Surgery for neuropathic bladder and incontinence

Godbole, Prasad; Wilcox, Duncan T.

doi:10.1017/cbo9780511545757.050

Cited by 2 publications

(1 citation statement)

References 93 publications

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“…The importance of AC is underscored by the fact that a major cause of mortality in adult spina bifida patients is renal failure 17,18 . However, many of the complications relating to AC are attributable to the presence of intestinal epithelium in the lower urinary tract 19 . A recent systematic review on the long‐term effectiveness and complication rates of AC in patients with neurogenic bladder found only a small number of relevant studies 20 …”

Section: Introductionmentioning

confidence: 99%

Complication profile of augmentation cystoplasty in contemporary paediatric urology: a 20‐year review

Taghavi

O'Hagan

Bortagaray

et al. 2021

ANZ Journal of Surgery

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Background The aim of this study was to describe the complication profile of augmentation cystoplasty in contemporary paediatric urology as well as its effect on bladder metrics. Methods Consecutive operative cases were retrospectively reviewed at a single institution over 20 years (1999–2019). Short‐ and long‐term outcomes and complications following augmentation cystoplasty were defined. Results Of the 71 operative cases; the most common underlying diagnoses were neurogenic bladder (34%), exstrophy‐epispadias complex (30%) and posterior urethral valves (23%). The most common tissue‐type utilized was ileal (58%) and ureteric (30%). Peri‐operative urine leak affected nine (13%) children but reservoir perforations were less common (4%). Mean end‐of‐study detrusor pressure improved significantly following bladder augmentation (38–17 cmH2O, P < 0.001). Bladder capacity improved significantly (67–89%, P = 0.041). The median follow‐up was 4.5 years (interquartile range: 1.9–10 years). Bladder urolithiasis affected 13 (18%) patients, and symptomatic urinary tract infections 36 (51%) patients. Formation of a continent catheterisable channel contributed a number of complications relating predominantly to stenosis (50%). Repeat augmentation cystoplasty was necessary in three (4%) cases. Conclusion Augmentation cystoplasty is a surgical intervention that improves bladder metrics. Given the potential complications, careful patient selection and appropriate pre‐operative counselling are essential. Furthermore, pro‐active post‐operative management and transitional care are vital in the surgical care of children following augmentation cystoplasty.

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Section: Introductionmentioning

confidence: 99%

Complication profile of augmentation cystoplasty in contemporary paediatric urology: a 20‐year review

Taghavi

O'Hagan

Bortagaray

et al. 2021

ANZ Journal of Surgery

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Uropathogens and Pyuria in Children With Neurogenic Bladders

Forster¹,

Shaikh

Hoberman

et al. 2018

Pediatrics

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BACKGROUND: A recent study revealed that specific uropathogens are associated with lower abstract odds of pyuria in a general pediatrics population. Children with neurogenic bladders who require clean intermittent catheterization (CIC) frequently have pyuria. Our objective with this study was to determine if an association exists between pyuria and type of uropathogen in CIC-dependent children. METHODS: We obtained urinalysis and urine culture results from electronic medical records from January 2008 through December 2014 for patients ≤18 years of age with neurogenic bladders managed at a single institution. Cultures without concurrent urinalyses were excluded from analysis, as were cultures that yielded no growth, fungal growth, or growth of unidentified mixed organisms. We used logistic regression to determine the association of pyuria and leukocyte esterase with specific uropathogens. RESULTS: We included 2420 cultures in this analysis. The growth of Enterococcus on urine culture was associated with lower odds of both pyuria and leukocyte esterase. In contrast, the growth of more than 100 000 colony-forming units per milliliter of Proteus mirabilis was associated with increased odds of both pyuria and leukocyte esterase, and the growth of Pseudomonas aeruginosa was associated with increased odds of leukocyte esterase but not pyuria. Certain etiologies of neurogenic bladder, such as bladder exstrophy and cloacal malformations, were also associated with increased odds of pyuria compared with neurogenic bladder due to myelomeningocele. CONCLUSIONS: In children with neurogenic bladders who require CIC, Enterococcus may grow in urine culture without pyuria or positive leukocyte esterase. Accordingly, urine cultures should be obtained in symptomatic children, regardless of urinalysis results.

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Surgery for neuropathic bladder and incontinence

Cited by 2 publications

References 93 publications

Complication profile of augmentation cystoplasty in contemporary paediatric urology: a 20‐year review

Complication profile of augmentation cystoplasty in contemporary paediatric urology: a 20‐year review

Uropathogens and Pyuria in Children With Neurogenic Bladders

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