Mp48-16 Augmentation Cystoplasty in Spinal Cord Injury: Is This Enough to Resolve Pathological Vesicoureteral Reflux?

You have accessJournal of UrologyReconstruction: Ureteral Reconstruction (Including Pyeloplasty) and Bladder Reconstruction (Including Trauma-Related Fistula) I (MP48)1 May 2024MP48-16 AUGMENTATION CYSTOPLASTY IN SPINAL CORD INJURY: IS THIS ENOUGH TO RESOLVE PATHOLOGICAL VESICOURETERAL REFLUX? Elena Seguí Moya, Sharon Gill, Sarah Knight, Mohamed Helal, Prashant Patel, Rizwan Hamid, Julian Shah, and Richard Nobrega Elena Seguí MoyaElena Seguí Moya , Sharon GillSharon Gill , Sarah KnightSarah Knight , Mohamed HelalMohamed Helal , Prashant PatelPrashant Patel , Rizwan HamidRizwan Hamid , Julian ShahJulian Shah , and Richard NobregaRichard Nobrega View All Author Informationhttps://doi.org/10.1097/01.JU.0001009512.15743.d7.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Safe follow-up of patients with neurogenic lower urinary tract dysfunction (NLUTD) has multiple objectives, including: protection of the upper urinary tract to prevent the development of renal failure; surveillance of the lower urinary tract to prevent infections, lithiasis, and tumours; achieving drainage, urinary continence and, ultimately, improving quality of life. Neurogenic bladders with high pressure from neurogenic detrusor overactivity or loss of compliance may lead to vesicoureteral reflux (RUV), which can cause pyelonephritis, renal scarring, and renal deterioration. In this large series, we analysed retrospectively the incidence and ongoing presence of RUV in patients who underwent AC. METHODS: From 1988 to 2018, 93 patients underwent AC for refractory neurogenic overactive bladder failing conservative, medical and endoscopic surgical treatments. We had access to the clinical history of 70 of 93 patients. The remaining 23 patients have not been considered for the study. Quantitative data are presented as the mean±SD. The paired Student's t-test was used to compare preoperative with postoperative values. The statistical program 'Prism by Graph pad®' was used, and a p<0.05 was considered statistically significant. RESULTS: We found 47 male and 23 female patients. Follow-up was until and including October 2023. The median follow-up was 19 years (5-36) and the median age of the patients at the time of surgery was 55 years. Pre-existing RUV was identified in 9 (13%) patients prior to AC. 7/9 (77.7%) patients who underwent AC had a correction of the RUV. One (14.3%) required a reimplantation at the same time of the AC. Other (14.3%) patient required a STING procedure before the AC. The other 5 (71.43%) patients did not require further surgery. After AC, 2 (28.6%) patients had ongoing RUV. One of them required reimplantation plus concomitant STING injection and the other patient underwent a STING injection alone. Despite this anti-reflux procedures, both patients had ongoing RUV but showed an improvement ingrade (V to II and IV to II grade reflux, respectively). CONCLUSIONS: In our large series, we demonstrate that AC surgery achieves an 80% resolution of RUV without requiring ureteric reimplantation or STING. We can conclude that in a patient with RUV from neurogenic bladder dysfunction, AC is the mainstay of treatment without the additional morbidity or ureteric reimplantation, except perhaps high-grade reflux. Furthermore, 68/70 (97.14%) patients with neurogenic bladder undergoing AC do not have post-operative RUV. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e779 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Elena Seguí Moya More articles by this author Sharon Gill More articles by this author Sarah Knight More articles by this author Mohamed Helal More articles by this author Prashant Patel More articles by this author Rizwan Hamid More articles by this author Julian Shah More articles by this author Richard Nobrega More articles by this author Expand All Advertisement PDF downloadLoading ...