Ten years’ experience of augmentation cystoplasty for varied indications and its outcome

Background: The aim of the study was to evaluate long term efficacy and complications of augmentation cystoplasty in patients with bladder dysfunction.  Methods: Our series comprises of 30 patients undergoing enterocystoplasty from March 2009 till December 2019. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.Results: Mean age of patients was 7 years and their mean follow up was for 4 years. Major complications occurred in 5 patients which were successfully managed and minor complication in 8 patients. Of these 16 patients were with neurogenic bladder and 14 with non-neurogenic bladder. The primary etiology of non-neurogenic bladder was extrophy epispadias complex (10 patients), posterior uretheral valves (2 patients), anterior uretheral valve (1 patient), and bilateral ectopic ureter (1 patient). The primary etiology of neurogenic bladder was meningomyocele (4 patients), anorectal malformation with vertebral anomalies (7 patients), partial sacral ageneis (4), nonneurogenic neurogenic bladder (1 patient). Relative continence was achieved in 97%. The preoperative serum creatinine and blood urea nitrogen (BUN) at the time of bladder augmentation (termed  creatinine-1 and BUN-1)and the serum  creatinine and BUN at the last follow up after bladder augmentation (termed  creatinine-2 and BUN-2)were sought and compared using chi square test showed statistically significant improvement (p<0.01).Conclusions: Augmentation cystoplasty is a necessary and safe procedure to increase the functional capacity of small contracted and poorly compliant bladder and allows patients to achieve relative continence and preserves renal function.

Clean Intermittent Catheterization after Sigmoid Augmentation Cystoplasty and Abdominal Sigmoidostomy: A Case Report / 中国康复理论与实践

Objective:To summarize the nursing care of a patient with clean intermittent catheterization after sigmoid augmentation cystoplasty and abdominal sigmoidostomy for the treatment of neurogenic bladder. Methods:On October 16, 2017, one patient with neurogenic bladder was admitted to Beijing Bo'ai Hospital. Psychological instructions were given to the patient after surgery. Catheter of appropriate type and material was selected, and then the patient was instructed to implement correct and regular clean intermittent catheterization procedures. At the same time, nursing care of abdominal sigmoidostomy was carried out. In order to prevent tube blocking, bladder irrigation was implemented at regular intervals. Follow-up visit was scheduled. Results:After four-month follow-up, the patient completed the whole procedures successfully, and its renal function was protected without severe urinary tract infection, also the patient was with good social adaptation. Conclusion:Comprehensive nursing care is needed in patients after sigmoid augmentation cystoplasty and abdominal sigmoidostomy. Correct and regular clean intermittent catheterization is critical. Psychological nursing, care of abdominal sigmoidostomy and tube blocking prevention should not be neglected, also long-term follow-up is of great significance for the outcome.

Initial experience of ileal ureter replacement combined with augmentation cystoplasty in the treatment of ureteral stenosis with contracted bladder / 中华泌尿外科杂志

Objective To explore the availability and safety of ileal ureter replacement combined with ileal augmentation cystoplasty in treating ureteral stenosis with contracted bladder.Methods From August 2015 to November 2018,three patients who underwent ileal ureter replacement combined with augmentation cystoplasty were treated with ileal ureter replacement combined with augmentation cystoplasty.There were 1 male and 2 females with the age ranging from 34 to 55 years (mean 39 years).Two patients suffered from left ureter stenosis,and one patient had stenosis on the both sides.The length of the ureter stenosis ranged from 6 to 18 cm (mean 9.8 cm).The preoperative bladder capacity ranged from 60 to 150 ml (mean 103.3 ml).In the surgery,part of ileum was used to replace the ureter,and the distal intestine was made into U-shape to enlarge the bladder.Results All operation were completed successfully.The operation time ranged from 220 to 400 min (mean 303.0 min),and the blood loss ranged from 150 to 500 ml (mean 283.3 ml).Laparoscopic surgery was performed in 1 case and open surgery in 2 cases.Three weeks after the surgery,the bladder volume underwent cystography ranged from 300 to 400 ml (mean 360.0 ml).Three months after the surgery,the postvoid residual urine volume ranged from 20 to 50 ml (mean 33.3 ml).Postoperative frequency and urgency of urine were completely relieved in 1 case,alleviated in 2 cases.Flank pain was completely relieved in 1 case,and alleviated in 2 cases postoperatively.The serum creatinine of 2 patients mildly increased after the surgery,while 1 patient remained stable.For complications,1 patient had urinary infection,and 1 patient suffered from metabolic acidosis.Conclusions Ileal ureteral replacement combined with augmentation cystoplasty can be the choice of treatment for long segment ureteral stenosis and enlarge the bladder simultaneously.The postoperative complications and the kidney functions should be regularly followed up.

