Intermittent catheterization following enterocystoplasty

To assess the segment of bowel used in enterocystoplasty and the need to perform intermittent self-catheterization (ISC) after enterocystoplasty for the treatment of incontinence.

Of 123 patients undergoing enterocystoplasty, 77 (mean age 29.5 years, range 13-61) had neurogenic disease (NB group) and 46 (mean age 45.7 years, range 16-74) had non-neuropathic bladders (NNB group). The success of enterocystoplasty, with respect to the segment of bowel used and the need for ISC, was assessed during a follow-up of 6-125 months.

Ileum was used in 84 (63.8%), ileum and caecum in 19 (15.4%) and sigmoid in 20 (16.3%) patients. In the NB group, more patients had a sigmoid cystoplasty (24.7 vs 2.2%) and less (67 vs 80%) had an ileo-cystoplasty than in the NNB group. A total of 87 (71%) patients required ISC; 63 (82%) of the NB group and 24 (52%) of the NNB group. The influence of the intestinal segment was conspicuous in the NB group, with 82% and 95% of patients with ileocaecal and sigmoid cystoplasty needing ISC against 77% of those patients with ileal cystoplasty. The difference was not so evident in the NNB group.

A social continence rate of 93.6% in the NB and 84.8% in the NNB patients was achieved, partly due to the patients' success with ISC, a necessary skill to be mastered by all patients before undergoing enterocystoplasty.