Objective: This study was designed to assess the outcome of clam ileocystoplasty(Cl) based on patients’ subjective perception and objectively validated scoring systems. Quality-of-life parameters were also examined as aspects of outcome. Material and Methods: Between 1989 and 1994, 27 patients (15 male and 12 female) underwent Cl. The median age was 41 years(13-75 years). Cl was performed after failed pharmacological treatment. The mean length of follow-up for this patient cohort was 18 months (range: 1-4 years). Results: Overall cure rate was objectively assessed at 61%. Seventytwo percent of patients described a subjective improvement of symptoms, and a small number of patients (12.5%) were subjectively worse following the operation. Quality of life was improved in 75% of patients, with 12.5% showing no improvement and 12.5% being worse. Fifty-six percent of patients noted a minor degree of voiding dysfunction, whereas 25% noted moderate and 19%noted severe voiding dysfunction. Conclusions: Cl offered improvement with satisfaction in the group of patients studied, however not all patients achieved a satisfactory outcome. The patients who were worse following the procedure were all young females with detrusor instability. Careful patient selection and pre-operative counselling may reduce the failure rate. Outcome analysis based on standardised questionnaires allows patients and surgeons to make informed decisions with realistic expectations.

Keywords:
Clam ileocystoplasty, Quality of life, Bladder augmentation
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1997
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