A retrospective review of the long term clinical outcomes of patients with neurogenic lower urinary tract dysfunction following transverse myelitis.

Aims: Transverse myelitis (TM) is an inflammation of the spinal cord which causes neurological deficit in motor, sensory, and autonomic pathways. Persistent neurogenic lower urinary tract dysfunction (NLUTD) is common even where motor and sensory impairment is recovered. Long term follow-up is required to ensure optimal bladder management and protection of the upper tracts.

Radiotherapy is associated with reduced continence outcomes following implantation of the artificial urinary sphincter in men with post-radical prostatectomy incontinence.

Objectives: The objective of this study is to present the outcomes of men undergoing implantation of artificial urinary sphincter, after treatment for prostate cancer and also to determine the effect of radiotherapy on continence outcomes after artificial urinary sphincter (AUS) implantation.

Materials And Methods: A prospectively acquired database of all 184 patients having AUS insertion between 2002 and 2012 was reviewed, and demographic data, mode of prostate cancer treatment(s) before implantation, and outcome in terms of complete continence (pad free, leak free) were assessed. Statistical analysis was performed by Chi-squared and Fisher's exact tests.

The uses and outcomes of the Martius fat pad in female urology.

Purpose: To assess the indications, morbidity, efficacy and outcomes of Martius fat pad (MFP) interposition in reconstructive female urology.

Materials And Methods: Data on 159 women with MFP interposition as part of their primary procedure between 2 September 2005 and 2 July 2015 were prospectively collected. Patient demographics and the indications for MFP interposition along with the outcomes of their primary procedures and short- and long-term complications related to the MFP, along with patient reported perception of post-operative appearance, were noted.

The Long-Term Outcome of the Turner-Warwick Vaginal Obturator Shelf Urethral Repositioning Colposuspension Procedure for Urodynamically Proven Stress Urinary Incontinence.

Objective: To analyze long-term continence, voiding dysfunction and secondary prolapse rates following Turner-Warwick Vaginal Obturator Shelf Urethral Repositioning colposuspension (VOSURP) for urodynamically proven stress urinary incontinence (USUI).

Patients And Methods: Telephone and/or outpatient review of the outcomes of 50 consecutive patients undergoing VOSURP between 1997 and 2008 was conducted. Outcomes assessed included urinary continence (pad free/leak free), need to self-catheterise (ISC), secondary posterior pelvic organ prolapse (POP) development and need for further continence and POP-related surgical interventions.

Long-term efficacy of polydimethylsiloxane (Macroplastique) injection for Mitrofanoff leakage after continent urinary diversion surgery.

Objective: To assess the long-term efficacy of polydimethylsiloxane (Macroplastique) injection (MPI) in the treatment of Mitrofanoff leakage secondary to valve incompetence.

Patients And Methods: Between 1995 and 2012, the records of 24 consecutive patients who underwent MPI for Mitrofanoff urinary leakage after continent cutaneous urinary diversion (CCUD) surgery were examined. All patients had a valve deemed of sufficient length (>2 cm) to attempt Macroplastique coaptation.

Long-term outcomes of augmentation ileocystoplasty in patients with spinal cord injury: a minimum of 10 years of follow-up.

Objective: To report the long-term outcomes of augmentation ileocystoplasty (AIC) in patients with spinal cord injury (SCI), with a minimum follow-up period of 10 years.

Patients And Methods: We retrospectively analysed all operations performed by a single surgeon at a specialist spinal unit. Outcomes were measured by comparing preoperative and follow-up videocystometrograms (VCMGs).

A 20-year follow-up of the mesh wallstent in the treatment of detrusor external sphincter dyssynergia in patients with spinal cord injury.

Objective: To assess the long-term (20 years) effectiveness of the UroLume wallstent(TM) (Pfizer Inc., UK) in the treatment of detrusor external sphincter dyssynergia (DESD) in patients with spinal cord injury (SCI).

Patients And Methods: Twelve patients with quadriplegia secondary to SCI underwent external striated sphincter stenting with the UroLume wallstent in place of sphincterotomy for DESD ≈ 20 years ago.

Long-term outcome of tension-free vaginal tape for treating stress incontinence in women with neuropathic bladders.

Objective: To evaluate the long-term safety and efficacy of the tension-free vaginal tape (TVT) for the treatment of stress urinary incontinence (SUI) in women with neuropathic bladder dysfunction.

Patients And Methods: Twelve women (mean age 53.3 years, range 41-80) with neuropathic bladder dysfunction and SUI confirmed by video-cystometrography (VCMG) were treated with a TVT in one institution by an expert neuro-urologist between November 1997 and December 2000.

Patients' perspective of botulinum toxin-A as a long-term treatment option for neurogenic detrusor overactivity secondary to spinal cord injury.

Objective: To evaluate patients' perspective on whether they would consider botulinum toxin-A (BTX-A) injections as a long-term treatment option for managing their neurogenic detrusor overactivity (NDO) secondary to spinal cord injury (SCI).

