Bladder autoaugmentation byvesicomyotomy in the pediatric neurogenic bladder

Stothers, Lynn; Johnson, Hjalmar W.; Arnold, W. J. D.; Coleman, Gerald U.; Tearle, Howard

doi:10.1016/s0090-4295(94)80019-7

Cited by 50 publications

(17 citation statements)

References 5 publications

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“…When the procedure is performed laparoscopically, possible mucosal perforation 9,12,13,18,21,23,25 is more dicult to correct than in the open approach.…”

Section: Discussionmentioning

confidence: 99%

“…The surgery time is 1 ± 2 h and hospitalisation 2 ± 6 days, as is corroborated in the literature. 10 ± 12,20 Additional implantation of an arti®cial sphincter is problematic, 18,21 even more so when the peritoneum is compromised after extensive pelvic surgery 10 and/or radiation. Over¯ow incontinence, acting as a`safety valve', is eliminated and thus bladder rupture may occur sooner.…”

Section: Discussionmentioning

confidence: 99%

“…Contrary to other groups, no ®lamentous detrusor bands are left, 12 nor do we use detrusor¯aps for ®xation. 10,11,21,24,25 The bladder is kept relatively slack during the dissection by regular partial drainage to prevent mucosal rupture, a not infrequent preoperative complication. 9,11 ± 13,18,21,23,25 Late sequelae are prevented by preoperative closing: clamping in a curved clamp and ligating with resorbable material (cf.).…”

Section: Methods and Patientsmentioning

confidence: 99%

“…9,11 ± 13,18,21,23,25 Late sequelae are prevented by preoperative closing: clamping in a curved clamp and ligating with resorbable material (cf.). 12,21 . A Redon wound drain is left for 2 days.…”

Section: Methods and Patientsmentioning

confidence: 99%

“…Recently, variations of the technique have been published. 9,12 ± 25 The dissected detrusor wall can be used either partly 10,11,21 or totally 24,25 for attachment of the bladder, partly 10,11,21 or totally 9,12,13 removed, or just deflected from the mucosa. 14 ± 19,23 Combinations with (demucosalised) enterocystoplasty or other coverage of the exposed mucosa are under study.…”

Section: Introductionmentioning

confidence: 99%

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Bladder autoaugmentation in adult patients with neurogenic voiding dysfunction

et al. 1997

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Bladder autoaugmentation oers an alternative to enterocystoplasties for patients with low capacity high pressure bladders caused by non-malignant pathology. In particular for patients with neuropathic hyperre¯exive bladders, refractory to less invasive therapy, bladder autoaugmentation will attain comparable results with less impact on life quality compared to other bladder augmentation procedures. The procedure does not preclude later enterocystoplasty or deaerentations. Over the last 7 years, 50 patients were treated by this method, some of them for other than neurogenic voiding dysfunction. Substantial increase of bladder capacity and compliance resulted, at the cost of increased residual urine and the need for intermittent catheterisation in most patients. Some patients are able to perform complete voiding at will. The time lapse between surgery and functional rehabilitation of the bladder (substantial increase of capacity and detrusor compliance) cannot be predicted yet. In most patients this amelioration was observed 1 ± 6 months after surgery, but in some the eect was equivocal for a year or longer. Low-dose anticholinergics appear to speed up the therapeutic eect. One patient had enterocystoplasty and one deaerentation later, one had rupture of the bladder, probably from the use of an arti®cial sphincter, and two are rated as failures because of psychogenic bladder-centred problems. Bladder autoaugmentation is a favourable treatment for patients who are motivated to wait possibly longer for functional changes to occur and are willing to perform intermittent catheterisation afterwards.

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“…When the procedure is performed laparoscopically, possible mucosal perforation 9,12,13,18,21,23,25 is more dicult to correct than in the open approach.…”

Section: Discussionmentioning

confidence: 99%