Department of Pediatric Urology, University Medical Center Groningen, Groningen, The Netherlands.
J Pediatr Urol. 2013 Jun;9(3):293-7. doi: 10.1016/j.jpurol.2012.05.002. Epub 2012 May 30.
The aim of this study is to evaluate the importance of a closed bladder neck during videourodynamic (VUDE) studies in relation to urinary continence following augmentation ileocystoplasty in myelodysplastic patients.
We retrospectively reviewed the records of 24 myelodysplastic patients who underwent augmentation ileocystoplasty, using a standard technique. All patients had a closed bladder neck during preoperative VUDE studies. Their charts, imaging studies and VUDE data before and after surgery were analyzed. The mean follow-up after augmentation ileocystoplasty was 8.4 years.
The overall incidence of urinary incontinence following the augmentation ileocystoplasty was 12.5%. Continence was achieved in 21 of 24 (87.5%) patients without additional outlet procedures. No significant upper tract changes developed. A clinically apparent tethered cord significantly hindered the achievement of continence. No significant correlation was found between the other videourodynamic parameters and obtaining continence.
Our study provides evidence that a coexisting cord tethering in this myelodysplastic group can affect bladder neck morphology and function, and subsequent continence.
本研究旨在评估在脊髓发育不良患者行回肠膀胱扩大术后，尿动力学检查（VUDE）中闭合的膀胱颈在尿失禁中的重要性。
我们回顾性分析了 24 例行回肠膀胱扩大术的脊髓发育不良患者的记录，采用标准技术。所有患者在术前 VUDE 研究中均有闭合的膀胱颈。分析了他们的图表、影像学研究和手术前后的 VUDE 数据。回肠膀胱扩大术后的平均随访时间为 8.4 年。
回肠膀胱扩大术后尿失禁的总发生率为 12.5%。24 例患者中有 21 例（87.5%）无需额外的出口手术即可达到尿控。没有明显的上尿路变化。明显的临床显性脊髓栓系明显阻碍了尿控的获得。没有发现其他尿动力学参数与获得尿控之间有显著相关性。
我们的研究提供了证据表明，在脊髓发育不良患者中，同时存在的脊髓栓系可能会影响膀胱颈的形态和功能，以及随后的尿控。
