NDLI: Long-term fate of the bladder after isolated bladder neck procedure.

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Long-term fate of the bladder after isolated bladder neck procedure.

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Long-term fate of the bladder after isolated bladder neck procedure.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Whittam, Benjamin Szymanski, Konrad Misseri, Rosalie Carroll, Aaron Kaefer, Martin Rink, Richard Cain, Mark
Description	Author Affiliation: Whittam B ( Division of Pediatric Urology, Riley Hospital for Children at Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN 46202, USA. Electronic address: bwhittam@iupui.edu.); Szymanski K ( Division of Pediatric Urology, Riley Hospital for Children at Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN 46202, USA.); Misseri R ( Division of Pediatric Urology, Riley Hospital for Children at Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN 46202, USA.); Carroll A ( Division of Pediatric Urology, Riley Hospital for Children at Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN 46202, USA.); Kaefer M ( Division of Pediatric Urology, Riley Hospital for Children at Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN 46202, USA.); Rink R ( Division of Pediatric Urology, Riley Hospital for Children at Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN 46202, USA.); Cain M ( Division of Pediatric Urology, Riley Hospital for Children at Indiana University School of Medicine, 705 Riley Hospital Drive, Suite 4230, Indianapolis, IN 46202, USA.)
Abstract	OBJECTIVE: Recent and historical studies suggest that bladder neck procedures (BNPs) without augmentation are safe and effective. In select patients we have performed BNPs without concomitant augmentation. We sought to determine long-term outcomes of this approach and attempt to identify risk factors for bladder deterioration. PATIENTS AND METHODS: A retrospective chart review was conducted to identify patients who underwent a BNP without bladder augmentation and followed for at least 4 years. BNPs were only performed in patients with favorable preoperative urodynamics (UDS). The charts were analyzed for long-term outcomes with the primary endpoint of bladder augmentation. RESULTS: Twenty-nine patients (21 females) with poor bladder outlet resistance underwent a BNP without augmentation (mean follow-up 8 years). Thirteen patients (45%) were augmented at an average of 2.6 years. No predictive UDS parameters were identified; however, exploratory analysis suggested detrusor pressure at 100 mL bladder volume prior to BNP (p = 0.009) was predictive of delayed augmentation. CONCLUSION: We report a 45% augmentation rate after isolated BNP in patients with favorable preoperative UDS parameters. We recommend close observation of this patient population with serial UDS, routine ultrasounds, and appropriate preoperative counseling prior to undertaking this approach, as this represents a life-long risk to the upper tracts.
File Format	HTM / HTML
ISSN	14775131
Issue Number	5
Volume Number	10
e-ISSN	18734898
Journal	Journal of Pediatric Urology
Language	English
Publisher	Elsevier
Publisher Date	2014-10-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Urology Discipline Pediatrics Urinary Bladder, Neurogenic Surgery Urinary Incontinence Adolescent Child Child, Preschool Compliance Female Follow-up Studies Humans Male Reoperation Retrospective Studies Time Factors Treatment Failure Complications Physiopathology Etiology Urodynamics Young Adult Journal Article
Content Type	Text
Resource Type	Article
Subject	Urology Pediatrics, Perinatology and Child Health

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