Nathan Y Hoy1, Joshua A Cohn2, Casey G Kowalik3, Melissa R Kaufman3, W Stuart Reynolds3, Roger R Dmochowski3. 1. Division of Urology, University of Alberta, Edmonton, AB, Canada. 2. Department of Urologic Surgery, Vanderbilt University Medical Center, 1302A Medical Center North, Nashville, TN, 37232, USA. joshua.cohn@vanderbilt.edu. 3. Department of Urologic Surgery, Vanderbilt University Medical Center, 1302A Medical Center North, Nashville, TN, 37232, USA.
Abstract
PURPOSE OF REVIEW: Functional complications after orthotopic neobladder urinary diversion (ONB), including urinary incontinence and urinary retention, present unique challenges. The purpose of this review is to outline contemporary treatment options for voiding dysfunction after ONB in females. RECENT FINDINGS: Meticulous surgical technique in the form of urethral nerve-sparing has been shown to play an important role in maintaining continence, as has sparing the uterus when possible. Data supporting the effectiveness of lifestyle measures, urethral bulking, pubovaginal slings, and transobturator slings in the treatment of urinary incontinence are widely variable and limited to case reports. Urinary retention is still most effectively managed with self-catheterization. Voiding dysfunction after ONB can be devastating. Recent advances focus on improving surgical techniques to decrease the risk of incontinence and retention, as post-operative management options are limited.
PURPOSE OF REVIEW: Functional complications after orthotopic neobladder urinary diversion (ONB), including urinary incontinence and urinary retention, present unique challenges. The purpose of this review is to outline contemporary treatment options for voiding dysfunction after ONB in females. RECENT FINDINGS: Meticulous surgical technique in the form of urethral nerve-sparing has been shown to play an important role in maintaining continence, as has sparing the uterus when possible. Data supporting the effectiveness of lifestyle measures, urethral bulking, pubovaginal slings, and transobturator slings in the treatment of urinary incontinence are widely variable and limited to case reports. Urinary retention is still most effectively managed with self-catheterization. Voiding dysfunction after ONB can be devastating. Recent advances focus on improving surgical techniques to decrease the risk of incontinence and retention, as post-operative management options are limited.
Authors: Georgios Gakis; Bedeir Ali-El-Dein; Marko Babjuk; Jan Hrbacek; Petr Macek; Fiona C Burkhard; George N Thalmann; Atallah-Abdel Shaaban; Arnulf Stenzl Journal: Urol Oncol Date: 2015-03-03 Impact factor: 3.498
Authors: B Ali-El-Dein; A Mosbah; Y Osman; N El-Tabey; M Abdel-Latif; I Eraky; A A Shaaban Journal: Eur J Surg Oncol Date: 2013-02-17 Impact factor: 4.424