|Anquetil et al. 2016
|Population: Detrusor overactivity; Mean age: 41.9 yr; Gender: males=16, females=14; Level of injury: paraplegia=12, tetraplegia=18; Severity of injury: complete=23, incomplete=7; Mean time post-injury: 16.57 yr.
Intervention: Study participants had received either at least two successive botulinum therapy injections (BT) or augmentation enterocystoplasty (AC).
Outcome Measures: Method of bladder drainage, urinary incontinence, complications, maximum detrusor pressure, low compliance, maximum cystometric bladder capacity, Qualiveen-30.
|1. In the BT group, 12 used clean intermittent self-catheterization, 2 used clean intermittent catheterization, and 0 used indwelling catheterization, while in the AC group, 14 used clean intermittent self-catheterization, 1 used clean intermittent catheterization, and 1 used indwelling catheterization.
2. Urinary incontinence occurred more frequently in BT than AC (p=0.0187).
3. Four AC participants had postoperative complications while there were no complications for BT participants. No significant differences between groups were observed in terms of urinary lower tract infections.
4. Two participants had a high maximum detrusor pressure and one participant had low compliance in the BT group compared to none in the AC group.
5. Maximum cystometric bladder capacity in BT group was 418 mL compared to 550 mL in AC group.
6. The mean Qualiveen-30 score was significantly higher (worse) in BT group than in AC group (p=0.037).
|Reyblat et al. 2009
|Population: SCI=68; Mean age: 34 yr; Gender: males=55, females=18.
Intervention: Charts were reviewed for individuals who had previously undergone extraperitoneal augmentation (n=49) and intraperitoneal augmentation (n=24) to assess effectiveness.
Outcome Measures: Complication rate, operation time, bowel function, catheterization time.
|1. Overall complication rate was similar in both groups (extraperitoneal 37% versus intraperitoneal 42%).
2. Intraperitoneal group had a significantly higher operation time than the extraperitoneal group (p<0.0001).
3. Bowel function returned earlier in extraperitoneal group than the intraperitoneal group (p=0.0005).
4. No significant difference was seen between the groups in mean time to catheter removal.
|Krebs et al. 2016
|Population: Neurogenic lower urinary tract dysfunction; Mean age: 34 yr; Gender: males=17, females=12; Level of injury: paraplegia=26, tetraplegia=3; Severity of injury: incomplete=13, complete=16; Injury etiology: trauma=12, non-trauma=6, myelomeningocele=11.
Intervention: Partcipants had received supratrigonal cystectomy and augmentation ileocystoplasty.
Outcomes: Continence, detrusor relaxation therapy, maximum detrusor pressure, reflex volume, bladder capacity, detrusor compliance, maximum detrusor pressure >40 cm H2O, detrusor compliance <20 mL/cm H2O, risk of renal damage, complications.
|1. At a median follow-up of 2.4 yr post-operatively, compared to prior treatment, there was a significant increase in the number of continent participants (p=0.001) and a significant decrease in number of participants requiring detrusor relaxation therapy (p=0.02).
2. Compared to prior treatment, participants receiving treatment had significant increases in reflex volume (p=0.006), bladder capacity (p=0.001), and detrusor compliance (p=0.001).
3. Compared to prior treatment, there was a significantly lower number of participants with high detrusor pressure (p=0.001), low detrusor compliance (p=0.001), and risk of renal damage (p=0.001).
4. Of the 29 participants, complications were observed in 11 participants, with 6 participants requiring surgical interventions to resolve the complications.
|Perrouin-Verbe et al. 2016
|Population: Median age: 35 yr; Gender: males=7, females=22; Level of injury: cervical=17, thoracic=10, lumbar=2; Median time post-injury: 9 yr.
Intervention: Individuals unable to perform intermittent self-catheterization through the native urethra received continent cutaneous urinary diversion with a concomitant supratrigonal and augmentation enterocystoplasty.
Outcome Measures: Postoperative complications, duration of hospitalization, long-term complications, urethral continence, antimuscarinics, onabotulinum toxin A, detrusor overactivity, low bladder compliance, maximal cystometric capacity, maximal detrusor pressure, creatinine clearance, upper urinary tract dilation, quality of life.
|1. During the first month post-surgery, there were three minor complications, two major complications and no deaths.
2. The overall complication rate was 44.8% and the total reoperation rate was 24.1%.
3. Compared to before surgery, the number of participants with urethral incontinence (p=0.013), using antimuscarinics, using onabotulinum toxin A, with detrusor overactivity (p=0.0006), with low bladder compliance (p=0.05), and upper urinary tract dilation significantly decreased.
4. There was a significant increase for the median maximal cystometric capacity (p=0.021), a significant decrease for maximal detrusor pressure (p=0.05), and no significant difference in creatinine clearance.
5. Urethral continence was achieved in 96% of participants and quality of life was improved in 90%.
|Gobeaux et al. 2012
|Population: Mean age: 34.7±11.2 yr (range=14-68); Gender: males=30, females=31; Level of injury: Above T6=18, T6-12=32, Below T12=11; Injury etiology: Traffic accident=41, Defenestration=7, Spinal cord surgery=6, Sport=3, Firearm=3, Other=1.Mean time post-injury: 9.7±1.6 yr.
