Detrusor hyper-reflexia as a factor in spontaneous perforation of augmentation cystoplasty for neuropathic bladder.
In a series of 30 children undergoing cystoplasty for neuropathic bladder, 14 had a combination of a competent sphincteric mechanism and detrusor hyper-reflexia. All 3 cases of spontaneous perforation of the augmentation occurred within this latter group and it is postulated that excessive intravesical pressure due to high pressure hyper-reflexia was the causal factor. Strategies to reduce the risk of perforation are discussed.
Anderson
P A
PA
Department of Urology, Royal Liverpool Children's Hospital.
Rickwood
A M
AM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D012809:Colon, Sigmoid / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008591:Meningomyelocele / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology*; D011312:Pressure; D012307:Risk Factors; D012422:Rupture, Spontaneous / Q000209:etiology; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000209:etiology; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery