CLAM CYSTOPLASTY FOR THE OVERACTIVE BLADDER: A REVIEW OF 23 CASES
Article first published online: 21 JAN 2008
Australian and New Zealand Journal of Surgery
Volume 64, Issue 2, pages 88–90, February 1994
How to Cite
Mark, S. D., McRae, C. U., Arnold, E. P. and Gowland, S. P. (1994), CLAM CYSTOPLASTY FOR THE OVERACTIVE BLADDER: A REVIEW OF 23 CASES. Aust. N.Z. J. Surg., 64: 88–90. doi: 10.1111/j.1445-2197.1994.tb02149.x
- Issue published online: 21 JAN 2008
- Article first published online: 21 JAN 2008
- Accepted for publication 23 June 1993.
- clam cystoplasty;
- overactive bladder dysfunction.
A clam enterocystoplasty was performed for refractory urge incontinence due to either idiopathic instability (13 patients) or neuropathic hyperreflexia (10 patients). Twelve patients became dry and appliance free. Of the remaining 11 wet patients, seven developed low pressure reservoirs, of whom five had stress incontinence and two had overtlow incontinence. The other four patients had persistent symptomatic involuntary phasic contractions and ongoing urge incontinence. The magnitude of the surgery and the voiding dysfunction associated with the relative lack of motivation of elderly patients made the operation less successful and more hazardous in those over the age of 65. Successful outcome could be improved by careful patient selection and by performing an antistress incontinence procedure, such as implantation of an artificial urinary sphincter cuff or a cystourethropexy, where there is associated bladder outlet incompetence.