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Traitements chirurgicaux des hyperactivités vésicales neurologiques

Surgical treatment of neurogenic vesical hyperactivity

  • Article de Synthèse / Review Article
  • Published:
La Lettre de médecine physique et de réadaptation

Résumé

Les traitements chirurgicaux des hyperactivités vésicales neurologiques sont réservés aux échecs des traitements médicaux, conservateurs. Le but de ces interventions est d’obtenir un réservoir vésical de bonne capacité qui se remplit à basse pression. Cela permet de diminuer les symptômes, de préserver le haut appareil urinaire et de diminuer les complications des vessies neurologiques. Plusieurs options thérapeutiques sont à décrire : les méthodes chirurgicales de dénervation vésicale, la détrusoromyomectomie, les entérocystoplasties avec ou sans dérivation urinaire continente et enfin les dérivations urinaires non continentes. Nous ne parlerons pas de la neuromodulation sacrée qui fera l’objet spécifiquement d’un article.

Abstract

Surgical treatment of neurogenic bladder hyperactivity is reserved for cases where conservative medical treatment has failed. The objective of such surgery is to obtain a bladder of adequate capacity, which fills at low pressure. This minimises symptoms, protects the upper urinary tract and reduces the complications of neurogenic bladder. There is a range of therapeutic options: surgical techniques for bladder denervation, detrusor myomectomy, enterocystoplasties with or without continent urinary diversion and, finally, non-continent urinary diversion procedures. We shall not discuss the technique of sacral neuromodulation, which will form the object of a separate article.

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  1. Service d’urologie, hôpital Tenon, 4, rue de la Chine, F-75020, Paris, France

    L. Peyrat

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  1. L. Peyrat
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Peyrat, L. Traitements chirurgicaux des hyperactivités vésicales neurologiques. Lett Med Phys Readapt 26, 81–85 (2010). https://doi.org/10.1007/s11659-010-0225-4

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