Pavlović Katica, Hrkać Adelina, Kožul Iva Salihagić, Zalihić Dino, Zalihić Amra, Gilja Ivan
University Clinical Hospital in Mostar, Clinic of Urology, Mostar, Bosnia and Herzegovina.
Clinical Hospital, Department of Urology, 'Sveti Duh', Zagreb, Croatia.
Cent European J Urol. 2021;74(2):178-184. doi: 10.5173/ceju.2021.0333.R1. Epub 2021 Mar 26.
The aim of this article was to report the long-term results of increased ileocystoplasty in 58 patients with spinal cord injury (SCI) with an impact on overall renal function and quality of life. In a representative number of patients, where we followed individual subjects for more than 20 years, we wanted to determine their quality of life and preservation of renal function after surgery.
After unsuccessful conservative therapy of urinary incontinence, increased ileocystoplasty was performed. In addition to biochemical analysis, intravenous urography (IVU) was performed preoperatively (urography and/or ultrasound assessment of the upper urinary tract) and urodynamic tests were performed in all patients preoperatively.
After a follow-up of patients within the group (>20 years), 2 patients reported being incontinent. The median elapsed time of action was 20 (13-24) years. Vesical capacity increased in all cases postoperatively when the median vesical capacity was 420.0 (387.5-460.0) ml (p <0.001). Long-term complications included use of bladder chambers, kidney stones and urosepsis. Creatinine clearance confirmed satisfactory renal function after the elapsed time period from surgery.
The results confirmed that augmentation ileocystoplasty had excellent long-term outcomes in the definitive therapy of refractory neurogenic detrusor overactivity in patients with SCI.
本文旨在报告58例脊髓损伤(SCI)患者行扩大回肠膀胱术的长期结果,及其对整体肾功能和生活质量的影响。在相当数量的患者中,我们对个体进行了20多年的随访,旨在确定他们术后的生活质量和肾功能保留情况。
在保守治疗尿失禁失败后,实施扩大回肠膀胱术。除生化分析外,术前进行静脉尿路造影(IVU)(对上尿路进行尿路造影和/或超声评估),并对所有患者进行术前尿动力学检查。
对该组患者进行随访(>20年)后,2例患者报告仍有尿失禁。中位起效时间为20(13 - 24)年。术后所有病例膀胱容量均增加,中位膀胱容量为420.0(387.5 - 460.0)ml(p <0.001)。长期并发症包括使用膀胱腔、肾结石和尿脓毒症。肌酐清除率证实术后经过一段时间后肾功能良好。
结果证实,扩大回肠膀胱术在脊髓损伤患者难治性神经源性逼尿肌过度活动的确定性治疗中具有出色的长期疗效。