Document Detail

Artificial urinary sphincter in patients with neurogenic bladder dysfunction.
MedLine Citation:
PMID:  8800894     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the role of the artificial urinary sphincter (AUS) in the management of sphincter weakness incontinence in neuropathic patients. PATIENTS AND METHODS: Ninety patients (75 male and 15 female, mean age 26 years, range 13-62) with neurogenic bladder dysfunction (71 with congenital and 19 with acquired cord lesions) who underwent implantation of an AUS were reviewed. All patients were followed up for a minimum of one year after the initial implantation of the sphincter (mean 4 years, range 1-10). Pre-operative video-urodynamics demonstrated sphincter weakness incontinence in all patients, with 24 patients having an acontractile-type bladder. Of 66 patients with intermediate-type bladders, 52 underwent cystoplasty. RESULTS: Eighty-three patients (92%) were continent both night and day, three were occasionally damp and controlled by pharmacotherapy, and four had a persistent poor result. Of the 66 patients with detrusor hyper-reflexia, 52 (79%) required a cystoplasty to achieve continence and 14 (21%) were controlled with anti-cholinergic therapy. The re-operation rate was 28% (25/90) and complications included six infections, seven erosions, eight system failures, two pump failures, one sheered tube and one rectal and one bladder perforation. Seventy (78%) of the patients currently perform intermittent catheterization to treat high post-voiding residual urine volumes. CONCLUSIONS: A rate of continence > 90% was achieved in these neurogenic patients after implantation of an AUS and we recommend a simultaneous cystoplasty in patients with detrusor overactivity.
G Singh; D G Thomas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of urology     Volume:  77     ISSN:  0007-1331     ISO Abbreviation:  Br J Urol     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-09-27     Completed Date:  1996-09-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15740090R     Medline TA:  Br J Urol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  252-5     Citation Subset:  IM    
Department of Urology, Royal Hallamshire Hospital, Sheffield, UK.
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MeSH Terms
Middle Aged
Treatment Outcome
Urinary Bladder, Neurogenic / complications*,  surgery
Urinary Incontinence / prevention & control*,  surgery
Urinary Sphincter, Artificial*
Videotape Recording
Comment In:
Br J Urol. 1996 Nov;78(5):808-9   [PMID:  8976797 ]

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