A real-world experience with augmentation enterocystoplastyHigh patient satisfaction with high complication rates

被引:21
作者
Wu, Shu-Yu [1 ]
Kuo, Hann-Chorng [1 ]
机构
[1] Tzu Chi Univ, Dept Urol, Buddhist Tzu Chi Gen Hosp, Hualien, Taiwan
关键词
augmentation enterocystoplasty; lower urinary tract dysfunction; neurogenic bladder; SPINAL-CORD-INJURY; 10-YEAR FOLLOW-UP; QUALITY-OF-LIFE; NEUROGENIC BLADDER; URINARY-TRACT; CYSTOPLASTY; OUTCOMES; DYSFUNCTION; CHILDREN; ADULTS;
D O I
10.1002/nau.23339
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
AimsTo investigate the real treatment outcomes after augmentation enterocystoplasty (AE) of patients with refractory neurogenic lower urinary tract dysfunction. MethodsRetrospective follow-up in a single center. The videourodynamic data, renal function, incontinence grade, voiding pattern and management, clinical outcome, and complications were evaluated. ResultsSeventy-nine patients (62 men and 17 women) were included. The mean age at operation was 39.411.6 years and the mean follow-up period was 128.4 +/- 85.2 months. At follow-up, 5 (6.7%) patients had spontaneous voiding, 60 (80%) had to perform clean intermittent catheterization, and 10 (13.3%) chose to keep the indwelling catheter. The catheter-dependent rate was 93.3% and complete catheter-dependent rate was 76%. Renal function of the patients did not appear to be significantly different after AE. Three patients developed end-stage renal disease. The incontinence grade showed significant improvement (P=0.000). Among all the patients, 41.8% experienced recurrent urinary tract infections requiring medical treatment and 21.5% suffered from chronic diarrhea. Overall, 45.6% of the patients experienced complications requiring surgical interventions, most of which were stones. Life-threatening complications like bowel obstruction and bladder cancer were also noted. Three patients even expired within one year postoperatively. The majority (86.8%) of patients reported moderate to excellent satisfaction with the outcome of AE. ConclusionsAE is a procedure with long-term durability and high rates of patient satisfaction. However, several bothersome complications affecting life quality may occur. Both patients and doctors thus need to consider possible outcomes carefully before the operation.
引用
收藏
页码:744 / 750
页数:7
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