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Bladder Augmentation and Urinary Diversion

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Female Genitourinary and Pelvic Floor Reconstruction

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Abstract

Bladder augmentation and urinary diversion are surgical options for patients with bladder storage and emptying disorders, when conservative measures have failed. Surgical treatment can be required for the preservation of renal function, for incontinence, or for a combination of both. However, it can also be required to regain quality of life in patients with intractable bladder dysfunction without the immediate risk of renal deterioration or severe incontinence. Patients include those with neurogenic lower urinary tract dysfunction (NLUTD) and those with severe idiopathic or iatrogenic (non-neurogenic) lower urinary tract dysfunction (LUTD).

For patients with a bladder emptying disorder but good reservoir function of low pressure, a continent catheterizable channel (CCC) can be an option. In the opposite scenario, in patients with only a storage disorder due to bladder dysfunction such as severe detrusor overactivity or poor compliance, neurogenic or non-neurogenic, a bladder augmentation may be indicated. In the case of concomitant bladder storage and emptying disorder, a combination of augmentation cystoplasty and a continent catheterizable channel is possible, if the patient is suited, and otherwise a supravesical continent or incontinent supravesical urinary diversion may be indicated. Urinary diversion may be a last resort for patients with devastated outlet after iatrogenic injury.

Long-term consequences of bladder augmentation and urinary diversion include recurrent urinary tract infections, bladder/reservoir stones, metabolic disturbance, strictures, and perforation. Nevertheless, these reconstructive options may give appropriately selected patients the opportunity for improved urinary storage capacity, continence, and preservation of renal function, as well as an improved quality of life.

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Authors and Affiliations

  1. Section of reconstructive urology and neurourology, Department of Urology, Oslo University Hospital Rikshospitalet, Oslo, Norway

    Henriette Veiby Holm

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  1. Henriette Veiby Holm
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Editors and Affiliations

  1. University of Lisbon, Lisbon, Portugal

    Francisco E. Martins

  2. University of Oslo, Oslo, Norway

    Henriette Veiby Holm

  3. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jaspreet Sandhu

  4. Eastern Virginia Medical School, Norfolk, VA, USA

    Kurt A McCammon

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Holm, H.V. (2023). Bladder Augmentation and Urinary Diversion. In: Martins, F.E., Holm, H.V., Sandhu, J., McCammon, K.A. (eds) Female Genitourinary and Pelvic Floor Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-71112-2_18-2

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  • DOI: https://doi.org/10.1007/978-3-030-71112-2_18-2

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  1. Latest

    Bladder Augmentation and Urinary Diversion
    Published:
    10 March 2023

    DOI: https://doi.org/10.1007/978-3-030-71112-2_18-2

  2. Original

    Bladder Augmentation and Urinary Diversion
    Published:
    19 January 2023

    DOI: https://doi.org/10.1007/978-3-030-71112-2_18-1

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