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Augmentation colocystoplasty in bladder exstrophy.

V Bhatnagar1, S Dave, S Agarwala

  • 1Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi-110029, India.

Pediatric Surgery International
|January 17, 2002
PubMed
Summary
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Detubularized augmentation colocystoplasty (ACC) is a safe and effective salvage procedure for bladder exstrophy (BE) patients with small, noncompliant bladders. This technique can improve continence and preserve upper urinary tract function in select cases.

Area of Science:

  • Pediatric Urology
  • Reconstructive Surgery
  • Bladder Exstrophy Management

Background:

  • Bladder exstrophy (BE) reconstruction success relies on bladder capacity and outlet resistance.
  • Augmentation cystoplasty (AC) is a salvage option for small, noncompliant bladders in BE patients.

Purpose of the Study:

  • To evaluate the efficacy and safety of detubularized augmentation colocystoplasty (ACC) as an adjunctive procedure in bladder exstrophy (BE) management.
  • To assess outcomes related to continence, voiding, and upper tract status following ACC in BE patients.

Main Methods:

  • Retrospective review of 89 BE patients treated over 12 years.
  • Analysis of 19 patients who underwent detubularized augmentation colocystoplasty (ACC).
  • ACC performed either at bladder-neck reconstruction (BNR) or as a secondary procedure for incontinence or upper-tract deterioration.

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Main Results:

  • 19 patients underwent ACC; 9 achieved complete daytime and nighttime dryness.
  • Upper tracts remained stable or normal in all patients.
  • Complications included UTIs, epididymo-orchitis, calculi, and fistula; no mortality or reservoir perforation.

Conclusions:

  • Detubularized augmentation colocystoplasty (ACC) is a valuable and safe adjunctive procedure for select bladder exstrophy (BE) patients with small, poorly compliant bladders.
  • ACC can improve continence and maintain upper urinary tract health.
  • Despite potential complications, a more liberal use of ACC in BE management is suggested.