Combined abdominal and vaginal approach for bladder neck closure and permanent suprapubic tube: urinary diversion in the neurologically impaired woman.
Chronic indwelling Foley catheter placement in the neurologically impaired patient can lead to pressure necrosis of the urethra with incontinence. We report on 2 series of patients who underwent bladder neck closure and insertion of a suprapubic catheter for this problem. Our initial group includes 4 patients who underwent 5 transvaginal procedures, of which 2 (40%) were successful. Subsequently, we modified our approach, and used a combined abdominal and transvaginal repair, which was successful in 10 consecutive patients with a followup of 6 to 40 months (mean 15.6).
Division of Urology, Graduate Hospital, Philadelphia, Pennsylvania.
J B
JB
Levy
J A
JA
Jacobs
A J
AJ
Wein
D000005:Abdomen; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications; D010264:Paraplegia / Q000150:complications; D013997:Time Factors; D017211:Treatment Failure; D001743:Urinary Bladder / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000601:surgery*; D014546:Urinary Catheterization; D014547:Urinary Diversion / Q000379:methods*; D014621:Vagina