Bladder augmentation and artificial sphincter implantation: Urodynamic behavior and effects on continence

Abstract Objective To quantify changes in bladder capacity, pressure and compliance after isolated bladder augmentation or augmentation associated with implantation of an artificial sphincter, and to compare the various types of augmentation. Patients and methods Preoperative and postoperative urody...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of pediatric urology Vol. 4; no. 1; pp. 8 - 13
Main Authors:	Rodó, Juan S, Cáceres, Freud A, Lerena, Javier R, Rossy, Enrica
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-02-2008
Subjects:	Adolescent Adult Artificial sphincter Bladder augmentation Bladder Exstrophy - surgery Child Child, Preschool Colocystoplasty Colon, Sigmoid - transplantation Female Humans Ileocystoplasty Ileum - transplantation Male Meningomyelocele - surgery Pediatrics Prosthesis Implantation Retrospective Studies Treatment Outcome Ureter - transplantation Ureterocystoplasty Urinary Bladder - physiopathology Urinary Bladder - surgery Urinary Incontinence - physiopathology Urinary Incontinence - surgery Urinary Sphincter, Artificial Urodynamics Urology Urodynamics Colocystoplasty Ureterocystoplasty Artificial sphincter Bladder augmentation Ileocystoplasty
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Abstract Objective To quantify changes in bladder capacity, pressure and compliance after isolated bladder augmentation or augmentation associated with implantation of an artificial sphincter, and to compare the various types of augmentation. Patients and methods Preoperative and postoperative urodynamic studies were performed in a group of 38 patients (18 males and 20 females; age range 2–19 years), who underwent a type of bladder augmentation. Results The bladder improved in capacity in all patients (mean values: initial 137 ml, final 336 ml, individual increase 229 ml; 434%) except two, in which the augmentation was done with ureter. The mean pressure improved (initial 32 cm of H2 O, final 14, decrease per patient 18 cm of H2 O; 49%). The curve of compliance, progressively increasing typical of hyperreflexia and poor compliance, present in 70% of the cases preoperatively, improved in 78% cases postoperatively, although there were several different patterns. Urodynamic behavior was analyzed with regard to the tissue used for augmentation (ileum, ureter or sigmoid colon). In the sigmoid colon group, there were no significant differences in the urodynamic behavior of the bladder neo-reservoir in relation to the configuration used. Conclusion With bladder augmentation comes an increase in bladder capacity, a reduction in pressure, and an improvement in compliance and continence. The level of change in capacity, pressure and compliance varies with the tissue used and the length and caliber of the insert. When the procedure is carried out using sigmoid colon tissue, there are no noteworthy differences among the various possible configurations.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1477-5131 1873-4898
DOI:	10.1016/j.jpurol.2007.02.009