Article

OBJECTIVES: To evaluate the efficacy and safety over a 10-year period of any
urological operations required by female patients with spinal cord lesions
(SCLs). METHODS: Retrospective study of urological surgeries from our database
performed on females with SCLs from 2001 to 2002. Surgery efficacy for neurogenic
lower urinary tract dysfunctions (N-LUTDs) was evaluated by comparing 7-day
voiding diaries pre- and post-surgeries, while individual investigations were
done pre- and post-surgery to evaluate urological complications. Drawbacks were
assessed. RESULTS: Thirty-eight out of 69 patients underwent one or more
urological procedures. Twenty-one out of 42 patients with suprasacral lesions
underwent interventions for N-LUTD. The main surgical treatment was endoscopic
detrusor infiltration of botulinum-A (Botox 300 UI or Dysport 750 UI) performed
107 times on 15 subjects using aseptic intermittent catheterizations for
neurogenic overactive bladder. Mean efficacy duration was 9.2 months. Six females
with infrasacral lesions underwent at least one intervention for N-LUTD. Two
females in each group underwent tension-free vaginal tape for stress urinary
incontinence (SUI), reducing episodes per week of SUI by >90% after 5 years. The
most serious urological complication was active vesico-ureteral reflux (VUR) in
three patients, treated endoscopically with submucosal injection of
Macroplastique. No VUR recurrence was detected during a 6-year follow-up. All
bladder stones (five cases) and renal calculi (five cases) were treated with
endoscopic transurethrally electrohydraulic lithotripsy and extracorporeal
shock-wave lithotripsy, respectively. Overall, no serious drawbacks were
observed. CONCLUSIONS: Mini-invasive surgeries were exclusively used to address
urological issues in chronic SCL patients.

Langue : ANGLAIS