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Isolated continent cystostomy on neurologic native bladder: Functional results.
O Decombe1, T Germain1, L Lenfant1
1Department of Urology, Sorbonne université, Pitié-Salpêtrière Academic Hospital, AP-HP, Paris, France.
The French Journal of Urology
|May 3, 2024
Summary
Continent cutaneous urinary diversion (CCUD) can lead to leakage, even with a stable bladder. This study found significant rates of stomal and urethral leakage post-CCUD, suggesting a need to revise patient selection criteria for this procedure.
Area of Science:
- Urology
- Neurosurgery
- Reconstructive Surgery
Background:
- Continent cutaneous urinary diversion (CCUD) is an option for chronic urinary retention.
- Neurogenic detrusor overactivity (NDO) often necessitates bladder augmentation.
- This study evaluates leakage in CCUD patients without prior augmentation.
Purpose of the Study:
- To determine the prevalence of stomal and/or urethral leakage in patients undergoing CCUD without bladder augmentation.
- To analyze urodynamic parameters and NDO development post-CCUD.
Main Methods:
- Retrospective monocentric study of 31 patients undergoing CCUD (Mitrofanoff, Monti, Casale channels).
- Exclusion of patients with prior or concomitant enterocystoplasty.
- Leakage defined as stomal or urethral, with urodynamic assessment.
Main Results:
- 26% experienced stomal leakage and 29% urethral leakage.
- Spinal cord injury patients showed higher leakage rates (36% stomal, 43% urethral).
- Postoperative bladder capacity decreased, and de novo NDO increased.
Conclusions:
- Isolated CCUD can result in leakage despite preoperative bladder stability.
- A decrease in bladder capacity and increase in NDO were observed.
- Careful revision of selection criteria for isolated CCUD is recommended.
