Ureteroneocystostomy in the Neuropathic Bladder Associated with
High-Grade Reflux

Goerdin, A.; Wyndaele, J J; Sy, W. A. De

doi:10.1159/000471655

Cited by 8 publications

(4 citation statements)

References 18 publications

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“…So, corrective treatments are more frequently required in symptomatic secondary VUR in adults. However, in VUR with neurogenic bladder, bladder trabeculation may impede ureteric reimplantation, and VUR recurrence or secondary obstruction may complicate recovery 11,12 . Open surgery for reflux may also worsen bladder compliance 13 .…”

Section: Discussionmentioning

confidence: 99%

“…However, in VUR with neurogenic bladder, bladder trabeculation may impede ureteric reimplantation, and VUR recurrence or secondary obstruction may complicate recovery. 11,12 Open surgery for reflux may also worsen bladder compliance. 13 ESI, performed easily and effectively in a daysurgery center, may prove especially beneficial for adult patients with VUR and D-BC.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance

Lee¹,

Han²,

Jeong³

et al. 2010

Int J of Urology

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Objective: To evaluate the outcome of endoscopic subureteral injection (ESI) in adults with vesicoureteral reflux (VUR) associated with decreased bladder compliance (D-BC). Methods: We retrospectively reviewed the medical records of 46 consecutive patients who underwent ESI for VUR at a single tertiary academic center. Fourteen patients (17 ureter units) who had underlying neurological disease with decreased bladder compliance, as determined by filling cystometry, were grouped as D-BC. Thirty-two patients (47 units) who had no signs or symptoms that suggested neurogenic lower urinary tract dysfunctions were grouped as normal bladder compliance (N-BC). We compared the cure rates for ESI between groups, defining cure as complete resolution of reflux on voiding cystourethrogram. Results: In 70.6% of the D-BC group and 70.2% of the N-BC group, VUR resolved completely after the first injection (P = 0.977). One failed unit of D-BC was cured after second ESI, and seven failed units of N-BC were cured after additional treatments (second ESI, two patients; ureteroneocystostomy, five patients). No additional treatments were applied to three units of D-BC or seven units of N-BC without symptoms. No complications related to the ESI were observed. Conclusions: The ESI was found to be effective in adults with VUR regardless of the bladder compliance. As a minimally invasive procedure with a favorable outcome, ESI may represent the first choice for treatment of VUR even in adults with D-BC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance

Lee¹,

Han²,

Jeong³

et al. 2010

Int J of Urology

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“…3,4 Furthermore open surgical procedures further stress already distressed patients with spinal injury. Endoscopic injection of Macroplastique 1 is simple, eective and without complications, and can be performed as a day case procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, these procedures are more dicult in thick walled trabeculated neuropathic bladders often with less rewarding results as compared to correction of primary VUR. 3,4 Correction of VUR by endoscopic injection of Te¯on paste was ®rst described by Matovschek in 1981. 5 Since then, numerous investigators have reported encouraging results of endoscopic correction of both primary and secondary VUR mostly in children.…”

Section: Introductionmentioning

confidence: 99%

Vesico-ureteric reflux in adults with neuropathic bladders treated with Polydimethylsiloxane (Macroplastique®)

Shah

Kabir²,

Lane³

et al. 2001

Spinal Cord

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Objective: To establish the ecacy of Macroplastique 1 in treating vesico-ureteric re¯ux (VUR) in adults with neuropathic bladder dysfunction. Patients and methods: Fifteen patients (12 male and three female), age range 19 to 80 years (mean age 38) were included in this study. Diagnosis was con®rmed by videourodynamics. In seven patients re¯ux was present bilaterally. Twenty-two re¯uxing ureters were treated. Twelve patients had detrusor hyper-re¯exia, two had are¯exic bladders and one had loss of bladder wall compliance. According to the International Grading System, 10 ureters had grade IV re¯ux, ®ve had grade III re¯ux, ®ve had grade II re¯ux, and two had grade I re¯ux. Macroplastique 1 (0.5 ± 1.5 ml) was injected submucosally under each ureteric ori®ce to convert the opening to a slit like shape. The patients were followed up from 9 to 68 months. Results: VUR was completely resolved in 72.7% (16) ureters following a single injection and in a further 4.5% (1) ureter following a second injection. 9.1% (2) ureters were improved and treatment failed in 13.7% (3) ureters. Two patients showed a recurrence of re¯ux 1 and 4 years after primary injection and subsequently had a curative second injection. Most of the patients in whom VUR was cured or improved showed a reduction in laboratory proven urinary infection rates. Conclusion: Macroplastique 1 produced an excellent result (86% with complete resolution or improvement of re¯ux) in treating VUR in adult neuropathic bladders. This is comparable to larger studies carried out on the paediatric population. This is an easy procedure, which avoids major surgery and can be performed as a day case. In cases of failure or recurrence, repeat injection or open surgery can be undertaken without any added complications. Spinal Cord (2001) 39, 92 ± 96

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Endoscopic correction of vesicoureteral reflux in patients with neurogenic bladder dysfunction

Sugiyama

Hashimoto

Kiwamoto

et al. 1995

International Urology and Nephrology

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Transurethral injection of Teflon paste (TUI) was carried out in 24 ureters of 16 patients with vesicoureteral reflux (VUR) secondary to neurogenic bladder dysfunction at an age ranging from 4 to 77 years, and the results were compared with those of conventional open surgery. During the mean follow-up period of 20.1 months, reflux disappeared in 19 ureters (79%), so that the success rate of endoscopic operation was considered to be satisfactory as compared with that of conventional open surgery, in which reflux disappeared in 16 (80%) of 20 ureters in 16 patients with neurogenic bladder dysfunction at our department. No exacerbation of hydronephrosis was observed postoperatively, and no complication was noted. This procedure, which is minimally invasive and technically simple, may be regarded as the first choice for VUR secondary to neurogenic bladder dysfunction.

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Ureteroneocystostomy in the Neuropathic Bladder Associated with High-Grade Reflux

Cited by 8 publications

References 18 publications

Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance

Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance

Vesico-ureteric reflux in adults with neuropathic bladders treated with Polydimethylsiloxane (Macroplastique®)

Endoscopic correction of vesicoureteral reflux in patients with neurogenic bladder dysfunction

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