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扩大膀胱成形术:10年随访的尿动力学和代谢结果。

Augmentation cystoplasty: Urodynamic and metabolic outcomes at 10-year follow-up.

作者信息

Cheng Kwun-Chung, Kan Chi-Fai, Chu Peggy Sau-Kwan, Man Chi-Wai, Wong Bill Tak-Hing, Ho Lap-Yin, Au Wing-Hang

机构信息

Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Kowloon, Hong Kong.

Division of Urology, Department of Surgery, Tuen Mun Hospital, New Territories, Hong Kong.

出版信息

Int J Urol. 2015 Dec;22(12):1149-54. doi: 10.1111/iju.12943. Epub 2015 Sep 22.

Abstract

OBJECTIVE

To review the urodynamic outcomes, renal function and metabolic complications after augmentation cystoplasty with at least 10 years of follow-up.

METHODS

Augmentation cystoplasty performed in two tertiary referral centers from 1995 to 2004 were reviewed. Ten years or more postoperative course was studied by review of the clinical notes, urodynamic reports and laboratory results.

RESULTS

A total of 40 patients were included in this study. The mean age at surgery was 43 years, and 47.5% of patients were female. Median follow up was 13 years. Bladder capacity significantly increased from 283 ± 151 to 492 ± 123 mL (P < 0.01), with a percentage change of +130%. The compliance of the bladder was increased by 87%, and detrusor overactivity decreased by 54.2%. There were no significant changes in preoperative and postoperative estimated glomerular filtration rate (68.3 mL/min vs. 76.6 mL/min, P = 0.798). Three patients (7.5%) had more than one episode of symptomatic urinary tract infection per year.

CONCLUSION

The present study confirms the effectiveness of augmentation cystoplasty in increasing bladder capacity, improving bladder compliance and reducing detrusor overactivity. The preservation of renal function and low metabolic complication rate provide solid evidence for carrying out this time-honored procedure in patients with neurogenic or non-neurogenic bladder dysfunction.

摘要

目的

回顾膀胱扩大成形术后至少10年的尿动力学结果、肾功能及代谢并发症。

方法

回顾了1995年至2004年在两个三级转诊中心进行的膀胱扩大成形术。通过查阅临床记录、尿动力学报告和实验室结果,研究术后10年或更长时间的病程。

结果

本研究共纳入40例患者。手术时的平均年龄为43岁,47.5%的患者为女性。中位随访时间为13年。膀胱容量从283±151 mL显著增加至492±123 mL(P<0.01),变化百分比为+130%。膀胱顺应性增加了87%,逼尿肌过度活动减少了54.2%。术前和术后的估计肾小球滤过率无显著变化(68.3 mL/min对76.6 mL/min,P=0.798)。3例患者(7.5%)每年有不止一次有症状的尿路感染发作。

结论

本研究证实了膀胱扩大成形术在增加膀胱容量、改善膀胱顺应性和减少逼尿肌过度活动方面的有效性。肾功能的保留和低代谢并发症发生率为在神经源性或非神经源性膀胱功能障碍患者中开展这一传统手术提供了有力证据。

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