Intervention: Participants underwent supratrigonal cystectomy with Hautmann pouch surgery.
Outcome Measures: Total continence rate, surgery success, maximum cystometric capacity (MCC), mean compliance (MC), mean detrusor pressure (MDP), neurogenic detrusor overactivity (NDO), complication rate, incidence of bowel dysfunction.
|1. Continence was significantly improved for 52 of the 58 participants (89.7% (p<0.05)) and total continence was achieved in 74.1% of cases (N=43).
2. Mean MCC and MC after treatment significantly increased (p<0.05).
3. MDP before versus after treatment significantly decreased from 54.1 to 19.1cmH2O resp. (p<0.05).
4. Persistent NDO was evident in 36 participants (59%) pre-surgery versus 12 participants (20.7%) post-surgery (p<0.05).
5. The overall surgery complication rate was 37.7% (N=23) of which 82.6% were ≤ grade 2 (N=19).
|Chen & Kuo 2009
|Population: Mean age: 36.3 yr; Gender: males=36, females=4; mean follow up: 7.8 yr (range 1-14 yr); level of SCI – suprasacral: 33, sacral: 7; 95% of participants had incontinence.
Intervention: Augmentation enterocystoplasty surgery.
Outcome Measures: Urodynamic variables; adverse events.
|1. The bladder capacity improved from 115 to 513mL postoperatively (p<0.0001).
2. Bladder compliance also improved significantly (p<0.0001). Four participants could achieve continence while 29 required clean IC for bladder management.
|Chartier-Kastler et al. 2000b
|Population: Mean age: 36.5 yr; Gender: males=11, females=6; Level of injury: above T6=4, T6-T12=9, below T12=4; Severity of injury: complete=14, incomplete=3; Mean duration of SCI=7.5 yr.
Intervention: Participants underwent partial cystectomy with enterocystoplasty or detubularized clam cystoplasty.
Outcome Measures: Continence, maximal cystometric capacity, filling pressure, complications.
|1. 15 participants were completely continent postoperatively.
2. A significant increase in maximal cystometric capacity by 191% was seen (p<0.05).
3. Maximal filling pressure decreased by 72% (p<0.05).
4. No complications were encountered.
|Gurung et al. 2012
|Population: Mean age: 28.9 yr (range=12-52); Gender: male=12, female=7; Level of injury: Cervical=1, Thoracic=16, Lumbar=2; injury etiology: RTA (road traffic accident) (N=11), Fall (N=6), Gunshot (N=2); Mean time from injury to operation: 4.5 yr (range=0.3-22).
Intervention: Participants underwent augmentation ileocystoplasty (AIC), with follow-up at 3 mo, 1 yr, 5 yr and <10 yr.
Outcome Measures: Maximum cystometric capacity (MCC), Maximum detrusor pressure (MDP), Quality of life (QoL).
|1. Of the 26 participants who had undergone AIC before 1998, only 19 participants were available for long-term follow-up/analysis. Two participants died from unrelated causes.
2. Of the 17 participants, continence was reported in 15/17 participants (vs 0 before surgery).
3. MCC at the latest follow-up at>10 yr post-surgery increased significantly from an estimated preoperative mean of 229ml to a mean of 494ml (range=387-601 ml) (p<0.001).
4. MDP at the latest follow-up at >10 yr post-surgery, decreased significantly from a preoperative value of 81cmH2O to a mean of 28cmH2O (range=15-40 cmH20) (p<0.001).
5. Of the 14 participants who completed the questionnaire survey, 13/14 were satisfied with the outcome such that they would consider undergoing the procedure again and would recommend it to someone else.
|Quek & Ginsberg 2003
|Population: Individuals with SCI and bladder augmentation: Mean age: 29 yr; Gender: males=18, females=8.
Intervention: Bladder augmentation with a minimum of retrospective review of 4 yr. The majority of participants had this done in conjunction with various other continence or antireflux techniques.
Outcome Measures: Bladder capacity, maximum detrusor pressure, subsequent operations, bowel function, UTI, complications, satisfaction. Mean follow up=8 yr.
|1. There was a signficant increase in bladder capacity from preaugmentation to postaugmentation (p<0.001).
2. Mean maximum detrusor pressure decreased significantly (p<0.01).
3. No significant changes in bowel function were seen in 23 participants.
4. 88% of participants with previous symptomatic urinary infections had significant improvement in the frequency of infections.
5. Participants were very satisfied with the bladder augmentation and would recommend it to a friend.
|Nomura et al. 2002
|Population: SCI: Mean age: 29.0 yr; Gender: males=10, females=1; Level of injury: thoracic=11; Severity of injury: complete=10, incomplete=1; Injury etiology: trauma=10, transverse myelitis=1; Mean time post-injury=73.5 mo.
Intervention: Retrospective review of augmentation ileocystoplasty.
Outcome Measures: Bladder capacity, continence, complications.
|1. Bladder capacity increased significantly postoperatively (p<0.001).
2. All participants showed improvement in urinary incontinence.
3. Complications included:
· Transient paralytic ileus occurred in 4 participants.
· Wound infection occurred in 1 particpant.