Clam augmentation enterocystoplasty as management of urge urinary incontinence and reduced bladder capacity

Abstract

Objectives: Third line treatment of urge urinary incontinence (UUI) and/or reduced bladder capacity is bladder augmentation. The aim of this study was to investigate whether clam enterocystoplasty (CECP) was an efficient treatment for patients who were refractory to conservative treatments of UUI and small functional bladder capacity and secondly if there was a difference in outcome in patients with neurogenic and non-neurogenic bladders.

Methods: We evaluated 118 patients retrospectively treated in the period 2006–2018 at a single university hospital. Data were collected retrospectively. Patient groups were compared with Wilcoxon signed-rank test and Fisher’s exact test.

Results: Overall, 76% became continent with 92% using clean intermittent self-catherization (CISC) of patients with neurogenic bladder, 82% became continent and 100% were using CISC, whereas of patients with non-neurogenic bladder 64% became continence and 77% were using CISC. The median overall improvement of capacity was 296.5 mL (IQR: 142–440), 310 mL (186–467) in the neurogenic group and 214 mL (IQR: 126.8–361.5) in non-neurogenic (p = 0.01).

Conclusion: CECP is an efficient treatment in UUI and reduced bladder capacity. Difference in outcome was seen with neurogenic patients having a bigger functional capacity and a higher rate of continence compared to the non-neurogenic.

Keywords:

• Bladder augmentation
• incontinence
• ileocystoplasty
• urge urinary incontinence
• neuropathic bladder disease
• clam

Disclosure statement

No research support was received for the current study. The authors have no conflict of interest.