Cambios urodinámicos posteriores a cirugía de ampliación vesical por vejiga neurogénica en pacientes pediátricos con mielomeningocele

Torres, Raúl Ignacio Zaragoza; Galarza-Flores, Mario Eduardo; Gómez-Castellanos, Julio Cesar; León, Juan Carlos Barrera-de

doi:10.1016/j.circir.2015.10.008

Cited by 7 publications

(5 citation statements)

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“…Compliance, end filling pressure, and continence also improved substantially. These results are consistent with the findings of other studies[ 3 , 4 ].…”

Section: Discussionsupporting

confidence: 94%

Surgical outcomes of bladder augmentation: A comparison of three different augmentation procedures

Sun¹,

Wang²,

Xu³

et al. 2020

WJCC

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BACKGROUND Augmentation cystoplasty is indispensable in many pediatric diseases, especially neurogenic bladder. Various methods and materials are used to augment the bladder, and these methods are associated with different shortcomings and complications. AIM The present study reported the mid-term outcomes of patients undergoing various bladder augmentation procedures in a single institution, and assessed whether seromuscular cystoplasty lined with urothelium (SCLU) provided better urodynamic results than auto-augmentation (AA). METHODS A retrospective review of 96 patients undergoing various augmentation methods between 2003 and 2018 was performed. The patients were divided into three groups according to the type of augmentation, and their outcomes were compared. All patients developed neurogenic bladder due to myelomeningocele or sacrococcygeal teratoma. The clinical data of all patients were collected. RESULTS The mean ages at surgery in the three groups (standard cystoplasty [SC], SCLU, AA) were 10.8, 7.5, and 4.8 years, respectively, with mean follow-ups of 36, 61, and 36 mo, respectively. The mean preoperative and postoperative bladder capacities of the SC, SCLU, and AA groups were 174 ± 11.7 vs . 387 ± 13.7 ( P < 0.0001), 165 ± 12.2 vs. 240 ± 14.7 ( P = 0.0002), and 138 ± 16.7 vs. 181 ± 9.9 ( P = 0.0360), respectively. Compared with the AA group, the SCLU procedure did not have better postoperative urodynamic parameters. Incontinence was reduced in most patients. The mean times of clean intermittent catheterization per day in the SC, SCLU, and AA groups were 5.6, 7.8, and 8.2, respectively. The main complications of the SC group were recurrent urinary tract infections (8%) and bladder calculi (6%). Re-augmentation was done in patients in the SCLU (8) and AA (3) groups. CONCLUSION SC provided sufficient bladder capacity and improved compliance with acceptable complications. After AA and SCLU, the patients acquired limited increases in bladder capacity and compliance with a high rate of re-augmentation. Compared with AA, SCLU did not yield better postoperative urodynamic parameters.

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“…Compliance, end filling pressure, and continence also improved substantially. These results are consistent with the findings of other studies[ 3 , 4 ].…”

Section: Discussionsupporting

confidence: 94%

Surgical outcomes of bladder augmentation: A comparison of three different augmentation procedures

Sun¹,

Wang²,

Xu³

et al. 2020

WJCC

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“…[ 40 ] Similar results were noted in a series of children with neurogenic bladder due to meningomyelocele with filling pressure reducing from 41 to 11 cm H 2 O. [ 41 ] In contrast, Vainrib et al . showed that 11% of adult meningomyelocele patients had unsatisfactory compliance at a mean follow-up of 10.4 years.…”

Section: Literature On Follow-up Urodynamicssupporting

confidence: 63%

Follow-up urodynamics in patients with neurogenic bladder

Sinha

2017

Indian J Urol

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Introduction:Neurogenic bladder patients are at long-term risk of secondary upper urinary tract damage. Symptoms are unreliable and follow-up urodynamics is the only method of ascertaining safety of bladder pressures. This review examines the recommendations, shortcomings and utilization of existing guidelines. The evidence with regard to follow-up urodynamics in different settings relevant to neurogenic bladder is evaluated and an algorithm is proposed.Methods:A pubmed search was conducted for studies on follow-up urodynamics in patients with neurogenic bladder. Additional search was made of secondary sources including reviews and guidelines.Results:The need for follow-up urodynamics should be considered in all patients undergoing an initial assessment and weighed against the risks. Existing guidelines, while unanimous in their recommendation of its utilization, give scant details regarding its incorporation in clinical management. Follow-up urodynamics can document efficacy and identify the need for escalation of therapy in patients on intermittent catheterization and antimuscarinics. Patients with spinal injury, spinal dysraphism and anorectal malformations are at higher risk for upper tract damage. Follow-up urodynamics can help identify patients suitable for intravesical botulinum and mark those destined for failure. Patients undergoing augmentation cystoplasty may be candidates for less aggressive urodynamic follow-up.Conclusions:Neurogenic bladder is managed by a broad cross-section of physicians. Clear recommendations and a management algorithm are important for improving patient care. Follow-up urodynamics can identify patients at risk, prevent renal dysfunction and improve the quality of life. There is an urgent need for more evidence on this important subject.

