Does intraoperative success predict outcome in the treatment of urethral sphincter insufficiency with bulking agent?

Autor: Niklas Pakkasjärvi, Seppo Taskinen
Přispěvatelé: University of Helsinki, Helsingin biolääketieteellinen tutkijakoulu (-2009), University of Helsinki, Children's Hospital
Rok vydání: 2018
Předmět:
ENDOSCOPIC INJECTION
Neurogenic bladder
030232 urology & nephrology
CHILDREN
Urinary incontinence
Injections
Intralesional
Cohort Studies
Bladder exstrophy
0302 clinical medicine
Hyaluronic Acid
Child
Urethral sphincter insufficiency
Dextrans
Cystoscopy
Combined Modality Therapy
3. Good health
Treatment Outcome
medicine.anatomical_structure
Child
Preschool
030220 oncology & carcinogenesis
URINARY-INCONTINENCE
medicine.symptom
medicine.drug
medicine.medical_specialty
Adolescent
Urology
BLADDER NECK RECONSTRUCTION
3121 Internal medicine
Risk Assessment
Statistics
Nonparametric
03 medical and health sciences
Urethra
Predictive Value of Tests
medicine
Non-neurogenic bladder
Humans
Initial treatment
Urinary Bladder
Neurogenic
DEXTRANOMER/HYALURONIC ACID
Retrospective Studies
Intraoperative Care
Urinary continence
business.industry
Urethral sphincter
COPOLYMER
medicine.disease
Surgery
Neck of urinary bladder
Urinary Incontinence
Deflux
Pediatrics
Perinatology and Child Health
Sphincter
Dextranomer
business
Follow-Up Studies
Zdroj: Journal of Pediatric Urology. 14:173.e1-173.e5
ISSN: 1477-5131
DOI: 10.1016/j.jpurol.2017.10.020
Popis: Introduction Sphincter insufficiency is mostly associated with neurogenic and some structural abnormalities in the pediatric population. As a mini-invasive treatment, urethral bulking agents have been used to treat this problem. Objective The aim was to evaluate if technical success, defined as intraoperative increase in abdominal leak point pressure (ALPP), predicts the outcome of the treatment of sphincter insufficiency with urethral bulking agent. Study design We reviewed all children treated first time with dextranomer/hyaluronicacid (Dx/HA) copolymer (Deflux) for urethral sphincter insufficiency and who intraoperatively had ALPPs measured during 2004-2014. Patient characteristics, change in urinary continence and the duration of the possible response were evaluated in neurogenic and non-neurogenic cases. Results The median age of the patients was 7.8 years (range 4.1-14.5) at initial treatment and median volume of Dx/HA instilled was 3.5 mL (IQR 2-5). Twelve patients had neurogenic disease and 15 had nonneurogenic disease. Median ALPPs before and after the injections were 19 cmH(2)O (IQR 14-28) and 70 cmH(2)O (IQR 48-80), p
Databáze: OpenAIRE
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