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Related Experiment Videos

Augmentation cystoplasty and the artificial genitourinary sphincter.

L R Strawbridge1, S A Kramer, O A Castillo

  • 1Department of Urology, Mayo Clinic, Rochester, Minnesota 55905.

The Journal of Urology
|August 1, 1989
PubMed
Summary

This study combined augmentation cystoplasty and artificial genitourinary sphincter surgery in 18 patients, achieving complete urinary control. The combined approach proved safe and effective for complex urinary incontinence.

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Area of Science:

  • Urology
  • Surgical Innovation

Background:

  • Urinary incontinence in patients with decreased bladder compliance and sphincteric incompetence presents a complex clinical challenge.
  • Previous management strategies may have limitations in achieving complete urinary control and preventing upper tract deterioration.

Purpose of the Study:

  • To evaluate the efficacy and safety of combining augmentation cystoplasty with artificial genitourinary sphincter placement for managing complex urinary incontinence.
  • To assess the impact of the timing of artificial genitourinary sphincter placement relative to bladder augmentation.

Main Methods:

  • A cohort of 18 patients with urinary incontinence underwent combined augmentation cystoplasty and artificial genitourinary sphincter implantation.
  • Surgical procedures were performed either simultaneously or sequentially, with varying timing of sphincter placement relative to cystoplasty.

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  • Bladder management included intermittent self-catheterization in 15 patients and spontaneous voiding in 3.

    • Main Results:

    • Complete urinary control was successfully achieved in all 18 patients.
    • Simultaneous placement or placement after cystoplasty showed favorable outcomes.
    • Placement of the artificial genitourinary sphincter before bladder augmentation was associated with later development of decreased bladder compliance, incontinence, and upper tract deterioration in some cases.

    Conclusions:

    • The combination of augmentation cystoplasty and artificial genitourinary sphincter implantation is a successful strategy for achieving complete urinary control in selected patients with complex urinary incontinence.
    • The timing of artificial genitourinary sphincter placement relative to bladder augmentation may influence long-term outcomes and upper tract health.
    • This combined approach can be performed without a significant increase in morbidity compared to individual procedures.