Continent Cutaneous Urinary Deviation (CUD), using the Mitrofanoff, Yang-Monti or Casale principle, is offered to patients with neurological diseases who are unable to perform intermittent catheterisation through the native urethra due to upper limb disability. There is very little data in the literature examining the long-term efficacy and complications of this technique. The main objective of this study is to evaluate the effectiveness of long-term CUDs in spinal cord injury patients. The secondary objectives are to evaluate the surgical complications and the impact on the patient's quality of life. For each patient, several data will be collected and analyzed: age at operation, sex, Body Mass Index (BMI), ASA score, ASIA score, type of bladder dysfunction assessed by urodynamic evaluation, urinary abnormalities assessed by morphological examination (ultrasound and / or computed tomography) and cystoscopy, creatinine clearance, operative indications, initial mictional mode, surgical assembly and any immediate or late complications. In a second stage, a questionnaire survey will be conducted by telephone.
Study Type
OBSERVATIONAL
Enrollment
70
For each patient, the following data will be collected and analyzed: age at operation, sex, Body Mass Index (BMI), ASA score, ASIA score, type of bladder dysfunction assessed by urodynamic evaluation, urinary abnormalities assessed by morphological examination (ultrasound and / or computed tomography) and cystoscopy, creatinine clearance, operative indications, initial mictional mode, surgical assembly, immediate and later complications.
A telephone survey will be conducted by means of a questionnaire in order to evaluate the patient's quality of life.
Nîmes University Hospital
Nîmes, Gard, France
RECRUITINGEfficacy of continent cutaneous urinary derivation: catheterisation.
The minimum frequency of urinary catheterisation in spinal injured patients equipped with a continent cutaneous urinary derivation will be recorded.
Time frame: 3 -16 years after their operation
Efficacy of continent cutaneous urinary derivation:leakage
Absence of leakage through the cystostomy in spinal injured patients equipped with a continent cutaneous urinary derivation will be recorded.
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: Age at start of care
The patient's age will be noted at the start of care
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: Sex
The patient's sex will be noted at the start of care
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: Body Mass Index
The patient's Body Mass Index will be noted at the start of care
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: ASA score
The ASA Physical Status Classification System is used to assess and communicate a patient's pre-anesthesia medical comorbidities. The classification system alone does not predict the perioperative risks, but used with other factors (eg, type of surgery, frailty, level of deconditioning) it can be helpful in predicting perioperative risks. ASA I = A normal healthy patient ASA II = A patient with mild systemic disease ASA III = A patient with severe systemic disease ASA IV = A patient with severe systemic disease that is a constant threat to life ASA V = A moribund patient who is not expected to survive without the operation ASA VI = A declared brain-dead patient whose organs are being removed for donor purposes
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: ASIA score
The ASIA (American Spinal Injury Association) assessment is the gold standard for assessing and documenting sensory and motor impairments after Spinal Cord Injury. The score ranges from A to E as follows: A = Complete injury. No motor or sensory function is preserved in the sacral segments S4 or S5. B = Sensory incomplete. Sensory but not motor function is preserved below the level of injury, including the sacral segments. C = Motor incomplete. Motor function is preserved below the level of injury, and more than half of muscles tested below the level of injury have a muscle grade less than 3 (see muscle strength scores table). D = Motor incomplete. Motor function is preserved below the level of injury and at least half of the key muscles below the neurological level have a muscle grade of 3 or more. E = Normal. No motor or sensory deficits, but deficits existed in the past. This score will be used to evaluate the patient at the start of care.
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: Bladder dysfunction
The type of bladder dysfunction will be evaluated by urodynamic evaluation
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: urinary tract anomalies evaluated via a morphological examination.
Urinary tract anomalies will be evaluated via a morphological examination (using ultrasound and / or tomodensitometry).
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: cytometry
Urinary tract anomalies will be evaluated via cytometry
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: creatinine clearance
Urinary tract anomalies will be evaluated according to the patient's creatinine clearance
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: operative indications
The indications for the initial surgery will be recorded.
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: mictional mode
The patient's initial mictional mode will be recorded.
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: surgical set-up
The patient's surgical set-up will be recorded.
Time frame: 3 -16 years after their operation
Surgical complications and impact on the patient's quality of life: immediate or later complications
All immediate or later complications will be recorded.
Time frame: 3 -16 years after their operation
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