Follow-up study of cystectasy using a demucosalized ileoseromuscular layer patch containing neurovascular pedicle for overactive neurogenic urinary incontinence
- VernacularTitle:回肠浆肌层补片膀胱扩大术治疗反射亢进型神经原性尿失禁的疗效随访
- Author:
Jiaxiang WANG
;
Da ZHANG
;
Yingzhong FAN
;
Qian ZHANG
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2005;9(14):190-192
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: There are various surgical treatments to neurogenic urinary incontinence, and the curative effects differ a lot. The present research was to study the effect of surgical treatment of neurogenic urinary incontinence.OBJECTIVE: To evaluate the therapeutic effect of cystectasy using a demucosalized ileoseromuscular layer patch containing neurovascular pedicle for the patients with overactive neurogenic urinary incontinence to suggest for improvement in operations.DESIGN: A retrospective case analysis based on the study of the patients.SETTING: Department of pediatric surgery of a university hospital.PARTICIPANTS: A follow-up study was conducted to 68 patients who were treated at the Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University from April 1998 to January 2004 for neurogenic urinary incontinence. There were 38 cases with full follow-up data.METHODS: All the 38 patients with overactive neurogenic urinary incotinence underwent bladder augmentation using a demucosalized ileoseromuscalar layer patch containing neurovascular pedicle and were followed up for 4to 69 months, and 17.2 months in average. Among the patients, 34 with pelvic diaphragm ptosis were treated with pelvic diaphragm strengthening at the same time.MAIN OUTCOME MEASURES: The preoperative and postoperative symptoms, bladder compliance and maximum bladder capacity and the relative safe bladder capacity were studied.RESULTS: Thirty of 38 patients showed improvement in the symptoms of urinary incontinence(micturition interval ＞ 1 hour) after the operation. The results of urodynamics showed that the all patients with bladder augmentation using a demucosalized ileoseromuscular layer patch containing neurovascular pedicle urinated under abdominal pressure, and no active contraction of detrusor urinae was detected. The compliance, the maximum bladder capacity and the relative safe bladder capacity were increased by(27.43 ± 24.78) mL/kPa (P ＜0.01), (122. 18±79.99) mL(P ＜0.01) and(98.63 ±86.78) mL ( P ＜ 0.01 ) respectively. No aggravation of upper urinary function injury was observed after the operation.CONCLUSION: The bladder augmentation using a demucosalized ileoseromuscular layer patch ontaining neurovascular pedicle can protect the upper urinary function, and it is an effective approach to treating overactive neurogenic urinary incontinence.
