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Tissue Engineering and Cell Therapies for Neurogenic Bladder Augmentation and Urinary Continence Restoration
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Hypertonic low-compliant bladder responsible for urinary incontinence or reflux in the upper urinary tract can develop during the course of several neurologic disorders.1,2 Bladder augmentation performed to treat neurogenic bladder traditionally involves the use of intestinal segments, which can lead to complications such as urolithiasis, and metabolic disturbances.3
Exstrophy-epispadias complex
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
If a patient presents with poor bladder growth and/or refractory urinary incontinence after surgical repair: Bladder augmentation or urinary diversion may be necessary.
Neurogenic bladder
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Initial assesment/outcome of neurogenic bladderCIC and pharmacotherapy as first-line therapy.Bladder neck procedures in all cases.Bladder augmentation in all cases.Normal continence can be achieved without any therapy in most cases.Sexual dysfunction in males and early puberty in females.Normal sexual function in males.Normal sexual function in females.Ultrasonography of the spine as initial investigation.MRI scan of the spine as initial investigation.Urodynamics as initial investigation.Urodynamics at regular intervals.Urodynamics only at puberty.
Urinary undiversion by conversion of the incontinent ileovesicostomy to augmentation ileocystoplasty in spinal cord injured patients
Published in The Journal of Spinal Cord Medicine, 2022
Patrick J. Shenot, Seth Teplitsky, Andrew Margules, Aaron Miller, Akhil K. Das
Although the potential reversibility of ileovesicostomy has previously been established, our cases represent the first report of simultaneous undiversion with augmentation ileocystoplasty, using the same bowel segment used for ileovesicostomy, to facilitate the creation of a large capacity bladder with low storage pressures. We performed bladder augmentation to increase bladder capacity and hopefully decrease the frequent catheterization burden for these patients to improve their quality of life. When making the pre-operative decision to augment the bladder or not, pre-operative assessment should play an important role. The augmentation is performed to increase bladder capacity and lower intravesical pressure to preserve the upper urinary tract. Pre-operative urodynamics showing low capacity, low bladder compliance, or high pressures would favor the bladder augmentation versus bladder closure. It is also important to pre-operatively assess the urethra and bladder outlet endoscopically and radiographically on video urodynamic evaluation to ensure outlet resistance will be adequate to provide acceptable continence during urine storages once undiversion is completed.
Effect of intravesical botulinum toxin injection on symptoms of autonomic dysreflexia in a patient with chronic spinal cord injury: a case report
Published in The Journal of Spinal Cord Medicine, 2019
Il-Young Jung, Kyo Ik Mo, Ja-Ho Leigh
Among the drugs used to treat overactive bladder, Myrbetriq (mirabegron), which activates the β3 adrenergic receptor in the bladder detrusor muscle, leads to muscle relaxation and an increase in bladder capacity.16 Myrbetriq, which reduces bladder spasm, may help improve symptoms of autonomic dysreflexia, although the effect of this drug has not been demonstrated in patients with chronic SCI. In addition, surgical treatment, such as bladder augmentation or urostomy, can be used as secondary treatment options. Augmentation cystoplasty has a proven long-term success based on urodynamic studies, and it has been found to decrease the symptoms of autonomic dysreflexia.17 However, surgical procedures lead to irreversible structural changes and can induce many complications, such as perforation, small bowel obstruction, peristomal skin problems, etc. Thus, when symptoms of autonomic dysreflexia do not improve with medication, an intravesical botulinum toxin injection can be administered as an effective treatment before surgical procedures in patients with chronic SCI.
Augmentation cystoplasty in neuropathic bladder
Published in The Journal of Spinal Cord Medicine, 2020
Sheilagh Reid, Paul Tophill, Nadir Osman, Chris Hillary
Between 2000 and 2010, the number of bladder augmentation procedures as recorded by the Hospital Episode Statistics database (Department of Health) has dropped from over 200 per year to less than 100. This was accompanied by the exponential rise in the number of intravesical botulinum toxin procedures during that period.8 This change is reflected in our findings where there has been a significant decline in the number of patients between these two papers and even within the later series there is a decrease in the number of procedures per year over time (Figure 2).