Management of neurogenic bladder dysfunction with incontinent ileovesicostomy
| Autor: | Kapil Puri, Edward L. Gheiler, Rabi Tiguert, Jeffrey A. Triest, Marko R. Gudziak |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Cystostomy Urology Urinary system medicine.medical_treatment Urinary Diversion Ileostomy Stoma (medicine) medicine Humans Urinary Bladder Neurogenic Spinal cord injury Neurogenic bladder dysfunction Aged Urinary bladder business.industry Middle Aged Clean Intermittent Catheterization medicine.disease Surgery medicine.anatomical_structure Anesthesia Female business |
| Zdroj: | Urology. 54:1008-1011 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/s0090-4295(99)00321-0 |
| Popis: | Objectives. Incontinent ileovesicostomy is an alternative form of urinary management applied to patients with neurogenic vesical dysfunction who are either unable or unwilling to perform clean intermittent self-catheterization or assisted catheterization. We review our operative results, urodynamic data, and complications observed in patients who underwent creation of incontinent ileovesicostomy at our institution. Methods. Thirteen patients (mean age 43.2 years) with neurogenic bladder dysfunction underwent an incontinent ileovesicostomy between 1994 and 1998. The etiologies of the neurogenic bladder dysfunction were spinal cord injury in 8 patients, multiple sclerosis in 4 patients, and tuberculous meningitis in 1 patient. The preoperative data, surgical records, urodynamic findings, and postoperative complications were assessed. Results. All patients experienced complications of their pretreatment bladder management. The mean operating room time was 242 minutes (range 170 to 395), including 14 additional procedures in 11 patients. The mean estimated blood loss was 403.8 mL (range 50 to 2000). No patient required blood transfusion. There were no intraoperative complications. Only 1 patient required reoperation for stomal revision. One patient had a ureteral stone 2 years after surgery; 1 patient has continued to have urinary tract infections despite a negative workup. The mean follow-up was 23 months (range 6 to 57). The mean bladder leak point pressure through the stoma was 8.2 cm H 2 O. Conclusions. The incontinent ileovesicostomy is a useful technique in the treatment of patients with neurogenic bladder unable to perform clean intermittent catheterization. It provides patients with a low-pressure urinary conduit that empties readily without an indwelling catheter. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect