Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction
The advent of specialized spinal units and better understanding of the pathophysiology of neurogenic urinary tract dysfunction has made long-term survival of these patients a reality. This has, in turn, led to an increase in quality and choice of management modalities offered to these patients inclu...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2013-01-01
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| Series: | Indian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2013;volume=29;issue=4;spage=328;epage=337;aulast=Johnson |
| _version_ | 1818495478080208896 |
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| author | E U Johnson Gurpreet Singh |
| author_facet | E U Johnson Gurpreet Singh |
| author_sort | E U Johnson |
| collection | DOAJ |
| description | The advent of specialized spinal units and better understanding of the pathophysiology of neurogenic urinary tract dysfunction has made long-term survival of these patients a reality. This has, in turn, led to an increase in quality and choice of management modalities offered to these patients including complex anatomic urinary tract reconstructive procedures tailored to the unique needs of each individual with variable outcomes. We performed a literature review evaluating the long-term outcomes of these reconstructive procedures. To achieve this, we conducted a world-wide electronic literature search of long-term outcomes published in English. As the premise of this review is long-term outcomes, we have focused on pathologies where evidence of long-term outcome is available such as patients with spinal injuries and spina bifida. Therapeutic success following urinary tract reconstruction is usually measured by preservation of renal function, improvement in quality-of-life, the satisfactory achievement of agreed outcomes and the prevention of serious complications. Prognostic factors include neuropathic detrusor overactivity; sphincter dyssynergia; bladder over distension; high pressure storage and high leak point pressures; vesicoureteric reflex, stone formation and urinary tract infections. Although, the past decade has witnessed a reduction in the total number of bladder reconstructive surgeries in the UK, these procedures are essentially safe and effective; but require long-term clinical and functional follow-up/monitoring. Until tissue engineering and gene therapy becomes more mainstream, we feel there is still a place for urinary tract reconstruction in patients with neurogenic lower urinary tract dysfunction. |
| first_indexed | 2024-12-10T18:20:53Z |
| format | Article |
| id | doaj.art-e1356739ee554ad290aec1fe40183aec |
| institution | Directory Open Access Journal |
| issn | 0970-1591 1998-3824 |
| language | English |
| last_indexed | 2024-12-10T18:20:53Z |
| publishDate | 2013-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Urology |
| spelling | doaj.art-e1356739ee554ad290aec1fe40183aec2022-12-22T01:38:13ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242013-01-0129432833710.4103/0970-1591.120116Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunctionE U JohnsonGurpreet SinghThe advent of specialized spinal units and better understanding of the pathophysiology of neurogenic urinary tract dysfunction has made long-term survival of these patients a reality. This has, in turn, led to an increase in quality and choice of management modalities offered to these patients including complex anatomic urinary tract reconstructive procedures tailored to the unique needs of each individual with variable outcomes. We performed a literature review evaluating the long-term outcomes of these reconstructive procedures. To achieve this, we conducted a world-wide electronic literature search of long-term outcomes published in English. As the premise of this review is long-term outcomes, we have focused on pathologies where evidence of long-term outcome is available such as patients with spinal injuries and spina bifida. Therapeutic success following urinary tract reconstruction is usually measured by preservation of renal function, improvement in quality-of-life, the satisfactory achievement of agreed outcomes and the prevention of serious complications. Prognostic factors include neuropathic detrusor overactivity; sphincter dyssynergia; bladder over distension; high pressure storage and high leak point pressures; vesicoureteric reflex, stone formation and urinary tract infections. Although, the past decade has witnessed a reduction in the total number of bladder reconstructive surgeries in the UK, these procedures are essentially safe and effective; but require long-term clinical and functional follow-up/monitoring. Until tissue engineering and gene therapy becomes more mainstream, we feel there is still a place for urinary tract reconstruction in patients with neurogenic lower urinary tract dysfunction.http://www.indianjurol.com/article.asp?issn=0970-1591;year=2013;volume=29;issue=4;spage=328;epage=337;aulast=JohnsonBotulinum toxinclam augmentationclam cystoplastyconduit urinary diversioncontinent diversiondetrusor myomectomyenterocystoplasyileocystoplastylong-term outcomeneobladderneurogenicreconstructionreviewsphincterotomyspinal cord injuryurethral stenturinary tract dysfunction |
| spellingShingle | E U Johnson Gurpreet Singh Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction Indian Journal of Urology Botulinum toxin clam augmentation clam cystoplasty conduit urinary diversion continent diversion detrusor myomectomy enterocystoplasy ileocystoplasty long-term outcome neobladder neurogenic reconstruction review sphincterotomy spinal cord injury urethral stent urinary tract dysfunction |
| title | Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction |
| title_full | Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction |
| title_fullStr | Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction |
| title_full_unstemmed | Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction |
| title_short | Long-term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction |
| title_sort | long term outcomes of urinary tract reconstruction in patients with neurogenic urinary tract dysfunction |
| topic | Botulinum toxin clam augmentation clam cystoplasty conduit urinary diversion continent diversion detrusor myomectomy enterocystoplasy ileocystoplasty long-term outcome neobladder neurogenic reconstruction review sphincterotomy spinal cord injury urethral stent urinary tract dysfunction |
| url | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2013;volume=29;issue=4;spage=328;epage=337;aulast=Johnson |
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