Long-term Outcomes of Augmentation Cystoplasty in a Pediatric Population With Refractory Bladder Dysfunction: A 12-Year Follow-up Experience at Single Center / 대한배뇨장애요실금학회지

PURPOSE: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. METHODS: A retrospective analysis was conducted of 42 patients (31 males; mean age, 14.2±6.2 years) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median 12.0±1.5 years of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. RESULTS: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. CONCLUSIONS: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

Sonographic abnormalities in augmented bladder using porcine intestinal submucosa (SIS) / Anormalidades ultrassonográficas em bexigas submetidas à cistoplastia utilizando submucosa intestinal suína (SIS)

Among the different materials for bladder augmentation, porcine intestinal submucosa (SIS) is the most widely investigated and stands out for its ability as a cell scaffold. In this context, the ultrasound examination allows the detection of changes from the surgical procedure, enabling the early verification of potential complications and evaluation of patient outcomes. The aim of this paper is to describe the main sonographic findings in dogs submitted to cystoplasty using acellular SIS and seeded with homologous smooth muscle cells at 30 (M30) and 60 (M60) days postoperatively. Sonographic changes included irregularities and thickening of bladder wall especially at M30. Additionally, were visualized urinary sediment and uroliths in animals submitted to acellular SIS cistoplasty. Abdominal ultrasonography was useful in the postoperative evaluation of animals undergoing cystoplasty with acellular or seeded SIS.(AU)

Entre os diferentes materiais utilizados para a reparação e o aumento da bexiga, a submucosa intestinal suína (SIS) é o mais amplamente investigado e se destaca por sua habilidade como um arcabouço celular. Nesse contexto, o exame ultrassonográfico possibilita a avaliação pós-operatória, bem como a detecção precoce de potenciais complicações. O objetivo deste artigo é descrever os principais achados ultrassonográficos em cães submetidos à cistoplastia utilizando a SIS acelular e semeada com células musculares lisas homólogas aos 30 (M30) e 60 (M60) dias de pós-operatório. As alterações ultrassonográficas pós-operatórias incluíram irregularidades e espessamento da parede da bexiga, especialmente aos M30. Além disso, foram visualizados sedimento urinário e urólitos em animais submetidos à cistoplastia utilizando a SIS acelular. A ecografia abdominal foi útil na avaliação pós-operatória dos animais submetidos à cistoplastia utilizando a SIS acelular e semeada com células musculares lisas homólogas.(AU)

Outcome of tissue engineered cystoplasty augmentation for the treatment of neurogenic bladder by using small intestinal submucosa / 中华泌尿外科杂志