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“…При наличии остатка мочи в объеме более 10 мл, особенно на фоне пиелоэктазии или мегауретера, необходимо устанавливать постоянный уретральный катетер (лучше использовать катетер Фолея соответствующего размера) на фоне антибактериальной терапии. Ребенок должен находиться под наблюдением уролога начиная с первого месяца жизни [1, 11,12].…”

Section: резюме _____________________________________________________...unclassified

Urodynamic Techniques in Clinical Practice as the "Gold Standard" for Examining Children with Urinary Disorders (A Lecture)

Морозов¹,

Длин²,

Подгорный³

et al. 2023

Педиатрия. Восточная Европа

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Одной из актуальных проблем педиатрической практики является нарушение мочеиспускания у детей, что обусловлено высокой частотой в детской популяции, кроме того, проблема актуальна не только в связи с ее высокой распространенностью, но и ухудшением качества жизни. Также большое значение для пациентов с нейрогенными расстройствами имеет развитие вторичных осложнений: пузырно-мочеточниковый рефлюкс, вторичный обструктивный пиелонефрит, поражение верхних мочевых путей (мегауретер, гидронефроз, рефлюкс-нефропатия), инфекция мочевой системы (цистит, пиелонефрит), гипертрофия и фиброз мочевого пузыря. Для эффективного лечения и предотвращения осложнений нейрогенного мочевого пузыря важной остается функциональная диагностика расстройств мочеиспускания. В настоящее время одним из современных методов для категоризации нейрогенных расстройств является клиническое уродинамическое исследование, в том числе и у детей первого года жизни. Современные подходы к диагностике позволяют правильно определить тип дисфункции мочевого пузыря и дальнейшую тактику ведения пациента с расстройствами мочеиспускания. Помимо диагностики различных вариантов нейрогенного мочевого пузыря большая роль клинического уродинамического исследования отмечена в контроле эффективности терапии, особенно у детей раннего возраста. One of the topical problems in pediatric practice is urinary dysfunction in children, owing to its high prevalence in pediatric population; moreover, this problem is relevant not only due to its high prevalence, but also because it worsens the quality of life. Furthermore, of great importance for patients with neurogenic disorders is the development of secondary complications: vesicoureteral reflux, secondary obstructive pyelonephritis, upper urinary tract involvement (megaureter, hydronephrosis, and reflux nephropathy), urinary infection (cystitis, pyelonephritis), bladder hypertrophy and fibrosis. For effective treatment and prevention of neurogenic bladder complications, functional diagnosis of urination disorders remains important. Currently, one of the modern methods for neurogenic disorders categorization is clinical urodynamic investigation, including that in children of the first year of life. Modern approaches to diagnosis allow correctly determining bladder dysfunction type and further management tactics for patients with urination disorders. In addition to diagnosing various variants of neurogenic bladder, a great contribution of clinical urodynamic investigations is highlighted in monitoring therapy effectiveness, especially in young children.

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Cambios urodinámicos posteriores a cirugía de ampliación vesical por vejiga neurogénica en pacientes pediátricos con mielomeningocele

Abstract: Augmentation cystoplasty with sigmoid colon significantly improved urodynamic parameters, such as bladder accommodation and filling pressure in children with myelomeningocele-associated neurogenic bladder.

Cited by 7 publications

References 9 publications

Surgical outcomes of bladder augmentation: A comparison of three different augmentation procedures

Surgical outcomes of bladder augmentation: A comparison of three different augmentation procedures

Follow-up urodynamics in patients with neurogenic bladder

Urodynamic Techniques in Clinical Practice as the "Gold Standard" for Examining Children with Urinary Disorders (A Lecture)

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