Autoaugmentation by detrusor myotomy: its lack of effectiveness in the management of congenital XXXX .

@entity1 @entity3570 @entity322 @entity1494 @entity1973 @entity3041 @entity1729
PURPOSE: We present our long-term results in 17 @entity1 with myelomeningocele undergoing autoaugmentation by vesicomyotomy. MATERIALS AND METHODS: Surgery was performed from 1990 to 1994 on 17 @entity1 with @entity1494 due to @entity3570 . Indications for autoaugmentation included @entity1729 and/or @entity322 secondary to hypperreflexia, hypocompliance or low bladder volume. All @entity1 had failed to respond to conservative medical and pharmacological treatments. Median @entity1 age at surgery was 10.2 years (range 2.2 to 13.2). Outcomes were evaluated retrospectively according to changes in upper tract status, continence and urodynamic parameters. Median clinical and urodynamic followup is 75 months (range 4 to 126). RESULTS: Progressive @entity3041 developed in 5 @entity1 , which required subsequent enterocystoplasty in 4. Of 13 @entity1 8 (62%) remain incontinent. Of the 17 cases 12 (71%) were considered clinical failures on the basis of @entity1729 and/or ongoing @entity322 . There were few clinically significant improvements in urodynamic parameters, as 14 of 15 cases (93%) were considered urodynamic failures on the basis of persistent hypocompliance and/or less than expected gains in safe bladder capacity with somatic growth. CONCLUSIONS: Although short-term reports of autoaugmentation have been promising, they do not appear durable. This procedure cannot be endorsed for the management of congenital @entity1973 .