Objective To investigate the feasibility and efficacy of using small intestinal submucosa (SIS) as scaffold in cystoplasty augmentation for treating the neurogenic bladder.Methods We retrospectively reviewed our database of 14 patients with neurogenic bladder,including ten male and four female,between January 2011 and March 2014.The mean age in those patients was 29 years old (range 14-56 years old).The etiology of neurogenic bladder included myelomeningoceles in 8 cases and spinal cord injuries in 6 cases.The urodynamic examination showed that the mean volume of maximal bladder pressure was (150.1± 64.2) ml,mean bladder compliance was (5.2± 3.9) ml/cmH2O,maximal detrusor pressure was (44.1 ± 29.2) cmH2O.The SIS cystoplasty was performed in all patients,which the Surgisis(R) ES was used during operation.In order to enlarge the bladder,the 4-layer tissue graft was fashioned into a strap shape,rehydrated and continuously sutured to the mucous edge of opening bladder walls.Seven patients accepted the ureter reimplantation with anti-reflux technique simultaneously.Serial video-urodynamics,magnetic resonance urography (MRU) and serum analyses were used to assess the outcomes of surgery.Results All patients were undergone the operation successfully.The mean operative time was 120 min.Bowel function returned promptly after surgery.No metabolic consequences were noted.Renal function was preserved.The duration of follow-up ranged from 6 to 48 months (mean 24 months).Compared to the preoperative findings,there were significant increasing in maximum bladder capacity (P＜0.05) at the 6,12 and 24-month follow-up (150.1± 64.2) ml preoperatively,(274.9±88.7) ml at 6 months,(322.5± 144.4) ml at 12 months and (279.9± 157.9) ml at 24 months,The significant differences also exhibited in the increasing of bladder compliance (P＜0.01) at the 24-month follow-up [(5.2±3.9) ml/cmH2O preoperatively,(26.1 ±29.4) ml/cmH2O at 24 months] and decreasing of maximum detrusor pressure (P＜0.05) at the 12 and 24-month follow-up [(44.1±29.2) cmH20 preoperatively,(20.1±9.8) cmH2O at 12 months,(20.2±19.1) cmH2O at 24 months].Two patients were observed scaffold rupture one week postoperatively and healed with patent drainage.One patient developed calculi in neo-bladder at 3-months follow-up and treated with transurethral lithotripsy.Four patients were noted vesico-ureteral reflux at 12-month follow-up.The botulin toxin detrusor injection was used in 2 cases.After indwelling the catheter for 3 months,the symptoms of reflux disappeared.The oral administration of solifenacin (5mg twice per day) and tolterodine (4mg once per day) was used in other 2 patients,who also accepted the catheter indwelling at the same time.The symptom of reflux relieved in only patient.Conclusions SIS can be used effectively as a scaffold for bladder augmentation.Tissue engineering technology provides a potentially viable option for genitourinary reconstruction in patients with neurogenic bladder.

Perioperative Pharmaceutical Care with Sigmoid Colon Cystoplasty for Neurogenic Bladder / 中国康复理论与实践

@#Objective To explore pharmacy services on a patient with sigmoid colon cystoplasty for neurogenic bladder by clinical pharmacist.Methods A case accepted sigmoid colon cystoplasty for neurogenic bladder was reported. Results and Conclusion Pharmaceutical care can improve the rational use of drugs and reduce side effect.

Treatment of contracted bladder from ketamine abuse with sigmoid cystoplasty / 中华泌尿外科杂志

Objective To discuss the surgical treatment of contracted bladder caused by ketamine abuse. Methods Twenty-five ketamine male abusers were included in this study.The ages were from 19 to 28 years old and mean age was 24 years old.AIl of them had abused ketamine history for 0.7 tO 4.0 years,and presented with severe lower urinary tract symptoms.including severe frequency,urgency,urge incontinence,and painful haematuria.Urine cultures were negative.Hepatic function and renal function were normal.B ultrasound examination of 23 cases demonstrated the presence of bilateral hydronephrosis,the separation of renal pelvic was(1.8±0.7)cm.B ultrasound examination of 22 cases demonstrated residual urine was 45-1 50 ml,mean 80 m1.Twenty-three IVU investigations demonstrated the presence of bilateral hydronephrosis with calyces renales minores cycloidal expansion and bladder contraction.All the patients took the urodynamies with bladder capacity was (89±34)ml,end filling detrusor pressure was(48±26)cm H2O,Qmax was(7.8±2.3)ml/s,residual urine volume was(82±47)m1.All patients had cystoscopies and random biopsies performed showed ulcerative cystitis only.All patients were required to withdraw the narcotics and the experimental medicines were given without symptoms alleviated.Sigmoid cystoplasty was performed in all the 25 patients. Results The mean follow up was 18 months(rang 6 to 36).Compared with that before operation, bladder capacity increased to (375 ±53)ml, end filling detrusor pressure reduced to( 13 ±9)cm H2O, Qmax increased to(17.6±5.8)ml/s, residual urine volume reduced to(20±10)ml.Compared with the preoperative, there were statistically significant differences.There was no complained of urinary incontinence, enuresis, frequency, urgency.Urine routine examination was normal.IVU showed the vesicoureteral reflux disappeared in all patients, and calyces renales no expansion or calyces renales minores light degree expansion.B ultrasound examination that the separation of renal collecting was(1.0 ±0.5)cm. Conclusions Sigmoidcystoplasty could increase bladder capacity and compliance, lower the intravesieal pressure.It could improve the patients' quality of life.

