Modified Young-Dees-Leadbetter Procedure for Urinary Continence in the Non-Neurogenic Bladder

2001 ◽  
Vol 9 (1) ◽  
pp. 1-8
Author(s):  
John P. Gearhart
Keyword(s):  
Neurogenic Bladder ◽  
Urinary Continence

scholarly journals Non-Traditional Management of the Neurogenic Bladder: Tissue Engineering and Neuromodulation

2007 ◽  
Vol 7 ◽  
pp. 1230-1241 ◽  
Author(s):  
Jane M. Lewis ◽  
Earl Y. Cheng
Keyword(s):  
Tissue Engineering ◽  
Spina Bifida ◽  
Neurogenic Bladder ◽  
Cell Biology ◽  
Bladder Wall ◽  
Bladder Augmentation ◽  
Current Status ◽  
Urinary Continence ◽  
Clean Intermittent Catheterization ◽  
Bladder Tissue

Patients with spina bifida and a neurogenic bladder have traditionally been managed with clean intermittent catheterization and pharmacotherapy in order to treat abnormal bladder wall dynamics, protect the upper urinary tract from damage, and achieve urinary continence. However, some patients will fail this therapy and require surgical reconstruction in the form of bladder augmentation surgery using reconfigured intestine or stomach to increase the bladder capacity while reducing the internal storage pressure. Despite functional success of bladder augmentation in achieving a low pressure reservoir, there are several associated complications of this operation and patients do not have the ability to volitionally void. For these reasons, alternative treatments have been sought. Two exciting alternative approaches that are currently being investigated are tissue engineering and neuromodulation. Tissue engineering aims to create new bladder tissue for replacement purposes with both “seeded” and “unseeded” technology. Advances in the fields of nanotechnology and stem cell biology have further enhanced these tissue engineering technologies. Neuromodulation therapies directly address the root of the problem in patients with spina bifida and a neurogenic bladder, namely the abnormal relationship between the nerves and the bladder wall. These therapies include transurethral bladder electrostimulation, sacral neuromodulation, and neurosurgical techniques such as selective sacral rhizotomy and artificial somatic-autonomic reflex pathway construction. This review will discuss both tissue engineering techniques and neuromodulation therapies in more detail including rationale, experimental data, current status of clinical application, and future direction.

scholarly journals Ten years’ experience of augmentation cystoplasty for varied indications and its outcome

2020 ◽  
Vol 7 (4) ◽  
pp. 1031
Author(s):  
Hemangi R. Athawale ◽  
Shivaji B. Mane ◽  
Natasha Vagheriya ◽  
Prathamesh More ◽  
Taha Daginawala
Keyword(s):  
Serum Creatinine ◽  
Neurogenic Bladder ◽  
Surgical Techniques ◽  
Bladder Augmentation ◽  
Renal Outcome ◽  
Urinary Continence ◽  
Ectopic Ureter ◽  
Safe Procedure ◽  
Augmentation Cystoplasty

Background: The aim of the study was to evaluate long term efficacy and complications of augmentation cystoplasty in patients with bladder dysfunction.  Methods: Our series comprises of 30 patients undergoing enterocystoplasty from March 2009 till December 2019. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.Results: Mean age of patients was 7 years and their mean follow up was for 4 years. Major complications occurred in 5 patients which were successfully managed and minor complication in 8 patients. Of these 16 patients were with neurogenic bladder and 14 with non-neurogenic bladder. The primary etiology of non-neurogenic bladder was extrophy epispadias complex (10 patients), posterior uretheral valves (2 patients), anterior uretheral valve (1 patient), and bilateral ectopic ureter (1 patient). The primary etiology of neurogenic bladder was meningomyocele (4 patients), anorectal malformation with vertebral anomalies (7 patients), partial sacral ageneis (4), nonneurogenic neurogenic bladder (1 patient). Relative continence was achieved in 97%. The preoperative serum creatinine and blood urea nitrogen (BUN) at the time of bladder augmentation (termed  creatinine-1 and BUN-1)and the serum  creatinine and BUN at the last follow up after bladder augmentation (termed  creatinine-2 and BUN-2)were sought and compared using chi square test showed statistically significant improvement (p<0.01).Conclusions: Augmentation cystoplasty is a necessary and safe procedure to increase the functional capacity of small contracted and poorly compliant bladder and allows patients to achieve relative continence and preserves renal function.

