نتائج تكبير المثانة لدى المرضى المصابين بمثانة عصبية ناجمة عن الأذيات للنخاع الشوكي الرضية
Abstract
هدف الدراسة: هو تحليل نتائج واختلاطات تكبير المثانة للمرضى المصابين بمثانة عصبية الناجمة عن أذية النخاع الشوكي الرضية .
المواد والطرائق: تم معالجة 18 مريضاً مصاباً بمثانة عصبية ناجمة عن أذية النخاع الشوكي بتكبير المثانة بقطعة من الأمعاء منذ عام 2005 في مشفى المواساة الجامعي . كان الهدف من المعالجة إيقاف الجذر المثاني الحالبي و تحسين السلس البولي و وظيفة الكلية و ذلك في الحالات كلها التي لم تستجب للمعالجة المحافظة . أجري لكل المرضى تقييم يوروديناميكي قبل و بعد الجراحة . أجري في كل الحالات تكنيك زرع الحالب بآلية مضادة للجذر . كما تم استخدام الأمعاء الدقيقة في كل الحالات كما هو منصوح في معظم المراجع . عولجت الحالات كلها لاحقا بالقثطرة الافراغية المتقطعة بعد العمل الجراحي .
إن تحسن السلس البولي و السعة المثانية الوظيفية في الحالات كلها و قد أثبت ذلك يور وديناميكيا . كل الاختلاطات التي تلت الجراحة عولجت بشكل محافظ .
إن تكبير المثانة بقطعة من الأمعاء يعد خياراً علاجياً جيدا للمثانة العصبية التشنجية و خاصة في حالات الجزر المثاني الحالبي المرافقة للمثانة العصبية الناجمة عن أذية النخاع الشوكي الرضية .
This study focuses on the retrospective analysis of augmenting Ileocystoplasty for a neurogenic bladder. The main objective of this research is to analyze the effects and complications of augmenting Ileocystoplasty on patients with neurogenic bladder due to spinal cord injury. Since 2005, we have treated 18 patients with neurogenic bladder due to SCI by augmenting Ileocystoplasty at Almuwasat University Hospital, Damascus. The purpose of the treatment is to stop vesicoureteral reflex (VUR) and/or amelioration of urinary incontinence and renal function. We have had an aerodynamic evaluation before and after surgery. In all cases, the antireflex operation was received simultaneously, and we used the small intestine in all cases as already recommended by most references. All cases performed clean intermittent self- catheterization postoperatively. Urinary incontinence has improved in all cases in the sense that the functional capacity is aerodynamically improved. Complications have occurred in patients with SCI, but they can be treated conservatively. To conclude, augmenting Ileocystoplasty is a good treatment option for contracted bladder or VUR, which occurs in patients with a neurogenic bladder due to spinal cord injuries.
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