Goodwin cup patch to treat a lady with contracted bladder and incontinence

M. Hadi, Azzawi

	Goodwin cup patch to treat a lady with contracted bladder and incontinence
Medical Journal of Tikrit
Article 1, Volume 1, Issue 131, 2012, Pages 141-143
Author
Azzawi M. Hadi
Abstract
Thirty years old lady developed painless urine retention and some sort of sensory loss and weakness of the lower limbs soon after thyroid surgery 6 years ago. She was kept on Foleys catheter for drainage . MRI suggest multiple area of demyelization Fig (1). Cystoscope done for her which show large bladder capacity with fine trabiculation. Cystometry show flaccid bladder paralysis with no sensation in the bladder even over 340cc.fig (2) After two years of clean intermittent catheterization(CIC) she had recurrent infection and hydronephrosis then suprapubic cystostomy done for her. Four years later she start to feel pain in her bladder when she close the suprapubic catheter which was removed and a trial of medical treatment (oxybutinine 5mg bid and imipramine 50mg bid) was started, she develops sever frequency and incontinence. Cystogram done for her shows small contracted bladder and develops sever pain at 75cc fig.(3). The decision to do augmentation cystoplasty was taken in the form of Goodwin cup patch. The patient had a very smooth post operative time and discharged home on oral antibiotics and daily bladder wash, her bladder capacity on discharge was 300cc when she start to feel pain. the catheter removed at day 15 post operative she had good empting of the pouch and good sphincter control.
Keywords
Goodwin cup patch to treat a lady with contracted bladder and incontinence

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