Patients And Methods: In all, 72 patients with SCI and urodynamically confirmed NDO refractory to anticholinergics, who have had at least one or more injections with BTX-A were invited to participate in a 5-min telephone questionnaire covering various aspects of their treatment. Questions about patient satisfaction were rated on a scale from 1 to 10 (1, not satisfied; to 10, very satisfied).

A tertiary experience of urethral diverticulectomy: diagnosis, imaging and surgical outcomes.

OBJECTIVE To review the outcomes of consecutive patients referred with urethral diverticula to a tertiary centre; to investigate the diagnostic, imaging and surgical factors relevant to success. PATIENTS AND METHODS A retrospective case note review of 30 consecutive patients treated between January 1999-2007 was performed and data retrieved on demographics, presenting symptoms, preoperative imaging, surgical technique, outcomes and need for further intervention. RESULTS All patients were tertiary referrals, four after failed local repairs.

A tertiary experience of vesico-vaginal and urethro-vaginal fistula repair: factors predicting success.

Objective: To review the outcomes of all patients referred with vesico-vaginal (V VF) and urethro-vaginal (UVF) fistulae to a tertiary centre, and to investigate the patient, fistula and surgical factors relevant to success.

Patients And Methods: We reviewed retrospectively the case-notes of 41 consecutive patients (32 with V VF; nine with UVF) treated between January 2000 and January 2006.

Results: All patients were tertiary referrals, eight after failed local repairs.

Effects of spinal cord injury on semen parameters.

Objective/background: Neurogenic reproductive dysfunction in men with spinal cord injury (SCI) is common and the result of a combination of impotence, ejaculatory failure, and abnormal semen characteristics. It is well established that the semen quality of men with SCI is poor and that changes are seen as early as 2 weeks after injury. The distinguishing characters of poor quality are abnormal sperm motility and viability.

An effective day case treatment combination for refractory neuropathic mixed incontinence.

Objective: Women with drug refractory neurogenic mixed incontinence (NMI) have limited minimally invasive treatment options and require reconstructive surgery. We examined efficacy of a combination of day case intradetrusor (ID) botulinum toxin (BTX-A) bladder injections and transobturator (TOT) or tension free vaginal tape (TVT).

Materials And Methods: Eleven women who are pharmacotherapy intolerant or who have drug refractory NMI were treated.

Management of detrusor-external sphincter dyssynergia.

Detrusor-external sphincter dyssynergia (DSD) is a debilitating problem in patients with spinal cord injury. DSD carries a high risk of complications, and even life expectancy can be affected. The mainstay of treatment is the use of antimuscarinic medication and catheterization, but in those for whom this is not possible external sphincterotomy has been the traditional management route.

Botulinum toxin-type A in the treatment of drug-resistant neurogenic detrusor overactivity secondary to traumatic spinal cord injury.

Objective: To assess, in a prospective study, whether botulinum toxin-type A (BTX-A) injected into the detrusor muscle, can be used as a day-case treatment for drug-resistant neurogenic detrusor overactivity (NDO) in patients with spinal cord injury (SCI).

Patients And Methods: BTX-A (Dysport, Ipsen, Luxembourg; 1000 units) was injected cystoscopically into the detrusor muscle of 37 patients with drug-resistant NDO and SCI, as a day-case procedure. The maximum cystometric capacity (MCC), maximum detrusor pressure (MDP), NDO, continence, and anticholinergic requirement were used as outcome variables.

Lower urinary tract dysfunction in ambulatory patients with incomplete spinal cord injury.

Purpose: We evaluated urinary tract dysfunction in individuals with spinal injury who remained able to ambulate. We observed changes with time in urological management.

Materials And Methods: All patients attending outpatient clinics with traumatic, incomplete (American Spinal Injury Association grades D and E) spinal cord injury during a 2-year period were identified.

Long-term results of a self-expanding wallstent in the treatment of urethral stricture.

Objective: To report the long-term outcome over 12 years of using the urethral Urolume wallstent (AMS, Minnetonka, MI, USA) for treating recurrent bulbar urethral stricture disease.

Patients And Methods: The case-notes of 60 consecutive men with urethral Urolume wallstents placed for treating recurrent bulbar strictures were reviewed retrospectively. Information was collected on patient demographics, stricture aetiology, stent-related complications and the need for further surgery to treat stent- or stricture-related complications.

Variation in urological practice amongst spinal injuries units in the UK and Eire.

Aims: To investigate variations in common urological practice between the Spinal Injuries Units (SIU) of UK and Eire.

Methods: In December 2002, each of the 12 SIU in the UK and Eire were sent a questionnaire addressing basic practice relating to urological outpatient follow-up, management of urinary tract infection, upper tract surveillance, and urodynamic studies.

Results: Regarding frequency of urological review, two units only saw patients when specifically required.

Management of the neuropathic bladder.

Neurological injury and disease are common, and intimately related to abnormalities of the urinary system. The prevention and treatment of urological sequelae in patients with neurological injury or disease requires a clear multidisciplinary management strategy.