VOIDING FUNCTION IN PATIENTS WITH THE PRUNE-BELLY-SYNDROME AFTER MONFORT ABDOMINOPLASTY

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.