Document Detail


Intestinocystoplasty in combination with clean intermittent catheterization in the management of vesical dysfunction.
MedLine Citation:
PMID:  3723679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intestinocystoplasty in combination with clean intermittent catheterization has been used in the management of 60 young patients with bladder dysfunction. Of the patients 39 (65 per cent) had the primary diagnosis of myelomeningocele, 8 had sacral agenesis, 3 had spinal cord tumors and 1 had spinal cord trauma. The remaining 9 patients had either congenital, surgical or traumatic loss of all or a large portion of the bladder. Of the 60 patients 30 had undergone prior urinary diversion, while the remaining 30 were considered failures with management by clean intermittent catheterization and medication. A total of 16 patients underwent ileocecocystoplasty, while 44 had augmentation with either cecum (8), sigmoid (18) or ileum (18). Mean followup was 4 years (range 16 months to 7 years). Fifty-nine patients have stable or improved renal function and the excretory urogram is stable or improved in all 60. Of the patients 38 (63 per cent) were considered dry after the initial bladder augmentation, while an additional 14 were rendered dry by a second procedure consisting of bladder neck reconstruction or placement of the artificial urinary sphincter, for a total of 52 (87 per cent) currently considered to be dry. Eleven patients have had at least 1 symptomatic urinary tract infection (18 per cent) and 21 had a positive urine culture but remained asymptomatic. In contrast to earlier beliefs, intestinocystoplasty can be applied effectively and appropriately to patients with bladder and urethral dysfunction. Intestinocystoplasty combined with clean intermittent catheterization offers a significant alternative to diversion in such patients.
Authors:
M E Mitchell; T B Kulb; D J Backes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  136     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  1986 Jul 
Date Detail:
Created Date:  1986-07-31     Completed Date:  1986-07-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  288-91     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bladder Exstrophy / therapy*
Cecum / surgery
Child
Child, Preschool
Colon, Sigmoid / surgery
Follow-Up Studies
Humans
Ileum / surgery
Infant
Prostheses and Implants
Time Factors
Urinary Bladder / surgery*
Urinary Bladder, Neurogenic / therapy*
Urinary Catheterization*
Urinary Diversion*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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