Advance in Small-intestinal Submucosa for Bladder Augmentation (review) / 中国康复理论与实践

@#The need to find an alternative to the use of bowel for urinary reconstruction has renewed research interests involving bladder regeneration. Small intestinal submucosa (SIS) is an acellular, nonimmunogenic, biodegradable, xenogeneic, collagen-based material that is derived from the submucosa layer of porcine small intestine. SIS has demonstrated regenerative capacities in multiple organ systems, including the aorta, vena cava, ligaments, tendons, abdominal wall, and skin. This article reviewed the history of the development of the bladder regeneration and the studies involving the use of SIS for bladder augmentation.

Perioperative Nursing of Sigmoid Colon Cystoplasty for Neurogenic Bladder after Spinal Cord Diseases / 中国康复理论与实践

@#ObjectiveTo discuss the perioperative nursing of sigmoid colon cystoplasty in neurogenic bladder patients after spinal cord diseases. Methods31 patients with neurogenic bladder due to the spinal cord diseases and received sigmoid colon cystoplasty were reviewed and followed up. ResultsThere were 2 cases complicated with bowel obstruction, 1 case with acute alleosis and 1 case with mycotic infection in bladder after the operation, who were all cured. After discharge, 2 cases lost the follow-up. During the follow-up period of 6 months to 4 years, 29 patients recovered well and kept in self-intermittent catheterization. ConclusionPreoperative psychological nursing and intestinal and bladder preparation, postoperative gastrointestinal and urinary drainage catheters nursing, intermittent catheterization training, regular follow-up and health guiding were the key nursing contents and the important step for ensuring an excellent outcome for the operation.

Experiences of Renal Transplantation after Correction of Dysfunctional Contracted Bladder / 대한이식학회지

BACKGROUND: There is some controversy about the safety of renal transplantation in patients with an augmentation cystoplasty. The purpose of this study is to assess the early and long-term results of renal transplantation in 6 patients who underwent augmentation cystoplasty to correct bladder dysfunction. METHODS: We retrospectively reviewed the surgical outcome of renal transplants in 6 recipients with augmentation cystoplasty including one ileal conduit. The etiology of bladder dysfunction was neurogenic bladder with detrusor hyperreflexia (4 pediatric patients) and renal tuberculosis (2 adult patients). Augmentation cystoplasty was performed before transplantation in all patients. The bowel segments used in the augmentation cystoplasty included stomach in 2 (including one revision case with ileum), ileum in 3, ileocecal segments in 1, and sigmoid colon in 1 patients. The mean patient's age at transplantation was 25.5 years. Four transplants were from living donors. The donor ureter was anastomosed to ileal conduit in 1, native bladder in 2, and the bowel segment in 3 patients. RESULTS: All transplanted kidneys were functioning at a mean follow-up of 103 months (range 5 to 220). The mean serum creatinine level was 1.0 mg/dl (range 0.7 to 1.8). Acute rejection was diagnosed in protocol biopsy in one patient without graft function deterioration. Four patients admitted for febrile urinary infection during the follow up periods. CONCLUSIONS: Augmentation cystoplasty is a safe and effective method to restore the renal function in patients who have noncompliant bladders. Renal transplantation can be performed safely after augmentation cystoplasty.

Perioperative Nursing of Sigmoid Colon Cystoplasty for Neurogenic Bladder / 中国康复理论与实践

@#The perioperative nursing of sigmoid colon cystoplasty for neurogenic bladder patients including: preoperative psychological nursing, intestinal and vesical preparation; postoperative gastrointestinal decompression, drainage catheters and complications nursing; intermittent catheterization training before discharge; follow-up and healthy direction after discharge.

Adenocarcinoma Arising in Augmented Bladder / 대한비뇨기과학회지

Adenocarcinoma arising in an augmented bladder is a relative rare neoplasm. We report here on 2 cases of adenocarcinoma that developed in augmented bladders 23 and 30 years after ileocystoplasty, and both tumors were associated with contracted bladder due to tuberculosis. We also reviewed the literatures related to neoplasms occurring after urinary diversion procedures.

