Esa A, Uchida A, Kiwamoto H, Ohnishi N, Sugiyama T, Park Y C, Akiyama T, Kurita T
Department of Urology, Kinki University, School of Medicine, Osaka, Japan.
Nihon Hinyokika Gakkai Zasshi. 1990 May;81(5):713-8. doi: 10.5980/jpnjurol1989.81.713.
Fifteen patients with low compliance bladder of varying etiologies (neurogenic bladder, radiation induced contracted bladder after radical hysterectomy, bladder tuberculosis and interstitial cystitis) underwent augmentation enterocystoplasty. The ileocecal tubular segment was used in 12 patients, ileal-patch in 2 and ileal-cup patch in 1. In all patients in whom partial reconstruction was done, the functional bladder capacity satisfactorily increased and the maximum detrusor pressure was low. The upper urinary tract did not deteriorate in 12 patients. Three died from recurrence of uterine or bladder cancer. Five neurogenic patients were managed by intermittent self-catheterization postoperatively. Another 10 patients was dry without voiding difficulty. Of 18 ureteral reimplantations in ileocecal cystoplasty, 13 had reflux without resultant progressive hydronephrosis. In 3 patients ureteral reimplantation was not required without reflux after ileal-patch and ileal-cup patch cystoplasty.
15例不同病因(神经源性膀胱、根治性子宫切除术后放射性收缩膀胱、膀胱结核和间质性膀胱炎)导致的低顺应性膀胱患者接受了回肠膀胱扩大术。12例患者使用回盲管状段,2例使用回肠补片,1例使用回肠杯状补片。在所有进行部分重建的患者中,功能性膀胱容量均得到满意增加,最大逼尿肌压力较低。12例患者上尿路未恶化。3例死于子宫癌或膀胱癌复发。5例神经源性患者术后采用间歇性自我导尿处理。另外10例患者无排尿困难且无尿失禁。在回盲膀胱扩大术中的18例输尿管再植术中,13例有反流,但未导致进行性肾积水。3例在回肠补片和回肠杯状补片膀胱扩大术后无反流,无需进行输尿管再植。