Published in:
01-12-2016 | Neurogenic Bladder (C Powell, Section Editor)
Cystectomy for Neurogenic Bladder
Authors:
Elizabeth Timbrook Brown, Joshua A. Cohn, Melissa R. Kaufman, Douglas Milam, Roger R. Dmochowski, W. Stuart Reynolds
Published in:
Current Bladder Dysfunction Reports
|
Issue 4/2016
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Abstract
Patients with a myriad of neurologic conditions can develop urinary symptoms as a result of impaired bladder function. Conservative management options for neurogenic bladder (NGB) may include catheterization and medical therapy. However, refractory individuals may require more aggressive intervention such as onabotulinumtoxinA injections or bladder augmentation. As a last resort, urinary diversion may be indicated for end-stage lower urinary tract dysfunction secondary to NGB. Urinary diversion may be performed with or without cystectomy. However, leaving the defunctionalized bladder in situ may lead to pyocystis, secondary carcinoma, or pain. As a result, there has been an increasing trend to perform a concomitant cystectomy at the time of urinary diversion. While this eliminates the sequelae of the retained bladder, performing a cystectomy at the time of urinary diversion can also increase the morbidity of the procedure.