[Intermediate results of surgical bladder augmentation in children]

The most common origin of the urinary incontinence are the myelodysplasia and congenital urogenital malformations in childhood. Surgical augmentation of the urinary bladder with or without continent diversion, may be indicated in case of unsatisfactory result of all other conservative treatments. Between 1987-2000 bladder augmentation or substitution was carried out with large bowel or gastric segment in 37 patients. The age at surgery was between 6-21 yrs, (mean 12.3 yrs). The authors discuss the results of the 30 patients in whom follow up was at least 1 yr (12-113 months, mean 43 months). The urinary incontinence could be solved in 24/30 of the children, 6/30 remained in the same condition without worsening any of them. In 11/30 patients complication was not observed at all, but in 19/30 further surgeries were necessary in 30 times, mainly due to stone formation. The authors state that the augmentation cystoplasty is a useful method for the creation of a low pressure urinary reservoire which with or without a continent diversion may solve the urinary incontinence, however the patients need a lifelong follow-up due to the possible long-term risks.