scholarly journals Medical Management of Neurogenic Bladder for Children and Adults: A Review

2019 ◽  
Vol 25 (3) ◽  
pp. 195-204
Author(s):  
Elizabeth Lucas
Keyword(s):  
Quality Of Life ◽  
Neurogenic Bladder ◽  
Medical Management ◽  
Chronic Condition ◽  
Upper Urinary Tract ◽  
Urinary Continence ◽  
Clean Intermittent Catheterization ◽  
Successful Management ◽  
Bladder Drainage

Neurogenic bladder is a chronic condition affecting patients of all ages with significant medical and quality of life implications. Goals of treatment consist of protection of the upper urinary tract and promotion of reliable urinary continence. Successful management involves medications and most often bladder drainage via clean intermittent catheterization. This article reviews current literature on medical management to achieve goals of treatment.

scholarly journals A single centre 10-year experience of Mitrofanoffs procedure for varied indications with its outcome

2020 ◽  
Vol 7 (4) ◽  
pp. 764
Author(s):  
Hemangi R. Athawale ◽  
Shivaji B. Mane ◽  
Natasha Vagheriya ◽  
Hussain Kotawala ◽  
Prathamesh More ◽  
...  
Keyword(s):  
Neurogenic Bladder ◽  
Surgical Techniques ◽  
Clinical Findings ◽  
Renal Outcome ◽  
Urinary Continence ◽  
Complication Rates ◽  
Chi Square ◽  
Preoperative Serum ◽  
Chi Square Test

Background: To evaluate long term efficacy and complications of Mitrofanoffs procedure in patients with bladder dysfunction.Methods: Authors retrospectively reviewed the medical records of 51 patients who underwent construction of a continent catherisable channel (mitrofanoffs and monti) from 2009 till 2019 in our institution. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.Results: Mean age was 7 years and mean follow up was for 3 years. 27 patients were with neurogenic bladder and 24 with non-neurogenic bladder. The most common type of conduit was appendicovesicostomy (38) followed by illeal monti (12) and ureter (1). The most common stomal site was umbilicus (44) followed by right lower abdominal quadrant (6). Catherterizable conduit complications included stomal leakage in 3, mucosal prolapse at the stoma site in1 and an intra peritoneal leak requiring exploratory laprotomy and revision in1. Relative stomal continence was achieved in 98%. The preoperative serum creatinine & blood urea nitrogen (BUN) at the time of mitrofanoffs procedure at the last follow up after the procedure were sought and compared using Chi square test showed statistically significant improvement (p<0.01). No differences in outcome and complication rates were noted between different types of conduit, sites of implantation, or segments used for augmentation.Conclusions: Mitrofanoff is a safe and reliable procedure in children who are dependent on intermittent catherisation in developing countries. Appendicovesicostomy is our first option followed by yang -monti illeovesicostomy.  While stomal continence is excellent patient education, family motivation and cost reduction are important factors for its lasting efficiency.

scholarly journals Pharmacotherapy in Pediatric Neurogenic Bladder Intravesical Botulinum Toxin Type A

ISRN Urology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Cristian Sager ◽  
Carol Burek ◽  
Victor Durán ◽  
Juan Pablo Corbetta ◽  
Santiago Weller ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Neurogenic Bladder ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Bladder Pressure ◽  
Urinary Continence ◽  
Novel Therapy ◽  
Bibliographic Search

