Neurourology pp 345-360 | Cite as

Augmentation Cystoplasty

  • Homero Bruschini
  • Pawan Vasudeva
  • Limin LiaoEmail author


The intention to create a good low pressure reservoir is fully accomplished with detubularized intestinal segment. Ileum, colon and cecum can be used. Facilities favor the use of ileum, which represent the majority of cases published. It is easy to remove, is close to the bladder and may be shaped easily into a reservoir [1]. Also, reconstitution of intestinal transit seems to be less problematic at the ileum. The intestinal segment needs to be long enough to be fashioned close to a spherical form [2, 3] and to create a volume consistent with patient’s requirements (Fig. 43.1). Care should be taken to avoid tension at the mesentery blood supply to the intestinal segment, in order to prevent ischemia. Mobilization of the segment to the bladder should always be checked before intestine excision, mainly in reoperations. Colon or ileum can either be chosen at the time of the surgery, according to this convenience.


  1. 1.
    Drake MJ, Apostolidis A, Emmanuel A, Gajewski J, Harrison SCW, Heesakkers J, Lemack G, Madersbacher H, Panicker J, Radziszewski P, Sakakibara R, Wyndaele JJ. Neurologic urinary and faecal incontinence. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence. 5th ed. Paris: Health Publications, Ltd; 2013. p. 827–1000.Google Scholar
  2. 2.
    Game X, Karsenty G, Chartier-Kastler E, Ruffon A. Treatment of neurogenic detrusor hyperactivity: enteroplasty. Prog Urol. 2007;17:584–96.CrossRefGoogle Scholar
  3. 3.
    Jednak R. The evolution of bladder augmentation: from creating a reservoir to reconstituting an organ. Front Pediatr. 2014;2:1–9.CrossRefGoogle Scholar
  4. 4.
    Gonzales R, Buson H, Reid C, Reinberg Y. Seromuscular colocystoplasty lined with urothelium: experience with 16 patients. Urology. 1995;45:124–9.CrossRefGoogle Scholar
  5. 5.
    Lima SV, Araujo LA, Vilar FO. Nonsecretory intestinocystoplasty: a 10-year experience. J Urol. 2004;171:2636–9.CrossRefGoogle Scholar
  6. 6.
    De Badiola F, Ruiz E, Puigdevall J, Lobos P, Moldes J, Lopez Raffo M, et al. Sigmoid cystoplasty with argon beam without mucosa. J Urol. 2001;165:2253–5.CrossRefGoogle Scholar
  7. 7.
    Soylet Y, Emir H, Lice Z, Yesildag E, Buyukunal SN, Danismend N. Quo vadis? Ureteric reimplantation or ignoring reflux during augmentation cystoplasty. BJU Int. 2004;94:379–80.CrossRefGoogle Scholar
  8. 8.
    Wang JB, Liu CS, Tsai SL, Wei CF, Chin TW. Augmentation cystoplasty and simultaneous ureteral reimplantation reduce high-grade vesicoureteral reflux in children with neurogenic bladder. J Chin Med Assoc. 2010;74:294–7.CrossRefGoogle Scholar
  9. 9.
    Misseri R, Rosenbaum DH, Rink RC. Reflux in cystoplasties. Arch Esp Urol. 2008;61:213–7.CrossRefGoogle Scholar
  10. 10.
    Szymanski KM, Cain MP, Whittam B, Kaefer M, Rink RC, Misseri R. All incontinence is not created equal: impact of urinary and fecal incontinence on quality of life in adults with spina bifida. J Urol. 2017;197:885–91.CrossRefGoogle Scholar
  11. 11.
    Herschorn S, Hewitt RJ. Patient perspective of long-term outcome of augmaentation cystoplasty for neurogenic bladder. Urology. 1998;52:672–8.CrossRefGoogle Scholar
  12. 12.