The Long-Term Outcomes of Augmentation Cystoplasty in Spinal Cord Injury Patients / 대한비뇨기과학회지

PURPOSE: The long-term outcomes of augmentation cystoplasty were investigated in spinal cord injury (SCI) patients with a neurogenic bladder, and included a study of the complications and patients' satisfaction. MATERIALS AND METHODS: 19 SCI patients that underwent an augmentation cystoplasty, between 1988 and 1994, were retrospectively reviewed. The mean follow-up period was 120, ranging from 94 to 169 months. The changes in the intravesical pressure, bladder capacity and complications were investigated. Urological examinations, including history taking, medical records, radiological evaluations and urodynamic studies were undertaken. All the patients were interviewed by direct contact. RESULTS: Six months postoperatively, the urodynamic results showed significantly decreased intravesical pressures and increased bladder capacities. The intravesical pressure (cmH2O) was decreased from 89.0+/-16.49 to 28.0+/-5.69 (p<0.05), and the functional bladder capacity (ml) was increased from 125.0+/-53.30 to 480.0+/-43.33 (p<0.05). From the long-term follow-up, 10 years postoperatively, the results were similar to the previous data (21.0+/-3.88cmH2O and 510.0+/-60.27ml). The symptomatic urinary tract infections had disappeared, but the asymptomatic bacteriuria continued. The vesicoureteral reflux was eliminated, and the renal function normalized, in all patients. The hydronephrosis had disappeared in most patients (89%). A few postoperative complications were reported. Most patients were very satisfied symptomatically (89%), with no patient expressing dissatisfaction. A clean intermittent catheterization (CIC) was performed every 4 to 6 hours, with the mean volume of drained urine was 450, ranging from 400 to 600ml. CONCLUSIONS: Augmentation cystoplasty could be an excellent method of treatment in selected patients with SCI. There were no significant complications, and a high degree patients' satisfaction, on the long-term follow-up.

The Long Term Results of Augmentation Cystoplasty in Contracted Bladder / 대한비뇨기과학회지

PURPOSE: In contracted bladder of various etiologies, if many of conservative managements fail, a surgical treatment seems to be the only therapeutic approach. We tried to evaluate the long term results of aug mentation cystoplasty including the postoperative complication and the degree of satisfaction in patients. MATERIALS AND METHODS: From 1989 to 1988, augmentation cystoplasties had been performed in 11 patients with contracted bladder of various etiologies. We reviewed the patients' medical records including the result of urodynamic examinations, retrospectively. Postoperative follow-up periods were 9 to 114months (mean:61months). Patients were interviewed by telephone. RESULTS: Urinary frequency, nocturia, dysuria and suprapubic pain were improved in all patients, but dysuria persisted in one patient with tuberculous cystitis. Clean intermittent catheterization (CIC) was done in there of 11 patients due to large volume of residual urine. The volume of residual urine was 200-300ml in one with hyperreflexic neurogenic bladder, and 100-200ml in two with interstitial cystitis. Self voiding was possible in 8 patients with residual urine volume less than 90ml. Almost all patients were very satisfied symptomatically in the telephone survey. There were no significant complications which required surgical revision. CONCLUSIONS: It is concluded that augmentation cystoplasty could be an excellent method of treatment for selective patients with contracted bladder, who have not improved symtomatically by medication or conservative management.

Bladder Cellular Regeneration after Augmentation Cystoplasty with Human Dura Mater (Tutoplast(R)) in Rat / 대한비뇨기과학회지

PURPOSE: To study the cellular events occuring during bladder development and regeneration, we used the human Dura mater (Tutoplast(R)) for augmenting the rat bladder. We compared their intravesical threshold pressure and volume, and observed the regenerative capacity of urothelium and smooth muscle cell within Tutoplast(R). MATERIALS AND METHODS: Among a total of 67 rats, 11 normal rats were checked their intravesical threshold pressure and volume(Group 1). 9 rats underwent only vesicotomy(Sham operation) and were checked their threshold pressure and volume at 2 months and 3 months postoperatively(Group 2). 47 rats underwent augmentation cystoplasty with Tutoplast(R) after partial cystectomy, which were checked pressure and volume at 1 day, 3-7 days, 2-4 weeks, 2-6 months postoperatively(Group 3). Specimens were examined histologically to assess the regeneration of urothelium and smooth muscle cell on the graft. RESULTS: There was a significant increase in intravesical volume of group 3 compared with group 1 and 2. There was a significant decrease in intravesical pressure of group 3 compared with group 2, but there was no significant difference between group 1 and 3. The specimens of 1 day postopratively showed inflammatory findings. Epithelialization on the graft margin was noted at 3 days postoperatively. At 7 days postoperatively, there was epithelial hyperplasia on the graft site. At 2 weeks postoperatively, there was a partial absorption of Tutoplast(R) as well as favorable progression of epithelialization. Smooth muscle regeneration and complete epithelialization were shown at 3 months postoperatively and absorption of Tutoplast(R) was completed thereafter. CONCLUSIONS: The regeneration of bladder cellular constituents within Tutoplast(R) will be valuable for further understanding the mechanism controlling bladder development and regeneration. Further studies will be necessary for using this method as an alternative strategy to the classical bladder augmentation.

