Results of bladder neck repair in patients with bladder exstrophy and incontinent epispadias [Mesane ekstrofisi ve inkontinan epispadiasli hastalarda mesane boynu onarimi sonuçlari]
Küçük Resim Yok
Tarih
2006
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Aim: In this study, the results of surgical repair of the bladder neck in patients with bladder exstrophy and incontinent epispadiasis were reviewed. Material and Method: Between 1992 and 2004, the records of 21 patients with bladder exstrophy and 2 patients with incontinent epispadias who underwent bladder neck repair were reviewed retrospectively. Patients who are continent for 2 hours or less were considered incontinent, those with over 3 hours as totally continent, while those between 2-3 hours as partially continent. Results: In 23 patients, 44 bladder neck repairs were performed. In all, Young-Dees-Leadbetter was the first surgical choice. During the first repair, the average age of the patients was 52.2±35.9 months. In 12 patients, surgical repair was performed once only. Of the 23 patients, 11 had intestinal augmentations and the remaining 13 had Mitrofanoff stomas. The average follow-up period was 63±35 months. Of the 23 patients, 11 (48%) were totally dry and 3 (13%) were partially dry, a total of 14 (61%) patients were totally continent. 11 of the continent patients were dry with intermittent catheterizations, the remaining 3 could micturate. In the series, facial sling was performed in 2 patients, and their bladder neck was closed subsequently. In general, periurethral injections were unsatisfactory. Conclusion: The main goal of bladder neck surgery in bladder exstrophy is to provide spontaneous micturition. Thus, bladder neck repair should be started with Young-Dees-Leadbetter procedure. The number of patients achieving this goal is unfortunately low. Our second option is to provide a continent bladder with intermittent cathetcrization that leaks whenever bladder capacity and pressure increases above normal levels to preserve safe drainage of the upper tract. For multiple failures, bladder neck closure is the last resort.
Açıklama
Anahtar Kelimeler
Bladder exstrophy, Bladder neck repair, Urinary incontinence
Kaynak
Cocuk Cerrahisi Dergisi
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
20
Sayı
1
