Augmentation enterocystoplasty on treatment of neurogenic bladder dysfunction : a single center outcomes and experience with 77 patients
10.3760/cma.j.issn.1000-6702.2012.09.005
- VernacularTitle:肠道膀胱扩大术治疗神经源性膀胱77例疗效观察
- Author:
Fan ZHANG
;
Limin LIAO
;
Guang FU
;
Juan WU
;
Wenli LIANG
;
Dong LI
;
Zongsheng XIONG
;
Chunsheng HAN
;
Yanhe JU
;
Wenbo SHI
- Publication Type:Journal Article
- Keywords:
Augmentation enterocystoplasty;
Ureteral reimplantation;
Neurogenic bladder dysfunction;
Urodynamies
- From:
Chinese Journal of Urology
2012;33(9):655-659
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess clinical and urodynamic results of augmentation enterocystoplasty (AE) in patients with ncurogcnic hladdcr dysfunction (NBD).Methods Retrospectively reviewed our database between 2005-2011 to identify 77 patients who underwent AE ( sigmoid 74 patients,ileum 3 patients).Postoperativc complications,renal function,urodynamics parameters and quality of daily life were evaluated.Results The mean follow-up length was 24 months.Compared with pre-operative condition,the mean bladder capacity significantly increased from (160.6 ± 128.3) to (468.5 ± 60.6) ml (P <0.001 ) and the maximum detrusor pressure decreased from ( 31.1 ± 26.4) to ( 10.9 ± 4.5 ) cm H2O ( P =0.002 ).Serum creatinine level decreased from (270.3 ± 113.6 ) to ( 174.4 ± 81.3 ) μmol/(l) ( P =0.00 1 ).There were significant decrease on mean number of incontinence episodes and pads used per day ( P <0.01 ).Post-operative complications included metabolic acidosis in two patients (2.6%),adhesive intestinal obstruction in four patients (5.2%),deteriorating renal function in one patients ( 1.2% ) and recurrence of vesicoureteral reflux in three patients (3.9%).Conclusions The results suggest that AE is safe and effective in treating patients with NBD.Concomitant URI is considerèd on patients with long illness history,vesicoureteral reflux at low intravesical pressures and upper urinary tract dilation.Patients with moderate and severe upper urinary tract deteriorations benefit from this procedure and the benefit can maintain a long time.