    Hasan ST, Marshall C, Robson WA, Neal DE. Clinical outcome and quality of life following enterocystoplasy for idiopathic detrusor instability and neurogenic bladder dysfunction. Br J Urol. 1995;76:551–7.CrossRefGoogle Scholar
  13. 13.
    Gurung PM, Attar KH, Abdul-Rahman A, Morris T, Hamid R, Shah PJ. Long-term outcomes of augmentation ileocystoplasty in patients with spinal cord injury: a minimum of 10 years of follow-up. BJU Int. 2012;109:1236–42.CrossRefGoogle Scholar
  14. 14.
    Husmann DA. Malignancy after gastrointestinal augmentation in childhood. Ther Adv Urol. 2009;1:5–11.CrossRefGoogle Scholar
  15. 15.
    Higuchi TT, Granberg CF, Fox JA, Husmann DA. Augmentation cystoplasty and risk of neoplasia: fact, fiction and controversy. J Urol. 2010;184:2492–7.CrossRefGoogle Scholar
  16. 16.
    Isharwal S, Desai V, Horn A, Lele SM, Lagrange CA. Desmoid tumor: an unusual case of gross hematuria. Ther Adv Urol. 2015;7:49–51.CrossRefGoogle Scholar
  17. 17.
    Hayashi Y, Shiyanagi S, Nagae I, Ishizaki T, Kasuya K, Katsumata K, et al. A case of tubular adenoma developing after bladder augmentation: case report and literature review. Int J Surg Case Rep. 2016;19:17–20.CrossRefGoogle Scholar
  18. 18.
    Soergel TM, Cain MP, Misseri R, Gardner TA, Koch MO, Rink RC. Transitional cell carcinoma of the bladder following augmentation cystoplasty for the neuropathic bladder. J Urol. 2004;172:1649–52.CrossRefGoogle Scholar
  19. 19.
    Higuchi TT, Fox JA, Husmann DA. Annual endoscopy and urine cytology for the surveillance of bladder tumors after enterocystoplasty for congenital bladder anomalies. J Urol. 2011;186:1791–5.CrossRefGoogle Scholar
  20. 20.
    Castellan M, Gosalbez R, Perez-Brayfield M, Healey P, McDonald R, Labbie A, et al. Tumor in bladder reservoir after gastrocystoplasty. J Urol. 2007;178:1771–4.CrossRefGoogle Scholar
  21. 21.
    Loftus CJ, Wood HM. Congenital causes of neurogenic bladder and the transition to adult care. Transl Androl Urol. 2016;5:39–50.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Kokorowski PJ, Routh JC, Boreer JG, Estrada CR, Bauer SB, Nelson CP. Screening for malignancy after augmentation cystoplasty in children with spina bifida: a decision analysis. J Urol. 2011;186:1437–43.CrossRefGoogle Scholar
  23. 23.
    Ivil KD, Doak SH, Jenkins SA, Parry EM, Kynaston HG, Parry JM, et al. Fluorescence in-situ hybridisation on biopsies from clam ileocystoplasties and on a clam cancer. Br J Cancer. 2006;94:891–5.CrossRefGoogle Scholar
  24. 24.
    DeFoor W, Tackett L, Minevich E, Wacksman J, Sheldon C. Risk factors for spontaneous bladder perforation after agumentation cystoplasty. Urology. 2003;62:737–41.CrossRefGoogle Scholar
  25. 25.
    Blok BF, Al Zahrani A, Capolicchio JP, Bilodeau C, Corcos J. Post-augmentation bladder perforation during urodynamic investigation. Neurourol Urodyn. 2007;26:540–2.CrossRefGoogle Scholar
  26. 26.
    Shekarriz B, Upadhyay J, Demirbilek S, Barthold JS, Gonzales R. Surgical complications of bladder augmentation: comparison of various enterocystoplasties in 133 patients. Urology. 2000;55:123–8.CrossRefGoogle Scholar
  27. 27.
