder

Urethral Complications in Spinal Cord Injury

Evaluation and Management of Failed Bladder Reconstructions

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