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学科主题: 临床医学
题名:
Should simultaneous ureteral reimplantation be performed during sigmoid bladder augmentation to reduce vesicoureteral reflux in neurogenic bladder cases?
作者: Zhang, Peng1; Yang, Yong2; Wu, Zhi-jin1; Zhang, Ning2; Zhang, Chao-hua1; Zhang, Xiao-dong1
关键词: Sigmoid bladder augmentation ; Neurogenic bladder ; Vesico-ureteral reflux ; Video urodynamics study
刊名: INTERNATIONAL UROLOGY AND NEPHROLOGY
发表日期: 2015-05-01
DOI: 10.1007/s11255-015-0958-4
卷: 47, 期:5, 页:759-764
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: NEUROPATHIC BLADDER ; CHILDREN ; MYELODYSPLASIA ; CYSTOPLASTY ; RESOLUTION
英文摘要:

To assess the necessity of performing simultaneous collateral reimplantation during sigmoid bladder augmentation (SBA) to reduce vesicoureteral reflux (VUR) in low-compliance neuropathic bladder with associated VUR.

We retrospectively identified 31 patients who underwent SBA alone or with simultaneous ureteral reimplantation at our hospital. The video urodynamics data, VUR status, renal function, and clinical symptoms were studied during follow-up.

The mean follow-up time was 57 months (range 12-117). All patients displayed significantly increased safe cystometric capacity (P < 0.001) and bladder compliance (P < 0.001) and decreased creatinine (P < 0.01) and urea nitrogen (P < 0.05) compared with preoperative levels. High-grade VUR was resolved in only 7 of 15 patients (47 %) in Group A (simultaneous ureteral reimplantation), whereas low-grade VUR was resolved in 13 of 16 patients (81 %) in Group B (SBA alone). The other 11 patients still displaying VUR after SBA had larger safe bladder volumes due to augmentation. The patients′ improving renal function benefited most from the enlarged bladder and partly from increased antireflux resistance of vesico-ureter anastomosis. Twelve (38.7 %) had recurrent febrile urinary tract infection after SBA, and one (3.2 %) suffered from vesico-ureter anastomosis contracture after ureteral reimplantation.

A preoperative intravesical VUR pressure of 20 cmH(2)O is not an effective cutoff point for whether ureteral reimplantation should be simultaneously performed during SBA. Augmentation appears to be more important than reimplantation for protecting kidney from damage due to febrile urinary tract infection after SBA. Simultaneous reimplantation may be not necessary during SBA in neurogenic bladder.

语种: 英语
WOS记录号: WOS:000353826400009
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/62175
Appears in Collections:北京大学临床肿瘤学院_泌尿外科_期刊论文

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作者单位: 1.Capital Med Univ, Beijing Chao Yang Hosp, Dept Urol, Beijing 100020, Peoples R China
2.Peking Univ, Beijing Tumor Hosp, Dept Urol, Beijing 100871, Peoples R China

Recommended Citation:
Zhang, Peng,Yang, Yong,Wu, Zhi-jin,et al. Should simultaneous ureteral reimplantation be performed during sigmoid bladder augmentation to reduce vesicoureteral reflux in neurogenic bladder cases?[J]. INTERNATIONAL UROLOGY AND NEPHROLOGY,2015,47(5):759-764.
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