    Stephany HA, Clayton DB, Tanaka ST, Thomas JC, Pope JC IV, Brock JW III, et al. Development of upper tract stones in patients with congenital neurogenic bladder. J Pediatr Urol. 2014;10:112–7.CrossRefGoogle Scholar
  28. 28.
    Roberts W, Gearhart J, Mathews R. Time to recurrent stone formation in patients with bladder or continent reservoir reconstruction: fragmentation versus intact extraction. J Urol. 2004;172:1706.CrossRefGoogle Scholar
  29. 29.
    Austin JC. Long-term risks of bladder augmentation in pediatric patients. Curr Opin Urol. 2008;18:408.CrossRefGoogle Scholar
  30. 30.
    Barroso U, Jednak R, Fleming P, Barthold JS, González R. Bladder calculi in children who perform clean intermittent catheterization. BJU Int. 2000;85:879.CrossRefGoogle Scholar
  31. 31.
    Blyth B, Ewalt DH, Duckett JW, Snyder HM 3rd. Lithogenic properties of enterocystoplasty. J Urol. 1992;148:575.CrossRefGoogle Scholar
  32. 32.
    Metcalfe PD, Cain MP, Kaefer M, Gilley DA, Meldrum KK, Misseri R, et al. What is the need for additional bladder surgery after bladder augmentation in childhood? J Urol. 2006;176:1801.CrossRefGoogle Scholar
  33. 33.
    Szymanski KM, Misseri R, Whittam B, Amstutz S, Kaefer M, Rink RC, et al. Cutting for stone in augmented bladders: what is the risk of recurrence and is it impacted by treatment modality? J Urol. 2014;191:1375–80.CrossRefGoogle Scholar
  34. 34.
    Rosenbaum DH, Cain MP, Kaefer M, Meldrum KK, King SJ, Misseri R, et al. Ileal enterocystoplasty and B12 deficiency in pediatric patients. J Urol. 2008;179:1544–8.CrossRefGoogle Scholar
  35. 35.
    Mingin GC, Nguyen HT, Mathias RS, Shepherd JA, Gidden D, Baskin LS. Growth and metabolic consequences of bladder augmentation in children with myelomeningocele and bladder exstrophy. Pediatrics. 2002;110:1193–8.CrossRefGoogle Scholar
  36. 36.
    Somani BK, Kumar V, Wong S, Pickard R, Ramsay C, Nabi G, et al. Bowel dysfunction after transposition of intestinal segments into the urinary tract: 8-year prospective cohort study. J Urol. 2007;177:1793–8.CrossRefGoogle Scholar
  37. 37.
    Leong CH. Use of the stomach for bladder replacement and urinary diversion. Ann R Coll Surg Engl. 1978;60:283–9.PubMedPubMedCentralGoogle Scholar
  38. 38.
    Adams MC, Mitchell ME, Rink RC. Gastrocystoplasty: an alternative solution to the problem of urological reconstruction in the severely compromised patient. J Urol. 1988;140:1152.CrossRefGoogle Scholar
  39. 39.
    Raz S, Ehrlich RM, Babiarz JW, Payne CK. Gastrocystoplasty without opening the stomach. J Urol. 1993;150:713–5.CrossRefGoogle Scholar
  40. 40.
    Docimo SG, Moore RG, Adams J, Kavoussi LR. Laparoscopic bladder augmentation using stomach. Urology. 1995;46:565–9.CrossRefGoogle Scholar
  41. 41.
    Leonard MP, Dharamsi N, Williot PE. Outcome of gastrocystoplasty in tertiary pediatric urology practice. J Urol. 2000;164:947–50.CrossRefGoogle Scholar
  42. 42.
    Sheldon CA, Gilbert A, Wacksman J, Lewis AG. Gastrocystoplasty: technical and metabolic characteristics of the most versatile childhood bladder augmentation modality. J Pediatr Surg. 1995;30:283–7.CrossRefGoogle Scholar
  43. 43.
    Hubert KC, Large T, Leiser J, Judge B, Szymanski K, Whittam B, et al. Long-term renal functional outcomes after primary gastrocystoplasty. J Urol. 2015;193:2079–84.CrossRefGoogle Scholar
  44. 44.
