Long-term urodynamic evaluation of a continent urinary reservoir.
Objective: To characterize urodynamic changes among patients who underwent a continent urinary reservoir (Florida Pouch).Methods: Patients who had a continent urinary diversion performed between January 1988 and December 1991 were asked to undergo sequential urodynamic evaluation to compare early (</=24 mo) versus late (>24 mo) changes in reservoir function. The difference in reservoir function was evaluated by defining change in maximum enterocystometric capacity of >/=100 mL, changes in pressure of 5 cm H(2)O, changes in segmental contractions were >/=3. High pressure contractions were those >/=30 mm H(2)O.Results: Seventeen patients underwent sequential urodynamic evaluation. The mean timing of the early study was 12.2 months (range 3-24 mo). The mean timing of the late study was 47.1 months (range 30-58 mo). The mean capacity of the reservoir initially was 698 mL (range 474-1000 mL). On long-term study the mean was 793 mL (range 400-1000 mL). The capacity remained unchanged or increased in 88% of patients. The pressure within the reservoir remained unchanged in seven patients, decreased in eight, and increased in two. Segmental contractions originally occurred in 15 patients with 11 low pressure and 4 high pressure type contractions. On long-term evaluation, 13 patients demonstrated contractions with 10 low pressure and 3 high pressure in character. Of note, 75% of those with initial high pressure contractions had no (1) or low pressure (2) contractions on subsequent evaluation.Conclusion: In long-term urodynamic evaluation of the continent urinary reservoir the reservoir capacity remained unchanged or increased in 88% of patients, while reservoir pressure remained unchanged or decreased in 88%. This long-term evaluation, therefore, demonstrates the continent urinary reservoir to be a low pressure system of adequate capacity thereby minimizing the risk of reflux.
Lynch
CM
University of South Florida College of Medicine, USA
Towsley
GA
Pow-Sang
JM
Seigne
JD
Lockhart
JL