Intermittent catheterization following enterocystoplasty

Authors


Department of Urology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.

Abstract

Objective To assess the segment of bowel used in enterocystoplasty and the need to perform intermittent self-catheterization (ISC) after enterocystoplasty for the treatment of incontinence.

Patients and methods Of 123 patients undergoing enterocystoplasty, 77 (mean age 29.5 years, range 13–61) had neurogenic disease (NB group) and 46 (mean age 45.7 years, range 16–74) had non-neuropathic bladders (NNB group). The success of enterocystoplasty, with respect to the segment of bowel used and the need for ISC, was assessed during a follow-up of 6–125 rhonths.

Results Ileum was used in 84 (63.8%), ileum and caecum in 19 (15.4%) and sigmoid in 20 (16.3%) patients. In the NB group, more patients had a sigmoid cystoplasty (24.7 vs 2.2%) and less (67 vs 80 %) had an ileo-cystoplasty than in the NNB group. A total of 87 (71%) patients required ISC; 63 (82%) of the NB group and 24 (52%) of the NNB group. The influence of the intestinal segment was conspicuous in the NB group, with 82% and 95% of patients with ileocaecal and sigmoid cystoplasty needing ISC against 77% of those patients with ileal cystoplasty. The difference was not so evident in the NNB group.

Conclusions A social continence rate of 93.6% in the NB and 84.8% in the NNB patients was achieved, partly due to the patients' success with ISC, a necessary skill to be mastered by all patients before undergoing enterocystoplasty.

Ancillary