Sigmoidocolocystoplasty with ureteral reimplantation for treatment of neurogenic bladder.

Abstract

OBJECTIVE:

To assess the clinical and urodynamic results of sigmoidocolocystoplasty in patients with neurogenic bladder dysfunction.

METHODS:

We retrospectively reviewed 78 augmentation enterocystoplasty cases in our database from 2005 to 2011 to identify 47 patients who had undergone sigmoidocolocystoplasty alone or combined with ureter reimplantation. The indications for surgery and postoperative complications were evaluated. Renal function preservation, increased postoperative bladder capacity, decreased maximal detrusor pressure, and overall patient satisfaction were deemed successful outcomes.

RESULTS:

The mean follow-up period was 24 months. The mean bladder capacity increased from 160.6 ± 128.3 to 468.5 ± 60.6 mL (P < .001) and the maximal detrusor pressure decreased from 31.1 ± 26.4 to 10.9 ± 4.5 cm H(2)O (P = .002). The serum creatinine level decreased from 270.3 ± 113.6 to 174.4 ± 81.3 μmol/L (P = .001). Most patients resolved the urinary incontinence using clean self-intermittent catheterization. The decrease in the mean number of incontinence episodes and pads used daily indicated a marked improvement in patients' quality of life. Postoperative complications included bowel dysfunction in 5 patients (10.6%), adhesive intestinal obstruction in 4 (8.5%), deteriorating renal function in 3 (6.4%), and vesicoureteral reflux recurrence in 2 patients (4.3%). Nearly all patients expressed satisfaction with the urologic management.

CONCLUSION:

Our results suggest that sigmoidocolocystoplasty is safe and effective in treating patients with neurogenic bladder dysfunction. Concomitant ureter reimplantation will be beneficial for patients with a long history of illness.

• Authors: Fan Zhang, Limin Liao
• Journal: Urology (Urology) Vol. 80 Issue 2 Pg. 440-5 (Aug 2012) ISSN: 1527-9995 [Electronic] United States
• PMID: 22857763 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Colon (surgery)
• Colon, Sigmoid (surgery)
• Female
• Follow-Up Studies
• Humans
• Male
• Retrospective Studies
• Time Factors
• Ureter (surgery)
• Urinary Bladder (surgery)
• Urinary Bladder, Neurogenic (surgery)
• Urinary Reservoirs, Continent
• Urologic Surgical Procedures (methods)