$Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study$
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Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study

Abstract Objectives To report the long-term efficacy and complications of the augmentation uretero-enterocystoplasty (AUEC), including augmentation cystoplasty with simultaneous ureteroplasty and ureteral anti-reflux implantation in a single center. Methods We retrospectively reviewed clinical recor...

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Autores principales:	Xiaoqian Ying, Limin Liao
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Augmentation cystoplasty Refractory bladder dysfunction Ureteral re-implantation Efficacy Complications Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/20ce7cbc2cdc4274a0a81a062f9f7067
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spelling	oai:doaj.org-article:20ce7cbc2cdc4274a0a81a062f9f70672021-12-05T12:19:53ZAugmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study10.1186/s12894-021-00927-z1471-2490https://doaj.org/article/20ce7cbc2cdc4274a0a81a062f9f70672021-11-01T00:00:00Zhttps://doi.org/10.1186/s12894-021-00927-zhttps://doaj.org/toc/1471-2490Abstract Objectives To report the long-term efficacy and complications of the augmentation uretero-enterocystoplasty (AUEC), including augmentation cystoplasty with simultaneous ureteroplasty and ureteral anti-reflux implantation in a single center. Methods We retrospectively reviewed clinical records, video-urodynamic data, and magnetic resonance urography of 210 patients who underwent the procedure for refractory lower urinary tract dysfunction (LUTD) from 2003 to 2019. International vesicoureteral reflux (VUR) and upper urinary tract dilatation (UUTD) grading systems were applied to assess upper urinary tract function, and post-operative complications were assessed. Results Mean age was 28.1 years, with a mean follow-up time of 57.4 months. A total of 338 ureters were simultaneously re-implanted, and ureteroplasty was performed on all ureters. There was a significant postoperative improvement in the bladder capacity, intravesical pressure, and compliance (P < 0.05). VUR improvement rate was 97.7% and postoperative improvement of UUTD presented in 72.5% ureters. Mean serum creatinine (Scr) level was significantly improved compared to preoperative Scr values (226.0 ± 89.4 μmol/L vs. 217.5 ± 133.9 umol/L, P < 0.05). The 1.0% patients had unacceptably postoperative urinary incontinence and 85.4% preoperative megaureters were improved. Primary complications included metabolic acidosis (9.5%), vesicoureteral anastomosis stenosis (6.2%), persistent VUR (2.7%), urinary calculi (6.6%), and intestinal dysfunction requiring laparotomy (3.3%). Conclusion In the study, a large series of patients treated with a complex surgical procedure was reported. It is novel, as this case series represents patients with aggressive surgical correction of VUR, ureteral tortuosity and upper tract dilation at the time of AC. AUEC was shown to have a positive role in treating patients with refractory LUTD associated with hydronephrosis and ureteral dilatation, stenosis or obstruction, with or without high- or low-pressure VUR. It was effective in improving renal function and protecting the UUT function from further deterioration in most patients with renal insufficiency.Xiaoqian YingLimin LiaoBMCarticleAugmentation cystoplastyRefractory bladder dysfunctionUreteral re-implantationEfficacyComplicationsDiseases of the genitourinary system. UrologyRC870-923ENBMC Urology, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Augmentation cystoplasty Refractory bladder dysfunction Ureteral re-implantation Efficacy Complications Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Augmentation cystoplasty Refractory bladder dysfunction Ureteral re-implantation Efficacy Complications Diseases of the genitourinary system. Urology RC870-923 Xiaoqian Ying Limin Liao Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study
description	Abstract Objectives To report the long-term efficacy and complications of the augmentation uretero-enterocystoplasty (AUEC), including augmentation cystoplasty with simultaneous ureteroplasty and ureteral anti-reflux implantation in a single center. Methods We retrospectively reviewed clinical records, video-urodynamic data, and magnetic resonance urography of 210 patients who underwent the procedure for refractory lower urinary tract dysfunction (LUTD) from 2003 to 2019. International vesicoureteral reflux (VUR) and upper urinary tract dilatation (UUTD) grading systems were applied to assess upper urinary tract function, and post-operative complications were assessed. Results Mean age was 28.1 years, with a mean follow-up time of 57.4 months. A total of 338 ureters were simultaneously re-implanted, and ureteroplasty was performed on all ureters. There was a significant postoperative improvement in the bladder capacity, intravesical pressure, and compliance (P < 0.05). VUR improvement rate was 97.7% and postoperative improvement of UUTD presented in 72.5% ureters. Mean serum creatinine (Scr) level was significantly improved compared to preoperative Scr values (226.0 ± 89.4 μmol/L vs. 217.5 ± 133.9 umol/L, P < 0.05). The 1.0% patients had unacceptably postoperative urinary incontinence and 85.4% preoperative megaureters were improved. Primary complications included metabolic acidosis (9.5%), vesicoureteral anastomosis stenosis (6.2%), persistent VUR (2.7%), urinary calculi (6.6%), and intestinal dysfunction requiring laparotomy (3.3%). Conclusion In the study, a large series of patients treated with a complex surgical procedure was reported. It is novel, as this case series represents patients with aggressive surgical correction of VUR, ureteral tortuosity and upper tract dilation at the time of AC. AUEC was shown to have a positive role in treating patients with refractory LUTD associated with hydronephrosis and ureteral dilatation, stenosis or obstruction, with or without high- or low-pressure VUR. It was effective in improving renal function and protecting the UUT function from further deterioration in most patients with renal insufficiency.
format	article
author	Xiaoqian Ying Limin Liao
author_facet	Xiaoqian Ying Limin Liao
author_sort	Xiaoqian Ying
title	Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study
title_short	Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study
title_full	Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study
title_fullStr	Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study
title_full_unstemmed	Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study
title_sort	augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/20ce7cbc2cdc4274a0a81a062f9f7067
work_keys_str_mv	AT xiaoqianying augmentationureteroenterocystoplastyforrefractoryurinarytractdysfunctionalongtermretrospectivestudy AT liminliao augmentationureteroenterocystoplastyforrefractoryurinarytractdysfunctionalongtermretrospectivestudy
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Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study

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