BLADDER AUGMENTATION IN PATIENTS WITH NEUROGENIC BLADDER AND VESICOURETERAL REFLUX

Title

BLADDER AUGMENTATION IN PATIENTS WITH NEUROGENIC BLADDER AND VESICOURETERAL REFLUX

Creator

Nasrallah P F; Aliabadi H A

Publisher

Journal of Urology

Date

1991
1991-08

Description

Current treatment of noncompliant neurogenic bladder associated with significant vesicoureteral reflux that is refractory to intermittent self-catheterization and anticholinergic therapy includes bladder augmentation coupled with a procedure to eliminate reflux. Antireflux surgery is often difficult in such a clinical setting. The diseased and thickened detrusor makes reimplantation into the bladder difficult, and successful reimplantation into the intestinal component is tricky and time-consuming. Augmentation alone was done in 14 patients with significant vesicoureteral reflux in the face of a noncompliant, high pressure neurogenic bladder. No effort was made to correct reflux surgically because, in theory, reflux is secondary to abnormal bladder pressure. Of the 13 patients who have had adequate evaluation with postoperative cystograms 12 no longer have reflux. The reflux in the remaining patient has improved from grade IV to grade II. Postoperative cystometric examination in 12 patients demonstrated low pressure and adequate volume. Correction of bladder dynamics alone reversed the reflux. Conversely, persistence of reflux postoperatively is an indication that augmentation has not successfully returned the bladder to a low pressure reservoir. Our experience indicates that antireflux procedures are not routinely needed in this group of patients.

Subject

bladder; children; neurogenic; Surgery; Urology & Nephrology; vesicoureteral reflux

Format

Journal Article

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

563-566

Issue

2

Volume

146

Citation

Nasrallah P F; Aliabadi H A, “BLADDER AUGMENTATION IN PATIENTS WITH NEUROGENIC BLADDER AND VESICOURETERAL REFLUX,” NEOMED Bibliography Database, accessed October 24, 2021, https://neomed.omeka.net/items/show/6622.

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