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Lower urinary tract reconstruction using stomach and the artificial sphincter
G S Ganesan1, D H Nguyen, M C Adams
1Division of Pediatric Urology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis.
The Journal of Urology
|May 1, 1993
Summary
Augmentation gastrocystoplasty combined with an artificial urinary sphincter effectively achieves urinary continence in patients with complex bladder conditions. This combination also allows for spontaneous urination with a low rate of infection.
Area of Science:
- Urology
- Pediatric Surgery
Background:
- Complex bladder conditions often require surgical intervention for urinary continence.
- Previous continence procedures may have failed in patients with conditions like bladder exstrophy and myelodysplasia.
Purpose of the Study:
- To evaluate the efficacy and safety of combining augmentation gastrocystoplasty with an artificial urinary sphincter.
- To assess the impact on urinary continence and voiding function.
Main Methods:
- 18 patients with various diagnoses including bladder exstrophy, myelodysplasia, and ectopic ureters underwent simultaneous augmentation gastrocystoplasty and artificial urinary sphincter implantation.
- The artificial urinary sphincter cuff was placed around either the reconstructed or intact bladder neck.
- Mean follow-up was 20.3 months.
Main Results:
- 16 out of 18 patients (88%) achieved day and night urinary continence.
- 61% of patients could void using Valsalva's maneuver alone.
- Complications included pump erosion (1 patient) and mechanical dysfunction (3 patients); no infectious complications were observed.
Conclusions:
- The combined procedure of augmentation gastrocystoplasty and artificial urinary sphincter implantation is a successful strategy for achieving urinary continence.
- This approach can restore spontaneous urination capabilities.
- The simultaneous combination of these procedures does not increase the risk of infectious complications.