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Related Experiment Videos

The "clam": indications and complications.

D K Lewis1, J R Morgan, P M Weston

  • 1Department of Urology, Royal Infirmary, Cardiff.

British Journal of Urology
|May 1, 1990
PubMed
Summary

The clam enterocystoplasty is a highly effective bladder reconstruction technique, achieving dryness in most patients with lower urinary tract issues. This procedure has revolutionized bladder reconstruction, with few patients experiencing imperfect outcomes.

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Area of Science:

  • Urology
  • Pediatric Surgery

Background:

  • Lower urinary tract reconstruction is essential for managing complex bladder conditions.
  • The "clam" enterocystoplasty has emerged as a significant advancement in surgical techniques.
  • Patient populations include those with neuropathic and non-neuropathic bladder dysfunction.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of "clam" enterocystoplasty in a large patient cohort.
  • To assess the procedure's success rates in achieving continence and protecting upper urinary tracts.
  • To identify factors influencing outcomes in patients undergoing bladder reconstruction.

Main Methods:

  • Retrospective review of 78 patients undergoing "clam" enterocystoplasty.
  • Analysis of patient demographics, underlying diagnoses (neuropathic vs. non-neuropathic), and pre-operative conditions.

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  • Assessment of post-operative continence, voiding methods, and upper tract status.

    • Main Results:

    • 69 out of 78 patients achieved dryness, with various voiding methods (spontaneous, artificial urinary sphincter, intermittent catheterization).
    • Most patients (nearly half non-neuropathic, remainder neuropathic) were treated for incontinence.
    • A small number of patients experienced residual enuresis or stress incontinence; upper tract damage was noted in 12 patients.

    Conclusions:

    • The "clam" enterocystoplasty is a transformative procedure for bladder reconstruction, offering high success rates for achieving continence.
    • The technique is effective across diverse patient groups, including those with neuropathic bladder conditions.
    • Predicting the small subset of patients who may not achieve optimal results remains challenging.