Long-term urodynamic findings following colo-, gastro- and ileocystoplasty
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In brief
In brief
This retrospective study compares long-term urodynamic outcomes in 84 patients who underwent colocystoplasty, gastrocystoplasty, or ileocystoplasty between 1987-2017. All techniques significantly improved bladder capacity and compliance, but ileocystoplasty showed the lowest rate of pathologic contractions (26%) compared to gastric (50%) and colonic (43%) segments.
- Bladder capacity increased significantly and compliance improved across all augmentation types (colocystoplasty, gastrocystoplasty, ileocystoplasty).
- Ileocystoplasty showed the lowest rate of postoperative pathologic contractions (26%) compared to gastrocystoplasty (50%) and colocystoplasty (43%).
- Maximal intravesical pressure decreased significantly in all augmentation groups, improving bladder storage function.
- Persistent pathologic contractions after augmentation may result from residual peristalsis in the detubularized bowel segment.
- From a urodynamic perspective, ileum is the most suitable bowel segment for long-term bladder augmentation outcomes.
Written by the GCMD Library team from the article.
Abstract
Purpose
To evaluate the urodynamic changes in patients who have undergone colocystoplasty (CCP), gastrocystoplasty (GCP) and ileocystoplasty (ICP) in a retrospective study. Changes in urinary continence, incidence of pathologic contractions before and after augmentation, alterations of urodynamic parameters were also examined.
Methods
Eighty-four patients were included in the study who underwent bladder augmentation between 1987 and 2017. Group I: 35 patients with CCP. Group II: 18 patients with GCP. Group III: 31 patients with ICP. Cystometry was performed at 3, 6, and every 12 months, then biannually after augmentation. Pre- and postoperative urodynamic changes were analysed statistically.
Results
In Group I, two patients and in Group III, one patient remained incontinent after CCP and ICP. Bladder capacity increased significantly, maximal intra-vesical pressure decreased and compliance improved in all groups (p < 0.001). Postoperative studies showed pathologic contractions in the augmented bladder in half of the patients with GCP, in 43% of patients after CCP and 26% of patients with ICP.
Conclusion
From the urodynamic point of view, ileum is the most adequate option in the long term. Contractions after augmentation might be caused by the remaining peristalsis of the detubularised segment. Further investigations are needed to evaluate pathologic contractions that remained after detubularisation.