Abou Chaaya C, Neuville P, Ruffion A, Arber T
Service d'urologie du Pr. Ruffion, centre hospitalier Lyon sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Benite, France.
Service d'urologie du Pr. Ruffion, centre hospitalier Lyon sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Benite, France.
Prog Urol. 2022 Dec;32(17):1498-1504. doi: 10.1016/j.purol.2022.07.149. Epub 2022 Sep 5.
The aim of this study is to evaluate the percentage of patients developing vesical overactivity after the realization of a continent stoma without bladder enlargement.
This is a retrospective monocentric study between January 2007 and April 2021. Patients undergoing an isolated continent urinary diversion for neurological or non-neurological reasons were included. The data collected concerned the clinical symptoms of bladder overactivity and their treatment as well as the pre- and postoperative urodynamic information.
During the period, 9 patients were included. The main indications for continent urinary diversion were patients with spinal cord injury. Clinical bladder overactivity was found postoperatively in 78% (7) of the patients, and detrusor overactivity in 57% (4) of them. The main symptoms were urinary incontinence (67%) and pollakiuria (56%, 5 patients). Most of the patients benefited from associated treatments (78% pre- and postoperative), mainly anticholinergic drugs. No patient required botulinum toxin injections preoperatively, compared with 6 (67%) postoperatively. The time of initiation of these injections varied between 3 and 8 months postoperatively.
Isolated continent urinary diversion seems to induce or increase bladder overactivity. A larger multicentric study is necessary to validate our hypothesis.
本研究的目的是评估在未进行膀胱扩大术的情况下实施可控造口术后出现膀胱过度活动症的患者百分比。
这是一项2007年1月至2021年4月间的回顾性单中心研究。纳入因神经或非神经原因接受孤立性可控尿流改道的患者。收集的数据包括膀胱过度活动症的临床症状及其治疗方法，以及术前和术后的尿动力学信息。
在此期间，纳入了9名患者。可控尿流改道的主要指征是脊髓损伤患者。术后78%（7名）患者出现临床膀胱过度活动症，其中57%（4名）患者出现逼尿肌过度活动。主要症状为尿失禁（67%）和尿频（56%，5名患者）。大多数患者接受了相关治疗（术前和术后均为78%），主要是抗胆碱能药物。术前无患者需要注射肉毒杆菌毒素，而术后有6名（67%）患者需要。这些注射的开始时间在术后3至8个月之间。
孤立性可控尿流改道似乎会诱发或加重膀胱过度活动症。需要进行更大规模的多中心研究来验证我们的假设。
