Lower urinary tract reconstruction using stomach and the artificial sphincter

G. S. Ganesan, D. H. Nguyen, M. C. Adams, S. J. King, R. C. Rink, M. W. Burns, M. E. Mitchell

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

We implanted the artificial urinary sphincter at gastrocystoplasty in 13 male and 5 female patients. The diagnoses were classical bladder exstrophy (8 patients), myelodysplasia (8), cloacal exstrophy (1) and bilateral ectopic ureters (1). Mean patient age was 14.3 years (range 7 to 32.5). Six patients (5 with bladder exstrophy and 1 with cloacal exstrophy) had failed bladder neck continence procedures, 3 myelodysplastic patients had failed artificial urinary sphincter placement, and 1 exstrophy patient had failed a Young-Dees bladder neck repair and artificial urinary sphincter placement. The sphincter cuff was placed around the reconstructed bladder neck in these patients, while in the remainder the artificial urinary sphincter was placed around the intact bladder neck. Mean followup was 20.3 months (range 1 to 5). Of the patients 16 (88%) are continent day and night, while 2 are wet. A total of 11 patients (61%) use Valsalva's maneuver alone for voiding and the remainder use Valsalva's maneuver and/or clean intermittent catheterization for bladder evacuation. Complications related to the artificial urinary sphincter were recurrent pump erosion requiring conversion to a Mitrofanoff continent stoma in 1 patient, and mechanical dysfunction requiring pump cuff and reservoir replacement in 3. There were no complications due to infection. Our report demonstrates that the combination of augmentation gastrocystoplasty and an artificial urinary sphincter leads to urinary continence and can allow for spontaneous urination. The rate of infectious complications is not increased when the 2 procedures are combined simultaneously.

Original languageEnglish (US)
Pages (from-to)1107-1109
Number of pages3
JournalJournal of Urology
Volume149
Issue number5
StatePublished - 1993
Externally publishedYes

Fingerprint

Urinary Tract
Artificial Urinary Sphincter
Stomach
Urinary Bladder
Bladder Exstrophy
Valsalva Maneuver
Intermittent Urethral Catheterization
Urination
Ureter
Infection

Keywords

  • artificial organs
  • bladder diseases
  • stomach
  • urinary incontinence
  • urinary tract

ASJC Scopus subject areas

  • Urology

Cite this

Ganesan, G. S., Nguyen, D. H., Adams, M. C., King, S. J., Rink, R. C., Burns, M. W., & Mitchell, M. E. (1993). Lower urinary tract reconstruction using stomach and the artificial sphincter. Journal of Urology, 149(5), 1107-1109.

Lower urinary tract reconstruction using stomach and the artificial sphincter. / Ganesan, G. S.; Nguyen, D. H.; Adams, M. C.; King, S. J.; Rink, R. C.; Burns, M. W.; Mitchell, M. E.

In: Journal of Urology, Vol. 149, No. 5, 1993, p. 1107-1109.

Research output: Contribution to journalArticle

Ganesan, GS, Nguyen, DH, Adams, MC, King, SJ, Rink, RC, Burns, MW & Mitchell, ME 1993, 'Lower urinary tract reconstruction using stomach and the artificial sphincter', Journal of Urology, vol. 149, no. 5, pp. 1107-1109.
Ganesan GS, Nguyen DH, Adams MC, King SJ, Rink RC, Burns MW et al. Lower urinary tract reconstruction using stomach and the artificial sphincter. Journal of Urology. 1993;149(5):1107-1109.
Ganesan, G. S. ; Nguyen, D. H. ; Adams, M. C. ; King, S. J. ; Rink, R. C. ; Burns, M. W. ; Mitchell, M. E. / Lower urinary tract reconstruction using stomach and the artificial sphincter. In: Journal of Urology. 1993 ; Vol. 149, No. 5. pp. 1107-1109.
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