Page 140 - Bladder Dysfunction in the Context of the Bladder-Brain Connection - Ilse Groenendijk.pdf
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Chapter 7
Patients with neurogenic bladder (n=26)
Underlying diagnoses and indications are shown in table 1. One patient showed no blad- der activity during urodynamic evaluation after severe traumatic pelvic injury.
Patients with non-neurogenic bladder (n=15)
Underlying diagnoses and indications are shown in table 1. Furthermore, one patient had severe dysfunctional voiding with residual micturition and progressive kidney insufficiency. One patient had a conversion disorder, three other patients had a hypo- contractile bladder.
Complications and reoperations
The overall reoperation rate was 48.8% (n=20) with a median of 10.5 months (IQR 4.5 – 30.8) after constructing the CCUC. This concerned 13 patients (50%) with neurogenic bladder and 6 patients (40%) with non-neurogenic bladder. There was no difference in the amount complications between the two centers.
From all complications superficial stenosis was by far the most common registered complication (20 times), followed by stomal incontinence (10 times). Stenosis at conduit- bladder lever occurred 4 times and stomal pain was considered a complication 3 times. Urosepsis occurred 3 times and urethral incontinence occurred twice. Stoma revision was the most performed reoperation (12 times) followed by conduit replacement (6 times). Complications and reoperations of patients with a neurogenic bladder are detailed in table 2, complications and reoperations of patients with a non-neurogenic bladder are detailed in table 3. Complications and reoperations could occur more than once in a patient.
Factors of influence
Factors potentially influencing the reoperation rate were analyzed. The probability of reoperation was significantly higher for patients above the age of 32 years compared with younger patients (Chi-square test p=0.043).
For BMI above or under the median BMI of 25, the Chi-square test was not statistically significant (p=0.431). BMI was missing in 14 cases.
Questionnaire
The questionnaire was sent to 32 of the 41 patients. Reasons not sending the question- naire to 9 patients were: the stoma had already surgically been closed (n=4), permanent catheter in the stoma (n=2) and death, unrelated to the CCUC (n=3). The response rate was 24/32 (75%) of which 5 were males, the rest were females. The median PGI-I rating was 2 (much better) and all but two of the patients who had returned the questionnaire (22/24) would recommend this surgery to others in a comparable situation. See table 4





















































































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