Between July 1986 and February 1989,21 patients,age ranged from 5 to 13 years,were operated upon for areflexic or hyporeflexic bladder with urinary incontinence.17 followed operations for myelomeningocele and 4were cases of sacral agenesis.Some of them have been treated conservatively but failed.The detrusor of bladder was strengthened by covering with smooth muscle from a segment of ileum about 20-25 cm long.18 patients were followed up for three months to 21/2 years,and 13 obtained satisfactory results.Urodynamic evaluation was done in all cases preand post-operatively,that the non-myelinated nerves of the intestinal wall grew into the detrusor of the bladder was observed in animal experiments.The postoperative feeling of a special abdominal pain could be experienced as a sensation of bladder distention and urinary urgency,which might be resulted from the stretching of the intestinal smooth muscle.The failures of the operation were also discussed.%在1986年7月至1989年2月间收治21例无反射或低反射性神经性膀胱,表现为尿失禁,年龄5～13岁,其中17例为脊膜膨出术后,4例骶骨发育不全,部分病例经药物治疗和尿道扩张术无效.手术用20～25厘米长的去粘膜回肠段包绕在膀胱外以加强膀胱逼尿肌.18例随访时间自3月至2年6个月,其中13例治疗效果明显.
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