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Satisfaction with Surgical Procedures and Bladder Management of Chronic Spinal Cord Injured Patients with Voiding Dysfunction Who Desire Spontaneous Voiding

We aimed to investigate treatment outcome and satisfaction with bladder outlet surgeries and bladder management in patients with spinal cord injury (SCI), voiding dysfunction, and to seek a spontaneous voiding or reflex voiding program. A total of 261 patients were included in this retrospective stu...

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Autores principales: Wu, Shu-Yu, Kuo, Hann-Chorng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604585/
https://www.ncbi.nlm.nih.gov/pubmed/36294890
http://dx.doi.org/10.3390/jpm12101751
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author Wu, Shu-Yu
Kuo, Hann-Chorng
author_facet Wu, Shu-Yu
Kuo, Hann-Chorng
author_sort Wu, Shu-Yu
collection PubMed
description We aimed to investigate treatment outcome and satisfaction with bladder outlet surgeries and bladder management in patients with spinal cord injury (SCI), voiding dysfunction, and to seek a spontaneous voiding or reflex voiding program. A total of 261 patients were included in this retrospective study. The mean age at surgical procedure was 49.2 ± 15.9 years; the median follow-up period was 11 (IQR 6, 17) years; 119 received a urethral Botox injection, 41 underwent transurethral incision of the bladder neck (TUI-BN), 77 underwent transurethral incision or resection of the prostate (TUI-P or TUR-P), and 24 had an external sphincterotomy. Satisfactory surgical outcome was reported by 80.5% of patients undergoing TUI-BN, 70.8% undergoing external sphincterotomy, 64.9% receiving TUI-P or TUR-P, and 59.7% receiving the urethral Botox injection. Persistent dysuria was the most common reason for dissatisfaction after the urethral Botox injection (73.1%) and TUI-BN (58.5%). Recurrent urinary tract infection continued in most patients after any type of surgery (all >75%). Most patients with SCI were satisfied with their initial bladder outlet operation in facilitating spontaneous voiding. However, repeat, or multiple surgical interventions were needed in 65.5% of SCI patients to achieve satisfactory voiding. A correct diagnosis is very important before every intervention and bladder management to reach the best satisfaction. VUDS is suggested before surgical procedures to ensure efficacy, even in patients with the same level of SCI.
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spelling pubmed-96045852022-10-27 Satisfaction with Surgical Procedures and Bladder Management of Chronic Spinal Cord Injured Patients with Voiding Dysfunction Who Desire Spontaneous Voiding Wu, Shu-Yu Kuo, Hann-Chorng J Pers Med Article We aimed to investigate treatment outcome and satisfaction with bladder outlet surgeries and bladder management in patients with spinal cord injury (SCI), voiding dysfunction, and to seek a spontaneous voiding or reflex voiding program. A total of 261 patients were included in this retrospective study. The mean age at surgical procedure was 49.2 ± 15.9 years; the median follow-up period was 11 (IQR 6, 17) years; 119 received a urethral Botox injection, 41 underwent transurethral incision of the bladder neck (TUI-BN), 77 underwent transurethral incision or resection of the prostate (TUI-P or TUR-P), and 24 had an external sphincterotomy. Satisfactory surgical outcome was reported by 80.5% of patients undergoing TUI-BN, 70.8% undergoing external sphincterotomy, 64.9% receiving TUI-P or TUR-P, and 59.7% receiving the urethral Botox injection. Persistent dysuria was the most common reason for dissatisfaction after the urethral Botox injection (73.1%) and TUI-BN (58.5%). Recurrent urinary tract infection continued in most patients after any type of surgery (all >75%). Most patients with SCI were satisfied with their initial bladder outlet operation in facilitating spontaneous voiding. However, repeat, or multiple surgical interventions were needed in 65.5% of SCI patients to achieve satisfactory voiding. A correct diagnosis is very important before every intervention and bladder management to reach the best satisfaction. VUDS is suggested before surgical procedures to ensure efficacy, even in patients with the same level of SCI. MDPI 2022-10-21 /pmc/articles/PMC9604585/ /pubmed/36294890 http://dx.doi.org/10.3390/jpm12101751 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wu, Shu-Yu
Kuo, Hann-Chorng
Satisfaction with Surgical Procedures and Bladder Management of Chronic Spinal Cord Injured Patients with Voiding Dysfunction Who Desire Spontaneous Voiding
title Satisfaction with Surgical Procedures and Bladder Management of Chronic Spinal Cord Injured Patients with Voiding Dysfunction Who Desire Spontaneous Voiding
title_full Satisfaction with Surgical Procedures and Bladder Management of Chronic Spinal Cord Injured Patients with Voiding Dysfunction Who Desire Spontaneous Voiding
title_fullStr Satisfaction with Surgical Procedures and Bladder Management of Chronic Spinal Cord Injured Patients with Voiding Dysfunction Who Desire Spontaneous Voiding
title_full_unstemmed Satisfaction with Surgical Procedures and Bladder Management of Chronic Spinal Cord Injured Patients with Voiding Dysfunction Who Desire Spontaneous Voiding
title_short Satisfaction with Surgical Procedures and Bladder Management of Chronic Spinal Cord Injured Patients with Voiding Dysfunction Who Desire Spontaneous Voiding
title_sort satisfaction with surgical procedures and bladder management of chronic spinal cord injured patients with voiding dysfunction who desire spontaneous voiding
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604585/
https://www.ncbi.nlm.nih.gov/pubmed/36294890
http://dx.doi.org/10.3390/jpm12101751
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