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Neurogenic Bladder Therapy in Patients with Spinal Dysraphism. Actual Strategy


Authors: P. Zerhau;  M. Husár
Authors‘ workplace: Urologický úsek KDCHOT FN Brno, přednosta: prof. MUDr. P. Gál, Ph. D., MBA
Published in: Rozhl. Chir., 2010, roč. 89, č. 5, s. 306-309.
Category: Monothematic special - Original

Overview

Purpose:
Retrospective evaluation of conservative and surgical treatment of detrusor hyperactivity in patients with spinal dysraphisms having been observed in our clinic during the last 20 years.

Material and method:
In the period 1989/2009, 87 patients in the age between 0 and 35 years suffering from the above disease were monitored. The period was divided into three terms. Term I: 1989/1995, Term II: 1996/2005, Term III: 2006/2009. 28 patients were followed-up in the Term I, 58 patients in the Term II and 69 patients in the Term III. The applied types of therapy (conservative, surgical, mini-invasive methods) were specified within the mentioned patients’ groups and substitution alterations were monitored.

Results:
54 patients were treated conservatively, 33 patients underwent an operation. During the Term I, 23 of the total 28 patients were treated conservatively, 5 (17.9%) patients were operated (3x ileocecal replacement, 2x ileocystoplasty). In Term II, 58 patients were treated, 23 (39.7%) thereof were operated (18x ileocystoplasty, 4x gastrocystoplasty, 1x sigmoideocystoplasty). In the Term III, 69 patients were followed-up and treated, 5 (7.2%) of them were operated (3x ileocystoplasty, 1x gastrocystoplasty, 1x sigmoideocystoplasty), and other 5 (7.2%) underwent a mini-invasive procedure by Botulinumtoxin A application.

Key words:
spinal dysraphisms – neurogenic urinary bladder – dyssynergy – augmentation – botulinumtoxin A


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