Urinary Diversion and Neuro-Vesical Dysfunction

  • David G. Thomas
  • Anthony M. K. Rickwood
Part of the Clinical Practice in Urology book series (PRACTICE UROLOG)


The most frequent reason for performing conduit urinary diversion has been, and remains, cystectomy for malignant disease. Probably the commonest reason for urinary diversion in non-malignant disease has been incontinence or Upper tract deterioration related to neuro-vesical dysfunetion. The ehoice of past tense is deliberate in this context where urinary diversion, always more widely used in treating patients with congenital rather than acquired lesions of the cord, is now viewed with increasing disfavour (Smith 1972; Zachary and Lister 1972; Guttman 1974). This reluctance to perform conduit diversion has been motivated largely by the development of alternative methods of treatment, but the emerging, and often disturbing, results of long-term follow up of conduit-diverted patients has added considerable support to the conservative approach (Middleton and Hendren 1976; Dunn et al. 1979; Eider et al. 1979; Pitts and Muecke 1979). The past decade has seen an increasing interest in the pathophysiology of neuro-vesical dysfunetion mainly as a consequence of modern urodynamic investigation but also a renewed interest in the pharmaeological manipulation of vesical and urethral funetion. The surgeon has come to learn that the pharmacological skills of the physician often have surprising and gratifying results.


Bladder Neck Urinary Diversion Detrusor Contraction Bladder Emptying Detrusor Instability 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1982

Authors and Affiliations

  • David G. Thomas
  • Anthony M. K. Rickwood

There are no affiliations available

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