The effect of urinary tract reconstruction on neurologically impaired women previously treated with an indwelling urethral catheter

Toyohiko Watanabe, David A. Rivas, Robin Smith, William E. Staas, Michael B. Chancellor

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: We investigated the changes in sexuality and quality of life that evolve after lower urinary tract reconstruction in neurologically impaired women previously treated with an indwelling urethral catheter. Materials and Methods: A total of 18 neurologically impaired women treated with an indwelling urethral catheter underwent bladder reconstruction. Pubovaginal sling urethral compression was required to restore perineal dryness in 13 patients and was the only operation required in conjunction with intermittent catheterization in 3. Eight patients underwent ileocystostomy, that is creation of a 'bladder chimney,' and 4 underwent augmentation cystoplasty with creation of a continent catheterizable stoma. In 3 patients ileocystoplasty alone with intermittent urethral catheterization was performed. All patients were followed 6 to 40 months (mean 18) after reconstructive surgery using a 9-part questionnaire to score numerically the effect of surgical reconstruction on sexuality and quality of life issues. Results: On a scale of 0 (worst) to 5 (best) mean scores for self-esteem improved from 1 preoperatively to 4 postoperatively, self-image from 1 to 4, sexual desire from 2 to 4 and ability to cope with disability from 1 to 4, respectively. In 4 of the 15 women who were sexually active preoperatively the frequency of sexual intercourse doubled from a mean of 3 to 6 times per month, respectively, and all 4 women reported improved sexual satisfaction. All 13 patients with pelvic pain and 5 with symptoms of autonomic dysreflexia noticed significant improvement if not complete resolution of the symptoms. Conclusions: Neurogenic lower urinary tract dysfunction treated with an indwelling urethral catheter is detrimental to sexuality and quality of life in neurologically impaired women. Urinary tract reconstruction restores not only quality of life but also sexuality by improving self-image, self-esteem and the ability to cope. Indwelling catheterization as a method of long-term urinary treatment should be avoided in women.

Original languageEnglish
Pages (from-to)1926-1928
Number of pages3
JournalJournal of Urology
Volume156
Issue number6
DOIs
Publication statusPublished - Dec 1996
Externally publishedYes

Keywords

  • bladder, neurogenic
  • spinal cord injuries
  • urethra
  • urinary incontinence
  • urodynamics

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'The effect of urinary tract reconstruction on neurologically impaired women previously treated with an indwelling urethral catheter'. Together they form a unique fingerprint.

  • Cite this