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Cystoscopic injection of polydimethylsiloxane to treat mitrofanoff channel leakage ‐ is it effective?
Author(s) -
AGRAVAL V.,
PATKI P.,
ARUMUGAM K.,
SHAH P.J.R.
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06085_83.x
Subject(s) - medicine , polydimethylsiloxane , surgery , leakage (economics) , materials science , economics , macroeconomics , nanotechnology
Leakage of urine via the Mitrofanoff channel is a difficult clinical problem. We report use of injections of Polydimethylsiloxane as a bulking agent to cure this problem. Methods: We performed 21 Polydimethylsiloxane implantations in the leaking Mitrofanoff channels in 14 women at a tertiary referral centre. Analysis of improvement in leakage was done at six‐weeks. Patients with partial or no improvement in leakage were re‐injected. Twelve bladders were neuropathic treated with augmentation ileo‐cystoplasty and Mitrofanoff and two were overactive. Double Monti technique was used in nine and appendix in five. Results: The mean age was 45 years (range 26–60), with a mean follow up of 11 months (range 2–29). The mean volume injected was 2.78 ml. (range 0.5–5). Multiple implantations were required in 4. Leakage stopped in 4/14 patients requiring only one injection. Partial improvement was seen in 3 patients. In seven no improvement was seen after an average of two injections (range 1–4). Urinary diversion was performed in two while three have had revision of Mitrofanoff channel. Conclusions: Injection of bulking agent like Polydimethylsiloxane was successful in 28.5% of patients, and partially successful in 21.4% patients. Half the patients (7/14) found no benefit from the procedure.