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Augmentation ureterocystoplasty could be performed more frequently
S V Perovic1, V M Vukadinovic, M L Djordjevic
1Department of Urology, University Children's Hospital, Belgrade, Yugoslavia.
The Journal of Urology
|August 25, 2000
Summary
Megaureter tissue is ideal for bladder augmentation. This study shows dividing the megaureter for augmentation and reimplantation increases its use in pediatric patients, improving bladder capacity and function.
Area of Science:
- Urology
- Pediatric Surgery
Background:
- Megaureter is a suitable tissue for bladder augmentation.
- Ureterocystoplasty has been historically underutilized for bladder augmentation.
Purpose of the Study:
- To demonstrate the feasibility and benefits of a modified ureterocystoplasty technique for bladder augmentation.
- To increase the frequency of using megaureter tissue for bladder augmentation in pediatric patients.
Main Methods:
- A cohort of 16 pediatric patients (3-12 years) underwent ureterocystoplasty between 1995 and 1998.
- The technique involved dividing the megaureter, using the distal segment for bladder augmentation, and reimplanting the proximal segment.
- Procedures were performed either as a 1-stage or 2-stage operation, with extraperitoneal dissection and extravesical detrusor tunneling ureteroneocystostomy.
Main Results:
- Mean follow-up was 2.8 years.
- Mean bladder capacity increased significantly to 371 ml (range 296-442 ml).
- Improved bladder compliance, reduced need for clean intermittent catheterization, and preserved renal function were observed. Three patients had asymptomatic vesicoureteral reflux.
Conclusions:
- Megaureter is an ideal tissue for bladder augmentation.
- Dividing the megaureter for augmentation and reimplantation is a viable and effective technique.
- This modified augmentation ureterocystoplasty can be performed more frequently in pediatric cases.