    Abdel-Azim MS, Abdel-Hakim AM. Gastrocystoplasty in patients with an areflexic low compliant bladder. Eur Urol. 2003;44:260–5.CrossRefGoogle Scholar
  45. 45.
    Singla A, Galloway N. Early experience with the use of gastric segment in lower urinary tract reconstruction in adult patient population. Urology. 1997;50:630–5.CrossRefGoogle Scholar
  46. 46.
    Kiliç N, Celayir S, Eliçevik M, Sarimurat N, Söylet Y, Büyükünal C, et al. Bladder augmentation: urodynamic findings and clinical outcome in different augmentation techniques. Eur J Pediatr Surg. 1999;9:29–32.CrossRefGoogle Scholar
  47. 47.
    Kurzrock EA, Baskin LS, Kogan BA. Gastrocystoplasty: is there a consensus? World J Urol. 1998;16:242–50.CrossRefGoogle Scholar
  48. 48.
    Metcalfe PD, Casale AJ, Kaefer MA, Misseri R, Dussinger AM, Meldrum KK, et al. Spontaneous bladder perforations: a report of 500 augmentations in children and analysis of risk. J Urol. 2006;175:1466–70.CrossRefGoogle Scholar
  49. 49.
    Gosalbez R Jr, Woodard JR, Broecker BH, Warshaw B. Metabolic complications of the use of stomach for urinary reconstruction. J Urol. 1993;150:710–2.CrossRefGoogle Scholar
  50. 50.
    Kurzrock EA, Baskin LS, Kogan BA. Gastrocystoplasty: long-term followup. J Urol. 1998;160:2182.CrossRefGoogle Scholar
  51. 51.
    Nguyen DH, Bain MA, Salmonson KL, Ganesan GS, Burns MW, Mitchell ME. The syndrome of dysuria and hematuria in pediatric urinary reconstruction with stomach. J Urol. 1993;150:707–9.CrossRefGoogle Scholar
  52. 52.
    Castellan M, Gosalbez R, Bar-Yosef Y, Labbie A. Complications after use of gastric segments for lower urinary tract reconstruction. J Urol. 2012;187:1823–7.CrossRefGoogle Scholar
  53. 53.
    Boissier R, Di Crocco E, Faure A, Hery G, Delaporte V, Lechevallier E, et al. What is the outcome of paediatric gastrocystoplasty when the patients reach adulthood? BJU Int. 2016;118:980–6.CrossRefGoogle Scholar
  54. 54.
    Simforoosh N, Tabibi A, Basiri A, Noorbala MH, Danesh AD, Ijadi A. Is ureteral reimplantation necessary during augmentation cystoplasty in patients with neurogenic bladder and vesicoureteral reflux? J Urol. 2002;168:1439–41.CrossRefGoogle Scholar
  55. 55.
    López Pereira P, Martinez Urrutia MJ, Lobato Romera R, Jaureguizar E. Should we treat vesicoureteral reflux in patients who undergo bladder augmentation for neuropathic bladder? J Urol. 2001;165:2259–61.CrossRefGoogle Scholar
  56. 56.
    Hayashi Y, Kato Y, Okazaki T, Lane GJ, Kobayashi H, Yamataka A. The effectiveness of ureteric reimplantation during bladder augmentation for high-grade vesicoureteric reflux in patients with neurogenic bladder: long-term outcome. J Pediatr Surg. 2008;42:1998–2001.CrossRefGoogle Scholar
  57. 57.
    Hendren WH, Hendren RB. Bladder augmentation: experience with 129 children and young adults. J Urol. 1990;144:445–53.CrossRefGoogle Scholar
  58. 58.
    Helmy TE, Hafez AT. Vesicouretral reflux with neuropathic bladder: studying the resolution rate after ileocystoplasty. Urology. 2013;82:425–9.CrossRefGoogle Scholar
  59. 59.
