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

Abstract

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.

Utilizing Colpocleisis to Repair a Vesicovaginal Fistula in a Cervical Cancer Patient with History of Pelvic Radiation: A Case Report and Literature Review

“…A paucity of studies exists on biologic grafts used in the setting of vesicovaginal fistulas. Caja et al reported on the use of CPT interposition to decrease the risk of vesicovaginal fistula formation [ 12 ]. Due to the low cost, ease of handling, and less immunogenicity, CPT may be used to help prevent fistula formation [ 13 ].…”

Anatomical Aspects of Neurogenic Bladder and the Approach in Its Management: A Narrative Review

“…Management of a neurogenic bladder case requires patient education and interventions such as manual expression, timed voiding, medicines, intermittent catheterizations, and indwelling urinary catheters, as well as surgical procedures [ 38 , 39 ]. A technique known as triggered reflex voiding involves stimulation of detrusor muscles by an externally elicited sacral reflex such as scratching the upper medial aspect of the thigh, suprapubic tapping or jabbing, or perineal manipulation and may be used to allow voiding.…”