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Surgical Management of the Congenital Neuropathic Bladder
Author(s) -
PARRY J. R. W.,
NURSE D. E.,
BOUCAUT H. A. P.,
MURRAY K. H. A.,
MUNDY A. R.
Publication year - 1990
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1990.tb14690.x
Subject(s) - medicine , sphincter , cuff , weakness , surgery , artificial urinary sphincter , urinary system , urethral sphincter , urinary incontinence
Summary— We have previously described 3 types of lower urinary tract dysfunction in the congenital neuropathic bladder—contractile, intermediate and acontractile—accounting for 35,40 and 25% of patients respectively. Subsequent urodynamic and surgical experience has shown that the intermediate type is commoner and the acontractile type less common than was thought. The contractile group accounts for 31% of patients and rarely requires surgery (a “clam” ileocystoplasty). The acontractile group accounts for only 9% but more commonly requires surgical treatment, usually the implantation of an artificial urinary sphincter (AUS). The intermediate group accounts for 60% of patients and usually requires surgery. If there is no significant sphincter weakness incontinence, a “clam” ileocystoplasty alone is performed; if there is sphincter weakness, a “clam and a cuff” procedure is performed with implantation of the remainder of the AUS at a later date, if required.