Nonsecretory intestinocystoplasty: postoperative outcomes of 25 years
Dantas RAF, Calisto FCFS, Vilar FO, Araujo LAP, Lima SVC
International braz j urol : official journal of the Brazilian Society of Urology · 2019-07
Abstract
Objective The objective of bladder augmentation (BA) is to create a low-pressure reservoir with adequate capacity. Despite its benefits, the use of intestinal patches in bladder enlargement provides a high risk of developing complications and BA with demucosalised bowel represents a potential alternative. Therefore, this study evaluated urological parameters and long-term clinical follow-up of patients submitted to nonsecretory BA in a single center with 25 years of experience. Materials and methods Patients treated with BA underwent urological evaluation, which included history, physical examination and urodynamic study. The main urodynamic parameters (bladder capacity and bladder compliance) were assessed in the pre and postoperative moments, and compared by the Wilcoxon Signed Rank test. The main long-term complications were described. Results 269 patients (mean age 14±13 years, 47% male) underwent BA with the use of demucolised intestinal segments. Among the patients in the sample, 187 (69.52%) had neurogenic bladder, 68 (25.28%) had bladder exstrophy, nine had tuberculosis (3.34%), four had a posterior urethral valve (1.49%) and one with hypospadia (0.37%). After the surgical procedure, a significant increment in both urodynamic parameters was found, with a 222% increase in bladder capacity and 604% in bladder compliance (p Conclusion The study showed statistically signifi cant increase in both compliance and bladder capacity after non-secretory BA, with a low rate of severe complications.
MeSH terms
- Humans
- Treatment Outcome
- Postoperative Period
- Urologic Surgical Procedures
- Statistics, Nonparametric
- Follow-Up Studies
- Prospective Studies
- Reproducibility of Results
- Urodynamics
- Adolescent
- Adult
- Middle Aged
- Child
- Child, Preschool
- Infant
- Female
- Male
- Urinary Bladder
- Urinary Bladder Diseases
- Young Adult