There was a total of 51, a total of 51 patients underwent bladder augmentation from January 2011 and October 2017 (n=12) or urinary diversion (ileal conduit: n=31, continent catheterisable reservoir, n=8) for NLUTD.
Of the 51 patients, mean age was 47 years (standard deviation ±16 years) and 25 (49%) were women. 20 patients suffered from spinal cord injury, 14 from multiple sclerosis, 8 from spina bifida, and 9 from other neurological disorders. Before bladder augmentation, patients were treated with 2 to 3 different antimuscarinics and with 2 to 16 intradetrusor onabotulinumtoxinA injection cycles. All patients with urinary diversion underwent cystectomy. Reasons for ileal conduit and decisions against continent catheterisable reservoir were severely impaired hand (n=18) or cognitive (n=8) function making intermittent self-catheterization impossible, renal failure in 3 and patients’ preference in 2 patients.
Despite the triumphal era of onabotulinumtoxinA treatment in neuro-urology, there is still a place for bladder augmentation and urinary diversion in very selected patients with refractory NLUTD. Thus, meticulous knowledge transfer to upcoming neuro-urologists is of utmost importance to guarantee optimal treatment for prospective neuro-urological patients.
Presented by: Mirjam Bywater, Department of Neuro Urology, Balgrist University Hospital, University of Zürich, Zürich
Co-Authors; Fröhlich M2, Eberli D2, Kessler T M1
1. Department of Neuro Urology, Balgrist University Hospital, University of Zürich, Zürich, 2. Department of Urology, University Hospital of Zürich, University of Zürich, Zürich
Written by: Bilal Farhan, MD; Clinical Instructor, Female Pelvic Medicine and Reconstructive Surgery, University of California, Irvine Medical Center, Twitter: @Bilalfarhan79 at the 2018 ICS International Continence Society Meeting - August 28 - 31, 2018 – Philadelphia, PA USA