Is a closed bladder neck on preoperative videourodynamic studies an important factor for continence following augmentation ileocystoplasty in myelodysplastic patients?
OBJECTIVE
The aim of this study is to evaluate the importance of a closed bladder neck during videourodynamic (VUDE) studies in relation to urinary continence following augmentation ileocystoplasty in myelodysplastic patients.


METHODS
We retrospectively reviewed the records of 24 myelodysplastic patients who underwent augmentation ileocystoplasty, using a standard technique. All patients had a closed bladder neck during preoperative VUDE studies. Their charts, imaging studies and VUDE data before and after surgery were analyzed. The mean follow-up after augmentation ileocystoplasty was 8.4 years.


RESULTS
The overall incidence of urinary incontinence following the augmentation ileocystoplasty was 12.5%. Continence was achieved in 21 of 24 (87.5%) patients without additional outlet procedures. No significant upper tract changes developed. A clinically apparent tethered cord significantly hindered the achievement of continence. No significant correlation was found between the other videourodynamic parameters and obtaining continence.


CONCLUSIONS
Our study provides evidence that a coexisting cord tethering in this myelodysplastic group can affect bladder neck morphology and function, and subsequent continence.
Department of Pediatric Urology, University Medical Center Groningen, Groningen, The Netherlands. mazenghanem@yahoo.com
Mazen A
MA
Ghanem
Joop
J
van Denhoek
Rien J M
RJ
Nijman
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D007223:Infant; D008297:Male; D009190:Myelodysplastic Syndromes / Q000601:surgery*; D057234:Preoperative Period; D011379:Prognosis; D001743:Urinary Bladder / Q000601:surgery; D014549:Urinary Incontinence; D014563:Urodynamics; D014741:Video Recording