Shu-Yu Wu1, Hann-Chorng Kuo1. 1. Department of Urology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan.
Abstract
AIMS: To investigate the real treatment outcomes after augmentation enterocystoplasty (AE) of patients with refractory neurogenic lower urinary tract dysfunction. METHODS: Retrospective follow-up in a single center. The videourodynamic data, renal function, incontinence grade, voiding pattern and management, clinical outcome, and complications were evaluated. RESULTS: Seventy-nine patients (62 men and 17 women) were included. The mean age at operation was 39.4 ± 11.6 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. CONCLUSIONS: AE 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.
AIMS: To investigate the real treatment outcomes after augmentation enterocystoplasty (AE) of patients with refractory neurogenic lower urinary tract dysfunction. METHODS: Retrospective follow-up in a single center. The videourodynamic data, renal function, incontinence grade, voiding pattern and management, clinical outcome, and complications were evaluated. RESULTS: Seventy-nine patients (62 men and 17 women) were included. The mean age at operation was 39.4 ± 11.6 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. CONCLUSIONS: AE 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.