Reid Sheilagh, Tophill Paul, Osman Nadir, Hillary Chris
Princess Royal Spinal Injuries Unit, Northern General Hospital, Sheffield, UK.
Urology Department, Hallamshire Hospital, Sheffield, UK.
J Spinal Cord Med. 2020 Mar;43(2):217-222. doi: 10.1080/10790268.2018.1525974. Epub 2018 Oct 9.
To look at the changing role of cystoplasty in the neuropathic population. Retrospective case series. Single center over a 10-year period from 2004 to 2014. In 1995, the Princess Royal spinal injuries unit published the outcomes of 78 neuropathic patients who had undergone cystoplasty in the 10-year period from 1982 to 1992. [Singh G, Thomas DG. Enterocystoplasty in the neuropathic bladder. Neurourol Urodyn 1995; 14(1): 5-10.]. In this series, we review 51 consecutive patients undergoing the same operation over a 10-year period from 2004 to 2014 in the same single unit. Demographic data were collected to include patient age, condition, and previous treatments. Pre- and post-operative details included sphincter insertions, renal function, continence rates, and complications. Despite an increase in the number of patients seen at the unit, there were considerably fewer cystoplasty procedures performed in the current series (51 vs. 78 in the 1982-1992 series). There were also significantly fewer patients with spina bifida and fewer concomitant sphincter insertions in the latter series (eight patients vs. 52 in the 82/92 series). Nevertheless, similar outcomes are observed between the current and 1982-1992 series, with continence rates of 93.7 and 93.6%, respectively and low numbers of reported adverse events for both retrospective cohorts. Cystoplasty remains a safe and effective option for the management of neuropathic bladder in a carefully selected group of patients.
观察膀胱扩大术在神经源性患者群体中不断变化的作用。回顾性病例系列研究。对2004年至2014年这10年间的单一中心病例进行研究。1995年,皇家公主脊髓损伤治疗中心发表了1982年至1992年这10年间78例接受膀胱扩大术的神经源性患者的治疗结果。[辛格·G,托马斯·D·G。神经源性膀胱的肠膀胱扩大术。《神经泌尿学与尿动力学》1995年;14(1):5 - 10。]在本系列研究中,我们回顾了2004年至2014年这10年间在同一单一治疗中心连续接受相同手术的51例患者。收集了人口统计学数据,包括患者年龄、病情和既往治疗情况。术前和术后的详细情况包括括约肌植入、肾功能、控尿率和并发症。尽管该治疗中心就诊的患者数量有所增加,但在当前系列中进行的膀胱扩大术手术数量明显减少(51例对比1982 - 1992年系列中的78例)。后一系列中脊柱裂患者也显著减少,同时进行括约肌植入的患者也更少(8例患者对比82/92系列中的52例)。然而,当前系列与1982 - 1992年系列的观察结果相似,控尿率分别为93.7%和93.6%,且两个回顾性队列报告的不良事件数量都很少。对于经过精心挑选的神经源性膀胱患者群体,膀胱扩大术仍然是一种安全有效的治疗选择。