Two Cases of Autoaugmentation Cystoplasty in Spastic Neurogenic Bladder with Vesicoureteral Reflux / 대한비뇨기과학회지

Urinary incontinence is an annoying complaint in patients with imbalanced upper motor neuron lesion, and prevention of vesicoureteral reflux and urinary tract infection is important for the preservation of renal function. We present two cases of autoaugmentation cystoplasty and extravesical ureteral reimplantation (Lich-Gregoir Technique) in paraplegics who have upper motor neuron lesion with vesicoureteral reflux.

An Experience of Spastic Neurogenic Bladder Treated with Augmentation Cystoplasty and External Urethral Sphincterotomy / 대한비뇨기과학회지

A 41-year-old man with a 12-year history of urinary incontinence and frequency was presented our hospital. He had a spinal cord injury after fell down from a utility pole. Spastic neurogennic bladder and detrusor external sphincter dyssynergia was diagnosed and augmentation cystoplasty was performed. And we performed additional external sphincterotomy to avoid intrmittent self catheterization. He can retain as much as 800m1 of urine without urinary incontinence and voids with abdominal pressure and retains little residual urine. We report the good result of additional external urethral sphincterotomy after augmentation cystoplasty.

Evaluation of the Augmentation Cystoplasty in the Pediatric Neurogenic Bladder / 대한비뇨기과학회지

From 1985 to 1995, 13 children with neurogenic bladder underwent augmentation cystoplasty. Diagnosis in these 13 children included Meningomyelocele in 11 and unknown origin in 2. Indications for augmentation cystoplasty were persists incontinence in 6 patients and progressive upper urinary tract deterioration in Bowel segments were used for augmentation included sigmoid colon in 1 patient, ileocecal segments incontinence in 6 patients stomach in 3. Dilated ureter also was used in 1 patient. Postoperatively, all the patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 12 require clean intermittent catheterization to empty bladder and 10 are completely continent. After operation, bladder capacity increased from 155 ml to 305 ml and there were significant increases in bladder compliance. Hypereflexia was present in 5 patients before operation and in 3 patients after operation. There has been no surgical mortality. Postoperative complications occurred in 4 patients included mild ileus in 2 patients, mucus obstruction in 1, mild hematuria in 1, metabolic alkalosis in 1 and superficial wound infection in All complications were transient and managed medically. the kind of bowel segments did not seem to influence results. We think that augmentation cystoplasty is a therapeutic modality that should be considered as a viable treatment option in selected patients with neurogenic bladder dysfunction.

Augmentation Cystoplasty with Mainz Pouch in Tuberculous Contracted Bladder / 대한비뇨기과학회지

A variety of surgical techniques for augmentation cystoplasty have been developed. To evaluate the clinical availability of the augmentation cystoplasty using the Mainz pouch, We reviewed 8 patients with tuberculous contracted bladder who underwent construction of a Mainz pouch. Preoperative frequency was dramatically improved in all of 8 patients. Mean bladder capacity increased from 36 ml preoperatively to 534ml postoperatively. On the uroradiologic study, preoperative hydronephrosis was improved or stable in 9 of l0 renal units and was aggravated in 1 renal unit. Preoperative vesicoureteral reflux disappeared in all of 3 patients. Urodynamic study revealed mean residual urine of 70ml and maximal intravesical pressure during contraction of 65cmH2O after cystoplasty. There were no significant complications which required surgical revision.