Artificial urinary sphincter insertion in congenital neuropathic bladder.
A series of 44 patients with neuropathic bladder dysfunction due to congenital myelodysplasia underwent implantation of an artificial urinary sphincter (AUS); in 26 patients a reconstructive procedure was performed at the same time. Five patients who initially had AUS implantation alone developed detrusor hyper-reflexia and required a clam cystoplasty. Forty patients (90%) are continent, 2 are occasionally damp and 2 are wet and awaiting further surgery; 66% of patients who underwent AUS insertion and reconstruction were found to have significant residual urine and they perform intermittent self-catheterisation (ISC). In patients with a good bladder capacity and normal compliance and detrusor hyper-reflexia controlled by anticholinergic drugs, cystoplasty is not necessary at the time of AUS insertion.
O'Flynn
K J
KJ
Spinal Injuries Unit, Lodge Moor Hospital, Sheffield.
Thomas
D G
DG
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009436:Neural Tube Defects / Q000150:complications; D011183:Postoperative Complications; D019736:Prostheses and Implants; D001743:Urinary Bladder / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000151:congenital* / Q000209:etiology; D014546:Urinary Catheterization; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*