Page 145 - Bladder Dysfunction in the Context of the Bladder-Brain Connection - Ilse Groenendijk.pdf

Long-term results of continent catheterizable urinary channels 143
a CCUC or not. Nine patients were, at the time of data collection, not using their CCUC anymore. Hopefully, this study contributes to make a better patient selection.
Besides the patient-related risk factors, other factors might influence the risk of complications, such as the quality of pre- and post-operative care. This quality can be enhanced by the availability of a specialized nursing team creating optimization of instructions and practice of self-catheterization.
One of the strengths of this study is the use of a questionnaire, which provided more insight in patients’ opinions, which appeared positive despite the high reoperation rate. Obvious limitations include the limited patient numbers and the retrospective character of the collected data. Furthermore, we did not send the questionnaire to the patients who did no longer use the CCUC and had received new treatments. Therefore, the questionnaire results on the use of the CCUC may have been biased to some extent, and these results may be questioned. Nine out of 24 patients stated that they had some urethral leakage during the past two weeks. Five of these had undergone a concomitant ileocystoplasty, all females. We cannot differentiate between a preexistent stress urinary incontinence or an incontinence due to a low capacity based on this question. Bladder capacity was measured using urodynamics in every patient before the construction of a CCUC, and an ileocystoplasty was constructed if the bladder capacity was low.
In conclusion, the construction of a continent catheterizable urinary channel in adults comes with a relatively high number of complications, no risk factors could be identified yet. In the context of shared decision making, both the urologist and the patient should carefully consider the risk of failure of the constructed CCUC, the reported results of the questionnaire and the paucity of other options. Prospective studies with larger cohorts will be needed to identify predicting factors for complications.
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