The treatment of catheterizable stomal incontinence with endoscopic implantation of dextranomer/hyaluronic acid.

摘要

PURPOSE: The creation of a catheterizable stoma has revolutionized the management of complex bladder reconstruction. Unfortunately, urinary incontinence per catheterizable stoma is seen in some patients. We present our experience with the use of submucosal implantation of dextranomer/hyaluronic acid in patients with catheterizable stomas with urinary incontinence. MATERIALS AND METHODS: A total of 14 patients 9 to 49 years old (mean age 17.8) underwent submucosal implantation of dextranomer/hyaluronic acid for incontinence of catheterizable stoma at our institutions between October 2001 and March 2004. RESULTS: There were 9 males and 5 females. Type of bowel for stoma creation included 12 appendixes and 2 small bowels. All patients had significant leak per stoma and were candidates for revision. The dextranomer/hyaluronic acid volume injected ranged from 2 to 6 cc (mean 3.7). A total of 10 patients were dry after 1 injection, 1 was dry after 2 injections and 3 remained incontinent after the procedure. Our success rate was 79%. CONCLUSIONS: Our initial experience with the endoscopic treatment of incontinence of catheterizable stoma is encouraging, with a 79% success rate. We believe that this minimally invasive approach is warranted as an initial step in the management of urinary incontinence of catheterizable stoma before undertaking more challenging procedures.