Bladder neck reconstruction: Long-term followup of reconstruction with omentum and silicone sheath

G. F. Quimby, D. A. Diamond, Y. Mor, Z. Zaidi, P. G. Ransley

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: In 1986 we reported the placement of a silicone sheath sandwiched between layers of omentum around a newly reconstructed bladder neck. We now present long-term followup of 94 cases of silicone sheath bladder neck reconstruction. Materials and Methods: A total of 94 silicone sheaths was placed in 84 patients between August 1983 and October 1992. We retrospectively reviewed our results and divided the reconstructions into 3 groups according to modifications in surgical technique. We report the results of each modification and current recommendations for use. Results: Each sequential modification of silicone sheath bladder neck reconstruction significantly reduced the risk of erosion from 100%, 32% and 7%, respectively (p <0.05). Erosion was independent of patient age, sex, pathological condition or whether bladder neck reconstruction was a repeat procedure. Patients who had silicone sheath erosion did not have different continence or loss of urethral continuity than those with no erosion. In 13 patients (16%) artificial sphincter placement was clearly facilitated by the silicone sheath. Conclusions: Modifications in the surgical technique of silicone sheath placement around a reconstructed bladder neck have resulted in a decrease in the erosion rate to 7%. The primary benefit of silicone sheath placement is ease of subsequent sphincter placement. Currently we reserve silicone sheath placement for a small subset of patients who are most likely to benefit from subsequent artificial sphincter placement.

Original languageEnglish
Pages (from-to)629-632
Number of pages4
JournalJournal of Urology
Volume156
Issue number2 SUPPL. 1
DOIs
StatePublished - Aug 1996

Keywords

  • Bladder
  • Silicones
  • Urethra

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