Surgical and Patient Reported Outcomes of 'Clam' Augmentation Ileocystoplasty in Spinal Cord Injured Patients

Khastgir, Jay

doi:10.1016/s0302-2838(03)00008-3

Cited by 58 publications

(60 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Risks of this surgery include kidney or bladder infections, new recurrent UTIs, metabolic derangements, mucus production, and in rare cases tumors within the bladder. Khastgir et al described outcomes measured for augmentation cystoplasty [21]. The emphasized outcomes were clinical outcomes (maximum detrusor pressure and bladder volume capacity) and the quantification of patient symptoms (incontinence episodes and number of pads).…”

Section: Resultsmentioning

confidence: 99%

Treatment success for overactive bladder with urinary urge incontinence refractory to oral antimuscarinics: a review of published evidence

et al. 2009

View full text Add to dashboard Cite

BackgroundTreatment options for overactive bladder (OAB) with urinary urge incontinence (UUI) refractory to oral antimuscarinics include: botulinum toxin type A (BoNTA), sacral neuromodulation (SNM), and augmentation cystoplasty (AC). A standard treatment success metric that can be used in both clinical and economic evaluations of the above interventions has not emerged. Our objective was to conduct a literature review and synthesis of published measures of treatment success for OAB with UUI interventions and to identify a treatment success outcome.MethodsWe performed a literature review of primary studies that used a definition of treatment success in the OAB with UUI population receiving BoNTA, SNM, or AC. The recommended success outcome was compared to generic and disease-specific health-related quality-of-life (HRQoL) measures using data from a BoNTA treatment study of neurogenic incontinent patients.ResultsAcross all interventions, success outcomes included: complete continence (n = 23, 44%), ≥ 50% improvement in incontinence episodes (n = 16, 31%), and subjective improvement (n = 13, 25%). We recommend the OAB with UUI treatment success outcome of ≥ 50% improvement in incontinence episodes from baseline. Using data from a neurogenic BoNTA treatment study, the average change in the Incontinence Quality of Life questionnaire was 8.8 (95% CI: -4.7, 22.3) higher for those that succeeded (N = 25) versus those that failed (N = 26). The average change in the SF-6D preference score was 0.07 (95% CI: 0.02, 0.12) higher for those that succeeded versus those that failed.ConclusionA treatment success definition that encompasses the many components of underlying OAB with UUI symptoms is currently not practical as a consequence of difficulties in measuring urgency. The treatment success outcome of ≥ 50% improvement in incontinence episodes was associated with a clinically meaningful improvement in disease-specific HRQoL for those with neurogenic OAB with UUI. The recommended success definition is less restrictive than a measure such as complete continence but includes patients who are satisfied with treatment and experience meaningful improvement in symptoms. A standardized measure of treatment success will be useful in clinical and health economic applications.

show abstract

Section: Resultsmentioning

confidence: 99%

Treatment success for overactive bladder with urinary urge incontinence refractory to oral antimuscarinics: a review of published evidence

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Augmentation cystoplasty combined with CIC is a standard practice with high satisfaction rates for improving bladder storage and emptying in patients with overactive bladder unresponsive to medical treatment [13] .…”

Section: Discussionmentioning

confidence: 99%

Application of Appendicular-Based Cecal Flap for Less Invasive Augmentation Cystoplasty: A Novel Technique

Shakeri

Aminsharifi²,

Jahanabadi

2009

Urol Int

View full text Add to dashboard Cite

Objectives: To evaluate the use of a new modified technique for augmentation cystoplasty on selected cases, both in terms of improvements in bladder urodynamics and creating an ideal conduit for clean intermittent catheterization. Methods: Ten patients suffering from intractable low-compliance bladder and reasonable capacity underwent appendicular-based cecal flap augmentation cystoplasty. The procedure comprised the isolation of a 10 to 12 × 3 to 5-cm cecal flap on the base of the appendicular pedicle, by which the bladder was augmented and the appendix was brought out through the abdominal wall for catheterization. Without any bowel anastomosis, the cecal anterior wall was repaired. Results: After a mean follow-up of 23.8 months, 9 of 10 patients became continent. Postoperative urodynamic study revealed a 53.8% increase in mean maximal cystometric capacity (from 171.4 to 263.7 ml; p = 0.012) and a 7.7-fold increase in mean bladder compliance (from 3.39 to 26.66 ml/cm H₂O; p = 0.012). Mean maximal detrusor filling pressure decreased by 79% (from 62.2 to 13 cm H₂O; p = 0.012). Renal function remained stable in all patients. Appendicular stoma was easy to catheterize, and no stomal stenosis occurred during the follow-up period. Conclusions: Early results of this less invasive technique could be promising in patients with high filling pressure and acceptable maximum bladder capacity.

show abstract

“…Considered a procedure of last resort, the risks of the surgery include recurrent UTI's, renal or bladder infections, metabolic changes and mucus production. (Khastgir et al, 2003) reviewed outcomes associated with augmentation cystoplasty. This group emphasized clinical outcomes (e.g.…”

Section: Augmentation Cystoplastymentioning

confidence: 99%

Diagnosis and Treatment of Overactive Bladder

2013

Female Pelvic Medicine &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Surgical and Patient Reported Outcomes of 'Clam' Augmentation Ileocystoplasty in Spinal Cord Injured Patients

Cited by 58 publications

References 19 publications

Treatment success for overactive bladder with urinary urge incontinence refractory to oral antimuscarinics: a review of published evidence

Treatment success for overactive bladder with urinary urge incontinence refractory to oral antimuscarinics: a review of published evidence

Application of Appendicular-Based Cecal Flap for Less Invasive Augmentation Cystoplasty: A Novel Technique

Diagnosis and Treatment of Overactive Bladder

Contact Info

Product

Resources

About