Ca. Smith et al., VOIDING FUNCTION IN PATIENTS WITH THE PRUNE-BELLY-SYNDROME AFTER MONFORT ABDOMINOPLASTY, The Journal of urology, 159(5), 1998, pp. 1675-1679
Purpose: We reviewed our experience with patients with the prune-belly
syndrome who had undergone Monfort abdominoplasty to assess whether o
ur clinical impression of improved voiding efficiency could be demonst
rated objectively. Materials and Methods: From 1990 to 1993, 12 patien
ts with the prune-belly syndrome underwent Monfort abdominoplasty with
or without concomitant genitourinary reconstruction. All patients com
pleted questionnaires on voiding before and after abdominoplasty, inco
ntinence, bladder sensation, urinary flow, history of urinary tract in
fections and the ability to defecate. Urodynamic testing was performed
in 8 patients before and after abdominoplasty. Results: Subjective ch
anges that occurred after abdominoplasty included resolution of or les
s double voiding in 9 patients, improved urinary continence in 7, impr
oved bladder fullness sensation in 11, improved urinary flow in 10 and
improved defecation in 5. The incidence of urinary tract infections d
ecreased from a preoperative average of 5.7 per patient per year to 1.
2 per patient per year postoperatively. Urodynamics demonstrated no si
gnificant changes in the measured urinary flow, capacity or maximal de
trusor pressure. Compliance decreased on average but it remained in th
e compliant range. However, post-void residual volumes did significant
ly decrease from a preoperative average of 40.3% of bladder capacity t
o 13% after abdominoplasty. If the 5 patients who underwent concomitan
t urinary reconstruction were excluded, the reduction in average post-
void residuals remained approximately the same, which was 40% of bladd
er capacity preoperatively to 14.3% after abdominoplasty. These data s
uggest that abdominoplasty alone was responsible for improved micturit
ion. Conclusions: In addition to the cosmetic benefits and exposure pr
ovided for genitourinary reconstruction Monfort abdominoplasty seems t
o improve voiding efficiency.