Clam ileocystoplasty in adult nocturnal enuresis

We investigated the effect of clam ileocystoplasty in patients with nocturnal enuresis with urodynamically proven detrusor instability which was recalcitrant to conservative therapy.

Twelve patients (10 males, 2 females) with ages ranging between 22 and 44 years (mean 32) underwent clam ileocystoplasty. In addition to cystometry all patients underwent pressure flow evaluation. Patients with obstruction; poor contractility and poor compliance that was diagnosed by pressure flow studies were not operated.

In a mean 38 months of follow-up all patients were cured symptomatically and urodynamically except one. In this patient, symptomatic improvement was observed despite the persistence of detrusor instability. No patient needed intermittent self catheterization. There were no postoperative complications except an incisional hernia diagnosed after two years postoperatively and corrected surgically.

Clam procedure could be the best treatment for patients with life long nocturnal enuresis recalcitrant to conservative therapy with coexistence of proven detrusor instability.