Urethral lengthening and reimplantation: Incidence and management of catheterization problems

P. R. Waters, N. C. Chehade, K. A. Kropp, E. Shapiro, M. Horowitz, H. C. Sherz, Steven Skoog, Peroit, H. B. Lottmann, R. D. Jeffs, I. Oesch, J. J. Yoo, P. G. Duffy, P. A. Dewan, M. A. Koyle

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: Creation of a 1-way catheterizable valve has resulted in dryness for a large group of children with intractable urinary incontinence. We document the incidence, time course and management of catheterization problems in 49 children who underwent urethral lengthening and reimplantation for intractable incontinence. Materials and Methods: We reviewed the records of 21 boys and 28 girls who underwent urethral lengthening and reimplantation between 1982 and 1995. Catheterization problems were defined as the inability of the patient or a family member to pass the catheter, and divided into early only, late only, recurrent and persistent problems. Results: Of the 49 patients 46 had neurogenic incontinence secondary to myelomeningocele and 35 (72%) never had difficulty catheterizing. Of the 14 children (28%) who had difficulty 7 (50%) were boys and 7 (50%) were girls. Two children (4%) with early only difficult catheterization have had no further difficulties during the last 14 and 6 years, respectively. In 3 children (6%) late only difficult catheterization began 17, 24 and 35 months, respectively, after the original bladder neck surgery. These problems were solved by changing to a Coude catheter and/or avoiding over distension. The 7 patients (14%) with recurrent catheterization problems, some with long intervals between episodes, now catheterize easily. The 2 children (4%) with persistent problems required alternate access to the bladder. Conclusions: The majority of children (72%) who undergo urethral lengthening and reimplantation never have any difficulty catheterizing. Those in whom difficult catheterization develops can be treated with minimally invasive methods without compromising the goals of the original surgery.

Original languageEnglish (US)
Pages (from-to)1053-1057
Number of pages5
JournalJournal of Urology
Volume158
Issue number3 SUPPL.
DOIs
StatePublished - 1997
Externally publishedYes

Fingerprint

Replantation
Catheterization
Incidence
Urinary Bladder
Catheters
Time Management
Meningomyelocele
Urinary Incontinence

Keywords

  • Replantation
  • Urethra
  • Urinary catheterization

ASJC Scopus subject areas

  • Urology

Cite this

Waters, P. R., Chehade, N. C., Kropp, K. A., Shapiro, E., Horowitz, M., Sherz, H. C., ... Koyle, M. A. (1997). Urethral lengthening and reimplantation: Incidence and management of catheterization problems. Journal of Urology, 158(3 SUPPL.), 1053-1057. https://doi.org/10.1016/S0022-5347(01)64387-8

Urethral lengthening and reimplantation : Incidence and management of catheterization problems. / Waters, P. R.; Chehade, N. C.; Kropp, K. A.; Shapiro, E.; Horowitz, M.; Sherz, H. C.; Skoog, Steven; Peroit; Lottmann, H. B.; Jeffs, R. D.; Oesch, I.; Yoo, J. J.; Duffy, P. G.; Dewan, P. A.; Koyle, M. A.

In: Journal of Urology, Vol. 158, No. 3 SUPPL., 1997, p. 1053-1057.

