The Comparison Of Two Different Bladder Enlargement Procedures For Treatment Of Hyperreflexia Neurogenic Bladder

ObjectiveTo observe and compare the preliminary clinical results of two different bladder enlargement procedures for the treatment of hyperreflexia neurogenic bladder.MethodsTwenty-three (18 males and 5 females) pations with neurogenic bladder underwent bladder augmentation cystoplasty. The patients, mean age at operation was 31 years. Ten pations underwent auto-augmentation, Thirteen pations underwent ileocystoplasty.23 cases were followed up 6-24 months. Preoperative and follow-up, having ultrasound, MRU, renal function and urodynamic examination. The surgical techniques, pre- and post-operative bladder capacity and renal functions of the two kinds of operation were compared and analyzed retrospectively.ResultsIn operation time and anus exsufflation, auto-augmentation group is better than ileocystoplasty group. (P<0.05).After operation, the safe bladder capacity of the pations who underwent auto-augmentation and ileocystoplasty increased respectively (178.2±31.8 vs 420.7±54.9ml,115.9±19.5 vs 517.4±48.3ml, P<0.05), increased bladder capacity compared two groups were significantly different, the bladder compliance of two groups significantly increased. Among the patients with auto-augmentation, complete continence on clean intermittent catheterization was achieved in 8, and improved markedly in 1. The renal function became normal in 6 and improved significantly in 2.The hydronephrosis solved and the vesicoureteral reflux disappeared. Among the patients with ileocystoplasty, complete continence disappeared in 9, and improved markedly in 2.The renal function became normal in 6 and improved in 1. Significant relief or complete disappearance in hydronephrosis was observed and the vesicoureteral reflux disappeared. After operation, three patients had episodes of UTI, one patient had diarrhea, one patient experienced urine leakage, one patient had vesical calculus. All the complications improved after treatment.ConclusionsBladder auto-augmentation is simple and safe, but it should be choosed circumspectly; Ileocystoplasty has significant curative effect, but it has more complications.