Sigmoidocolocystoplasty With Ureteral Reimplantation for Treatment of Neurogenic Bladder

OBJECTIVE To assess the clinical and urodynamic results of sigmoidocolocystoplasty in patients with neurogenic bladder dysfunction. METHODS We retrospectively reviewed 78 augmentation enterocystoplasty cases in our database from 2005 to 2011 to identify 47 patients who had undergone sigmoidocolocystoplasty alone or combined with ureter reimplantation. The indications for surgery and postoperative complications were evaluated. Renal function preservation, increased postoperative bladder capacity, decreased maximal detrusor pressure, and overall patient satisfaction were deemed successful outcomes. RESULTS The mean follow-up period was 24 months. The mean bladder capacity increased from 160.6 +/- 128.3 to 468.5 +/- 60.6 mL (P < .001) and the maximal detrusor pressure decreased from 31.1 +/- 26.4 to 10.9 +/- 4.5 cm H2O (P = .002). The serum creatinine level decreased from 270.3 +/- 113.6 to 174.4 +/- 81.3 mu mol/L (P = .001). Most patients resolved the urinary incontinence using clean self-intermittent catheterization. The decrease in the mean number of incontinence episodes and pads used daily indicated a marked improvement in patients' quality of life. Postoperative complications included bowel dysfunction in 5 patients (10.6%), adhesive intestinal obstruction in 4 (8.5%), deteriorating renal function in 3 (6.4%), and vesicoureteral reflux recurrence in 2 patients (4.3%). Nearly all patients expressed satisfaction with the urologic management. CONCLUSION Our results suggest that sigmoidocolocystoplasty is safe and effective in treating patients with neurogenic bladder dysfunction. Concomitant ureter reimplantation will be beneficial for patients with a long history of illness. UROLOGY 80: 440-445, 2012. Crown Copyright (c) 2012 Published by Elsevier Inc.