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European Surgery

, Volume 44, Issue 4, pp 248–254 | Cite as

Augmentation cystoplasty: diagnosis, treatment and outcome

  • A. BasharkhahEmail author
  • E. Sterl
  • A. Haberlik
Main Topic
  • 96 Downloads

Summary

BACKGROUND: Augmentation cystoplasty is an accepted treatment modality for medically refractory neurogenic bladder dysfunction and malformed bladder by providing a highcapacity reservoir with low bladder pressure. A continent urinary diversion is often performed concomitantly for easier clean intermittent catheterization. METHODS: The patient records of 26 (m:w = 13:13; mean age 13 a) children who underwent augmentation cystoplasty between February 1995 and February 2011 were reviewed retrospectively. In follow-up, standardized interviews were performed and all patients underwent ultrasound, videourodynamic or voiding cystography and cystomanometry. Additionally, blood analyses (e.g. creatinine level, electrolytes and vitamin B12 level) were carried out. All complications were evaluated. RESULTS: Augmentation cystoplasty and continent urinary diversion were performed in 26 and 16 patients. Postoperative videourodynamic revealed a significant increase in bladder capacity (mean 569.7 ml; p-value < 0.001) and bladder compliance (mean 51 ml/cm H2O; p-value < 0.001). Postoperatively 22 patients were socially continent. The most common complications were insufficiency and stricture of continent urinary diversion (56%;) and bladder calculi (23%;). One patient needed re-do of augmentation, due to a thrombosis of the ileocystoplasty, another developed intestinal obstruction and another showed insufficiency of the anastomosis, therefore a revision was performed. No malignancy was found. Renal function stayed stable in 25 children and improvement was found in 1 patient. CONCLUSIONS: Augmentation cystoplasty can increase the bladder volume and the bladder compliance. This procedure allows the majority of patients to achieve continence and to stabilize renal function. Careful follow-up is necessary for early recognition of complications e.g. malignancies and stones.

Keywords

Ileocystoplasty Bladder calculi Vesico-ureteric reflux Bladder compliance Mitrofanoff 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of Pediatric and Adolescent SurgeryMedical University of GrazGrazAustria

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