When the neurogenic bladder is refractory to anticholinergics, botulinum toxin type A is used as an alternative. The neurotoxin type A reduces bladder pressure and increases its capacity and wall compliance. Additionally, it contributes to improving urinary continence and quality of life. This novel therapy is ambulatory with a low incidence of adverse effects. Due to its transitory effect, it is necessary to repeat the injections in order to sustain its therapeutic effect. In these review article we talk about Mechanism of Action, Indications, effects, administration and presentations of the Botulinum Neurotoxin Type A in pediatric patients. Also, we make references to controversial issues surrounding its use. A bibliographic search was done selecting articles and revisions from Pubmed. The key words used were botulinum toxin A, neurogenic bladder, and children. The search was limited to patients younger than 18 years of age and reports written in English in the past ten years.

Medical Management of Neurogenic Bladder

2017 ◽  
Author(s):  
Anne P Cameron ◽  
John T Stoffel
Keyword(s):  
Botulinum Toxin ◽  
Neurogenic Bladder ◽  
Urinary Continence ◽  
Nocturnal Polyuria ◽  
Combination Drug ◽  
Suitable Alternative ◽  
Bladder Drainage ◽  
Bladder Compliance ◽  
Cord Injury

In the management of neurogenic bladder (NGB), the goals are first and foremost to protect the upper tract from damage. The second treatment goal is to maintain urinary continence, but all the while maintaining the patient’s quality of life. These goals are achieved by treating most patients with NGB in a targeted fashion based on urodynamic findings. Medical therapy optimization and appropriate bladder drainage are the cornerstones of NGB management. Detrusor overactivity, poor bladder compliance, and incontinence related to these are best initially managed with antimuscarinic agents,; however, there is an increasing role for the new beta3 agonists. In the event these therapies fail, botulinum toxin is often the next choice; however,  is an expensive treatment, and some patients may be treated with combination drug therapy. Nocturnal polyuria is also extremely common in this group of patients and is quite bothersome. After other risk factors have been excluded, medical treatment with desmopressin may be a suitable alternative. This review contains 3 highly rendered figures, 2 tables, and 85 references Key words: adrenergic alpha blockers, antimuscarinics, botulinum toxin, desmopressin, imipramine, mirabegron, multiple sclerosis, neurogenic bladder, spinal cord injury

scholarly journals URINARY CONTINENCE DIVERSION IN CHILDREN WITH NEUROGENIC BLADDER

2015 ◽  
Vol 22 (1) ◽  
Author(s):  
Yopie T Satyawan ◽  
Arry Rodjani ◽  
Irfan Wahyudi
Keyword(s):  
Urinary Diversion ◽  
Neurogenic Bladder ◽  
Medical Records ◽  
Urinary Continence ◽  
Initial Experience ◽  
Inclusion Criteria ◽  
Recurrent Uti ◽  
Common Etiology ◽  
Child Age

Objective: We evaluate the initial experience of the implementation of the urinary diversion procedure in patients with neurogenic bladder continence in children. Material & method: The study was conducted retrospectively by collecting data contained in patient medical records of patients who come for treatment to Cipto Mangunkusumo Hospital Jakarta, from 2003 to 2012, and by interviews with parents of patients over the phone or when the patients control to the clinic. The patient is a child (age 0-18 years), diagnosed with congenital neurogenic bladder, and had urinary diversion continence procedure. Results: There are eight cases with urinary diversion continence undertaken in Cipto Mangunkusumo Hospital and found only 7 cases met the inclusion criteria with more girls than boys. Common etiology was spina bifida (57%). Most of the patients complained of recurrent UTI, and the most techniques used are Mitrofanoff (72%) with complications 33%. Conclusion: Urinary diversion continence procedure that has been done in Urology of Cipto Mangunkusumo Hospital is Mitrofanoff-Monti. Of the total of seven cases performed, the initial evaluation gives good results after urinary diversion continence procedure. Improved quality of life of patients with the achievement continence, overcome recurrent UTI problems and kidney function can be retained. Keywords: Neurogenic bladder, Mitrofanoff techniques, Yang-Monti.

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