Portal de Periódicos da CAPES

Combined Use of Enterocystoplasty and a New Type of Artificial Sphincter in the Treatment of Urinary Incontinence

1996; Lippincott Williams & Wilkins; Volume: 156; Issue: 2S Linguagem: Inglês

10.1016/s0022-5347(01)65766-5

1527-3792

Salvador Vilar Correia Lima, Luiz Alberto P. Araújo, Fábio O. Vilar, Carmen L. Kummer, Eduardo Cavalcanti Lima,

Bladder and Urothelial Cancer Treatments

No AccessJournal of UrologyIncontinence1 Aug 1996Combined Use of Enterocystoplasty and a New Type of Artificial Sphincter in the Treatment of Urinary Incontinence Salvador Vilar C. Lima, Luiz Alberto P. Araujo, Fabio O. Vilar, Carmen L. Kummer, and Eduardo C. Lima Salvador Vilar C. LimaSalvador Vilar C. Lima More articles by this author , Luiz Alberto P. AraujoLuiz Alberto P. Araujo More articles by this author , Fabio O. VilarFabio O. Vilar More articles by this author , Carmen L. KummerCarmen L. Kummer More articles by this author , and Eduardo C. LimaEduardo C. Lima More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65766-5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report the results of the combination of enterocystoplasty and a periurethral expander, a simplified type of artificial sphincter, in the treatment of urinary incontinence. Materials and Methods: The new 1-piece device has an adjustable cuff connected to a port positioned at the subcutaneous space in the abdomen. The cuff is adjusted to the bladder neck and the pins are fixed according to the diameter of the urethra. The port is punctured percutaneously and saline is injected until continence is achieved. Eight boys and 3 girls underwent nonsecretory sigmoid cystoplasty and placement of the device at a single operation. Nine patients had neurogenic bladder and in 2 exstrophy reconstruction had failed. Followup ranged from 4 to 26 months. Results: All patients were continent with improved bladder compliance 6 to 8 weeks after the operation, when the device was activated. In 1 case the device was extracted after 2 months due to frequent episodes of hematuria and edema at the port site. Two patients had erosion of the skin at the port site. Urodynamics were repeated at the time of activation. Maximal urethral closing pressure increased from 16.27 to 157.44 percent. Two patients needed a second injection to achieve continence. The patients with exstrophy void spontaneously and those with neurogenic bladder are on clean intermittent catheterization. Conclusions: Although more followup is needed, the combination of these procedures seems to offer a new option for the treatment of urinary incontinence in children. References 1 : Bladder augmentation in patients with neurogenic bladder and vesicoureteral reflux. J. Urol., part 21991; 146: 563. Abstract, Google Scholar 2 : Bladder augmentation: experience with 129 children and young adults. J. Urol., part 21990; 144: 445. Abstract, Google Scholar 3 : Colocystoplasty rather than ileo-cystoplasty. J. Urol.1959; 82: 587. Link, Google Scholar 4 : Experience with bladder reconstruction in children. J. Urol.1987; 138: 1002. Link, Google Scholar 5 : Bladder augmentation and the pediatric neuropathic bladder. J. Urol.1983; 129: 552. Link, Google Scholar 6 : Results of ileocystoplasty. J. Urol.1958; 80: 461. Link, Google Scholar 7 : Gastrocystoplasty: an alternative solution to the problem of urological reconstruction in the severely compromised patient. J. Urol.1988; 140: 1152. Link, Google Scholar 8 : The development of tumors in experimental gastroenterocystoplasty. J. Urol., part 21993; 150: 730. Abstract, Google Scholar 9 : Complications of enterocystoplasty. Urology1992; 40: 9. Google Scholar 10 : Surgical correction for total urinary incontinence: 5 years after. J. Urol.1967; 97: 869. Link, Google Scholar 11 : An operation for the cure of incontinence of urine. Surg., Gynec. & Obst.1919; 28: 84. Google Scholar 12 : Clinical evaluation of a surgical technique for the correction of complete urinary incontinence. J. Urol.1972; 107: 402. Link, Google Scholar 13 : A new operation for male incontinence. Surg., Gynec. & Obst.1970; 131: 513. Google Scholar 14 : Congenital epispadias with incontinence. J. Urol.1949; 62: 513. Link, Google Scholar 15 : Nonsecretory sigmoid cystoplasty: experimental and clinical results. J. Urol.1995; 153: 1651. Link, Google Scholar 16 : How to perform enterocystoplasty without opening the intestine. A preliminary report. Urology1996; 47: 269. Google Scholar 17 : Alteration in detrusor behavior and the effect on renal function following insertion of the artificial urinary sphincter. J. Urol.1986; 136: 632. Link, Google Scholar 18 : Lower urinary tract reconstruction using stomach and the artificial sphincter. J. Urol.1993; 149: 1107. Link, Google Scholar 19 : Perforation of gastric segment of an augmented bladder secondary to peptic ulcer disease. J. Urol.1992; 148: 369. Link, Google Scholar 20 : Treatment of urinary incontinence by implantable prosthetic sphincter. Urology1973; 1: 252. Google Scholar 21 : The long-term results of artificial sphincters in children. J. Urol.1991; 146: 396. Link, Google Scholar 22 : Experiencia com o uso do esfincter artificial AS 800 em urologia. J. Bras. Urol.1988; 14: 209. Google Scholar 23 : Use of the AS792 artificial sphincter following urinary undiversion. J. Urol.1982; 129: 548. Google Scholar From the Sections of Urology and Pediatric Surgery, Hospital Infantil Manoel Almeida, Recife, Brazil.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byFarrugia M, Lottmann H, Neilson A, Nicholls G, Woodward M and Malone P (2012) Outcome of the Lima Periurethral Constrictor in Children and Adolescents: A European PerspectiveJournal of Urology, VOL. 188, NO. 4S, (1555-1560), Online publication date: 1-Oct-2012.Lima S, Araujo L, de O. Vilar F, Lima R and Lima R (2018) Nonsecretory Intestinocystoplasty: A 15-Year Prospective Study of 183 PatientsJournal of Urology, VOL. 179, NO. 3, (1113-1117), Online publication date: 1-Mar-2008.DE O VILAR F, ARAÚJO L and LIMA S (2018) PERIURETHRAL CONSTRICTOR IN PEDIATRIC UROLOGY: LONG-TERM FOLLOWUPJournal of Urology, VOL. 171, NO. 6 Part 2, (2626-2628), Online publication date: 1-Jun-2004.LIMA S, ARAÚJO L and VILAR F (2018) NONSECRETORY INTESTINOCYSTOPLASTY: A 10-YEAR EXPERIENCEJournal of Urology, VOL. 171, NO. 6 Part 2, (2636-2640), Online publication date: 1-Jun-2004. Volume 156Issue 2SAugust 1996Page: 622-624 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Salvador Vilar C. Lima More articles by this author Luiz Alberto P. Araujo More articles by this author Fabio O. Vilar More articles by this author Carmen L. Kummer More articles by this author Eduardo C. Lima More articles by this author Expand All Advertisement PDF downloadLoading ...