Research output: Contribution to journalArticle

Waters, PR, Chehade, NC, Kropp, KA, Shapiro, E, Horowitz, M, Sherz, HC, Skoog, S, Peroit, Lottmann, HB, Jeffs, RD, Oesch, I, Yoo, JJ, Duffy, PG, Dewan, PA & Koyle, MA 1997, 'Urethral lengthening and reimplantation: Incidence and management of catheterization problems', Journal of Urology, vol. 158, no. 3 SUPPL., pp. 1053-1057. https://doi.org/10.1016/S0022-5347(01)64387-8
Waters PR, Chehade NC, Kropp KA, Shapiro E, Horowitz M, Sherz HC et al. Urethral lengthening and reimplantation: Incidence and management of catheterization problems. Journal of Urology. 1997;158(3 SUPPL.):1053-1057. https://doi.org/10.1016/S0022-5347(01)64387-8
Waters, P. R. ; Chehade, N. C. ; Kropp, K. A. ; Shapiro, E. ; Horowitz, M. ; Sherz, H. C. ; Skoog, Steven ; Peroit ; Lottmann, H. B. ; Jeffs, R. D. ; Oesch, I. ; Yoo, J. J. ; Duffy, P. G. ; Dewan, P. A. ; Koyle, M. A. / Urethral lengthening and reimplantation : Incidence and management of catheterization problems. In: Journal of Urology. 1997 ; Vol. 158, No. 3 SUPPL. pp. 1053-1057.
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abstract = "Purpose: Creation of a 1-way catheterizable valve has resulted in dryness for a large group of children with intractable urinary incontinence. We document the incidence, time course and management of catheterization problems in 49 children who underwent urethral lengthening and reimplantation for intractable incontinence. Materials and Methods: We reviewed the records of 21 boys and 28 girls who underwent urethral lengthening and reimplantation between 1982 and 1995. Catheterization problems were defined as the inability of the patient or a family member to pass the catheter, and divided into early only, late only, recurrent and persistent problems. Results: Of the 49 patients 46 had neurogenic incontinence secondary to myelomeningocele and 35 (72{\%}) never had difficulty catheterizing. Of the 14 children (28{\%}) who had difficulty 7 (50{\%}) were boys and 7 (50{\%}) were girls. Two children (4{\%}) with early only difficult catheterization have had no further difficulties during the last 14 and 6 years, respectively. In 3 children (6{\%}) late only difficult catheterization began 17, 24 and 35 months, respectively, after the original bladder neck surgery. These problems were solved by changing to a Coude catheter and/or avoiding over distension. The 7 patients (14{\%}) with recurrent catheterization problems, some with long intervals between episodes, now catheterize easily. The 2 children (4{\%}) with persistent problems required alternate access to the bladder. Conclusions: The majority of children (72{\%}) who undergo urethral lengthening and reimplantation never have any difficulty catheterizing. Those in whom difficult catheterization develops can be treated with minimally invasive methods without compromising the goals of the original surgery.",
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T2 - Incidence and management of catheterization problems

AU - Waters, P. R.

AU - Chehade, N. C.

AU - Kropp, K. A.

AU - Shapiro, E.

AU - Horowitz, M.

AU - Sherz, H. C.

AU - Skoog, Steven

AU - Peroit,

AU - Lottmann, H. B.

AU - Jeffs, R. D.

AU - Oesch, I.

AU - Yoo, J. J.

AU - Duffy, P. G.

AU - Dewan, P. A.

AU - Koyle, M. A.

PY - 1997

Y1 - 1997

N2 - Purpose: Creation of a 1-way catheterizable valve has resulted in dryness for a large group of children with intractable urinary incontinence. We document the incidence, time course and management of catheterization problems in 49 children who underwent urethral lengthening and reimplantation for intractable incontinence. Materials and Methods: We reviewed the records of 21 boys and 28 girls who underwent urethral lengthening and reimplantation between 1982 and 1995. Catheterization problems were defined as the inability of the patient or a family member to pass the catheter, and divided into early only, late only, recurrent and persistent problems. Results: Of the 49 patients 46 had neurogenic incontinence secondary to myelomeningocele and 35 (72%) never had difficulty catheterizing. Of the 14 children (28%) who had difficulty 7 (50%) were boys and 7 (50%) were girls. Two children (4%) with early only difficult catheterization have had no further difficulties during the last 14 and 6 years, respectively. In 3 children (6%) late only difficult catheterization began 17, 24 and 35 months, respectively, after the original bladder neck surgery. These problems were solved by changing to a Coude catheter and/or avoiding over distension. The 7 patients (14%) with recurrent catheterization problems, some with long intervals between episodes, now catheterize easily. The 2 children (4%) with persistent problems required alternate access to the bladder. Conclusions: The majority of children (72%) who undergo urethral lengthening and reimplantation never have any difficulty catheterizing. Those in whom difficult catheterization develops can be treated with minimally invasive methods without compromising the goals of the original surgery.

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KW - Replantation

KW - Urethra

KW - Urinary catheterization

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