    Soygur T, Bzumrutbas B. The need for ureteric re-implantation during augmentation cystoplasty: video-urodynamic evaluation. BJU Int. 2010;105:530–2.CrossRefGoogle Scholar
  60. 60.
    Liao L, Zhang F, Chen G. Midterm outcomes of protection for upper urinary tract function by augmentation enterocystoplasty in patients with neurogenic bladder. Int Urol Nephrol. 2014;46:2117–25.CrossRefGoogle Scholar
  61. 61.
    Zhang F, Liao L. Sigmoidocolocystoplasty with ureteral reimplantation for treatment of neurogenic bladder. Urology. 2012;80:440–5.CrossRefGoogle Scholar
  62. 62.
    Wang Z, Liao L. Effectiveness and complications of augmentation cystoplasty with or without non-refluxing ureteral reimplantation in adult patients with long-standing bladder dysfunction: a single center 11-year experience in 173 cases. J Urol. 2018;199:200–5.CrossRefGoogle Scholar
  63. 63.
    Duckett JW, Bellinger MF. A plea for standardized grading of vesicoureteral reflux. Eur Urol. 1981;8:74–7.CrossRefGoogle Scholar
  64. 64.
    Liao LM. A new comprehensive classification system for both lower and upper urinary tract dysfunction in patients with neurogenic bladder. Urol Int. 2015;94:244–8.CrossRefGoogle Scholar
  65. 65.
    Liao LM, Zhang F, Chen G. New grading system for upper urinary tract dilation using magnetic resonance urography in patients with neurogenic bladder. BMC Urol. 2014;14:38.CrossRefGoogle Scholar
  66. 66.
    Biers SM, Venn SN, Greenwell TJ. The past, present and future of augmentation cystoplasty. BJU Int. 2012;109:1280–93.CrossRefGoogle Scholar
  67. 67.
    Skinner DG, Studer UE, Okada K, Aso Y, Hautmann H, Koontz W, et al. Which patients are suitable for continent diversion or bladder substitution following cystectomy or other definitive local treatment? Int J Urol. 1995;2:105–12.CrossRefGoogle Scholar
  68. 68.
    Nadeau G, Herschorn S. Augmentation cystoplasty. BJU Int. 2001;88:511.CrossRefGoogle Scholar
  69. 69.
    Morioka A, Miyano T, Ando K, Yamataka T, Lane GJ. Management of vesicoureteral reflux secondary to neurogenic bladder. Pediatr Surg Int. 1998;13:584–6.CrossRefGoogle Scholar
  70. 70.
    Singh G, Thomas DG. Bowel problems after enterocystoplasty. BJU Int. 1997;79:328–32.CrossRefGoogle Scholar
  71. 71.
    Akerlund S, Campanello M, Kaijser B, Jonsson O. Bacteriuria in patients with a continent ileal reservoir for urinary diversion does not regularly require antibiotic treatment. BJU Int. 1994;74:177–81.CrossRefGoogle Scholar
  72. 72.
    Khoury AE, Salomon M, Doche R, Soboh F, Ackerley C, Jayanthi R, et al. Stone formation after augmentation cystoplasty: the role of intestinal mucus. J Urol. 1997;158:1133–7.CrossRefGoogle Scholar
  73. 73.
    DeFoor W, Minevich E, Reddy P, Sekhon D, Polsky E, Wacksman J, et al. Bladder calculi after augmentation cystoplasty: risk factors and prevention strategies. J Urol. 2004;172:1964–6.CrossRefGoogle Scholar
  74. 74.
    Nurse DE, Mundy AR. Metabolic complications of cystoplasty. BJU Int. 1989;63:165.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of UrologyUniversity of Sao PauloSão PauloBrazil
  2. 2.VM Medical College and Safdarjang HospitalDelhiIndia
  3. 3.Department of Urology, China Rehabilitation Research CenterCapital Medical UniversityBeijingChina

Personalised recommendations