| Artificial urinary sphincter in patients with neurogenic bladder dysfunction. | |
MedLine Citation:
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PMID: 8800894 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
Authors:
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G Singh; D G Thomas |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: British journal of urology Volume: 77 ISSN: 0007-1331 ISO Abbreviation: Br J Urol Publication Date: 1996 Feb |
Date Detail:
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Created Date: 1996-09-27 Completed Date: 1996-09-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15740090R Medline TA: Br J Urol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 252-5 Citation Subset: IM |
Affiliation:
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Department of Urology, Royal Hallamshire Hospital, Sheffield, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Female Humans Male Middle Aged Reoperation Treatment Outcome Urinary Bladder, Neurogenic / complications*, surgery Urinary Incontinence / prevention & control*, surgery Urinary Sphincter, Artificial* Urodynamics Videotape Recording |
| Comments/Corrections | |
Comment In:
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Br J Urol. 1996 Nov;78(5):808-9
[PMID:
8976797
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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