We retrospectively reviewed the records of 24 myelodysplastic patients who underwent augmentation ileocystoplasty, using a standard technique. All patients had a closed bladder neck during preoperative VUDE studies. Their charts, imaging studies and VUDE data before and after surgery were analyzed. The mean follow-up after augmentation ileocystoplasty was 8.4 years.
The overall incidence of urinary incontinence following the augmentation ileocystoplasty was 12.5 % . Continence was achieved in 21 of 24 (87.5 % ) patients without additional outlet procedures. No significant upper tract changes developed. A clinically apparent tethered cord significantly hindered the achievement of continence. No significant correlation was found between the other videourodynamic parameters and obtaining continence.
Our study provides evidence that a coexisting cord tethering in this myelodysplastic group can affect bladder neck morphology and function, and subsequent continence.