Augmentation duracystoplasty in neurogenic bladder dysfunction.

Abstract

Augmentation cystoplasty is the treatment of choice for patients with neurogenic bladder dysfunction in cases that are unresponsive to other medical treatment. Although intestinal segments as bladder substitutes are preferred over the other alternatives at present, they are not ideal bladder replacements due to several potential hazards. The purpose of this study was to determine whether or not augmentation duracystoplasty can be an alternative to augmentation enterocystoplasties. Ten patients with neurogenic bladder dysfunction unresponsive to conservative measures, underwent augmentation duracystoplasty by using the modified Bramble-Clam technique. The follow-up period was T-28 months. At present, seven of 10 patients are completely continent for with clean intermittent catheterization. The remaining three patients required oral oxybutinin therapy, postoperatively, to achieve continence although lower dosages than those required in the preoperative period. We did not observe any serious pre- or postoperative complications. Based on these preliminary findings we think that duracystoplasty can be considered as a treatment alternative for hyperreflexic and/or low compliant neurogenic bladders.