MP29-07 COMPLICATIONS ASSOCIATED WITH CLEAN INTERMITTENT SELF CATHETERISATION IN PATIENTS WITH ARTIFICIAL URINARY SPHINCTER FOR THE TREATMENT OF NEUROPATHIC BLADDER DYSFUNCTION.

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Ureter, Bladder, External Genitalia and Urotrauma II1 Apr 2015MP29-07 COMPLICATIONS ASSOCIATED WITH CLEAN INTERMITTENT SELF CATHETERISATION IN PATIENTS WITH ARTIFICIAL URINARY SPHINCTER FOR THE TREATMENT OF NEUROPATHIC BLADDER DYSFUNCTION. Anastasia Frost, Andrew Cole, Michael Fadel, Simon Bugeja, Daniela Andrich, and Anthony Mundy Anastasia FrostAnastasia Frost More articles by this author , Andrew ColeAndrew Cole More articles by this author , Michael FadelMichael Fadel More articles by this author , Simon BugejaSimon Bugeja More articles by this author , Daniela AndrichDaniela Andrich More articles by this author , and Anthony MundyAnthony Mundy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.610AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Augmentation cystoplasty has been used for over 50 years as a surgical treatment for patients with dysfunctional bladder disorders. Some of these patients may require an artificial urinary sphincter (AUS) to maintain continence; and to perform clean intermittent self-catheterisation (CISC) to ensure bladder emptying. This study reviews outcomes of patients with neuropathic bladder disorders who have had both cystoplasty and AUS implantation. We compare the outcomes of those that regularly CISC with those that do not. METHODS In this retrospective cohort study, 123 patients (77 male, 46 female) underwent augmentation cystoplasty, by a single surgeon, with implantation of an AUS. The cohort was divided into 2 groups. Group 1 (n=67) performed CISC and group 2 (n=56) did not. Mean age at time of initial surgery was 22 years (4.3-73 years). Mean follow up was 25 years (12-32 years). RESULTS Of 123 patients, 85 (group 1 n=42 vs. group 2 n=43) had the AUS removed after a mean of 6.3 years (2 days - 23.4 years). The mean time to explant was equal in groups 1 and 2 (6.4 years vs 6.2 years). In group 1, erosion occurred in 48.8%, infection in 2.4%, and malfunction 48.8%. The mean time to explant was 4.95 years (42 days - 18 years) for erosion and 8.2 years (85 days - 23.5 years) for malfunction. 1 patient had infection at 2 days. In group 2 the devices were removed due to erosion in 53.4%, and malfunction in 44.3%; after a mean of 5.1 years (60 days - 21.4 years), and 9.6 years (0.7 - 23.5 years) respectively. There was 1 AUS removed for infection after 23 days. 51 patients went on to have a second AUS implanted with 28 (55%) being removed after a mean of 4.9 years, with 14 patients in each group. Erosion occurred in 39.2%, infection in 3.7%, and malfunction in 57.1%. The mean time to explant following erosion was similar in groups 1 and 2 (4.04 vs. 4.05 years). In group 1 there was one patient with infection at 91 days. There were no early infections in group 2. CONCLUSIONS Patients with augmentation cystoplasty and an AUS developed erosion and infection at equal rates and mean time whether they performed CISC or not. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e342 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anastasia Frost More articles by this author Andrew Cole More articles by this author Michael Fadel More articles by this author Simon Bugeja More articles by this author Daniela Andrich More articles by this author Anthony Mundy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...