신경탓 방광 환자에서의 회장을 이용한 Goodwin형 방광 확대술의 임상 경험

Abstract

PURPOSE: We evaluated the long-term outcomes in patients undergoing augmentation ileocystoplasty with Goodwin(')s ileal cup patched bladder. MATERIALS AND METHODS: This was a retrospective study of 72 consecutive patients who underwent augmentation ileocystoplasty because of decreased bladder capacity, vesico-ureteral reflux and urinary incontinence. The outcomes assessed included the continence status, bladder capacity, upper tract status, and significant post-operative complications. RESULTS: The 72 patients studied(61 men and 11 women) were 12 to 62 years old(mean age 35.6). The follow up was 0.3 to 7.9 years(mean 5.4). The preoperative diagnoses were a neurogenic bladder from spinal cord injury in 54 patients, meningomyelocele in 5, pelvic trauma in 3, polymyelitis in 2, GU tuberculosis in 2, cerebrovascular diseases in 2, and disc rupture in 2. The bladder capacity was significantly increased from 168cc to 392cc postoperatively and the maximal bladder capacity was increased along with the decreased number of daily clean intermittent catheterizations. The most common complication related to surgery was a paralytic ileus. While most cases of unilateral reflux disappeared, bilateral or high grade reflux remained during the postoperative follow up period. CONCLUSIONS: Bladder augmentation provided durable clinical and urodynamic improvement for patients with neurogenic and contracted bladders