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Related Experiment Videos

Artificial urinary sphincter insertion in congenital neuropathic bladder.

K J O'Flynn1, D G Thomas

  • 1Spinal Injuries Unit, Lodge Moor Hospital, Sheffield.

British Journal of Urology
|February 1, 1991
PubMed
Summary

Artificial urinary sphincter (AUS) implantation effectively manages neuropathic bladder dysfunction in myelodysplasia patients. Simultaneous reconstructive surgery is often needed, but not always required if bladder function is otherwise normal.

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Area of Science:

  • Urology
  • Pediatric Surgery
  • Neuroscience

Background:

  • Neuropathic bladder dysfunction is a common complication of congenital myelodysplasia.
  • Artificial urinary sphincter (AUS) implantation is a surgical option for managing urinary incontinence.
  • Reconstructive procedures may be necessary in conjunction with AUS implantation.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of artificial urinary sphincter (AUS) implantation in patients with neuropathic bladder dysfunction due to congenital myelodysplasia.
  • To assess the necessity of concurrent reconstructive procedures, such as clam cystoplasty, during AUS implantation.
  • To identify factors influencing continence and the need for intermittent self-catheterisation (ISC) post-surgery.

Main Methods:

  • A retrospective review of 44 patients with neuropathic bladder dysfunction secondary to congenital myelodysplasia who underwent AUS implantation.

Related Experiment Videos

  • Analysis of concurrent reconstructive procedures (n=26) performed alongside AUS insertion.
  • Evaluation of continence rates, need for secondary procedures, and occurrence of complications like detrusor hyper-reflexia and significant residual urine.

    • Main Results:

    • 90% of patients achieved continence following AUS implantation.
    • Six patients experienced incontinence (2 occasionally damp, 2 wet), requiring further surgical intervention.
    • 66% of patients who had AUS insertion with reconstruction required intermittent self-catheterisation (ISC) due to significant residual urine.
    • Five patients initially receiving AUS alone developed detrusor hyper-reflexia necessitating clam cystoplasty.

    Conclusions:

    • Artificial urinary sphincter (AUS) implantation is a highly effective treatment for urinary incontinence in myelodysplasia patients.
    • Concurrent reconstructive surgery is not universally required; careful patient selection based on bladder capacity, compliance, and detrusor activity is crucial.
    • Intermittent self-catheterisation (ISC) is frequently necessary in patients undergoing combined AUS and reconstructive procedures due to residual urine.