Abstract
The distinctive problems of congenital paraplegia are compared with those of the acquired form, particularly with regard to associated handicaps, renal immaturity, lack of perceptual experience and social deprivation in early life.
Reference is made to the management of retention of urine and to the changing urological picture as age advances.
The satisfactory management of male incontinence is discussed.
Against this background are enumerated the requirements of the ideal urinary diversion. The isolated ileal loop operation, or ileocutaneous ureterostomy is discussed. A series of 70 patients is surveyed and the criteria for operation are presented in relation to pre-operative management, morbidity and mortality.
Long-term follow-up data are given concerning 50 consecutive girl patients operated on between 1955 and 1963 selected for ileal loop diversion from 473 paraplegic children under observation since 1946. The operative mortality was nil. The subsequent fallout rate due to death from the paraplegia or related conditions has been seven (14 per cent.), three in the first 4 months, one in the 3rd year, two in the 4th year and one in the 10th year.
Ileal loop urinary diversion is claimed to be the most satisfactory method of dealing with incontinence arising from congenital paraplegia in the female, and should not be undertaken before the age of five.
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References
Nash, D F E (1956). Brit. J. Urol. 28, 387.
Tribe, C R (1963). Paraplegia, 1, 19.
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Nash, D. Urinary diversion in congenital paraplegia. Spinal Cord 4, 216–225 (1967). https://doi.org/10.1038/sc.1966.28
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DOI: https://doi.org/10.1038/sc.1966.28