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Updated: Sep 28, 2026
Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
Published on: August 9, 2012
Growth and metabolic consequences of bladder augmentation in children with myelomeningocele and bladder exstrophy
Gerald C Mingin1, Hiep T Nguyen, Robert S Mathias
1Department of Urology, University of California, San Francisco, Children's Hospital, San Francisco, California 94143-0738, USA.
Insights
Bladder augmentation using intestinal segments is safe for children with bladder exstrophy and myelomeningocele. The procedure does not negatively impact linear growth or bone density in these patients.
Area of Science:
- Pediatric Urology
- Pediatric Surgery
- Pediatric Endocrinology
Background:
- Bladder augmentation with intestinal segments is a common procedure for patients with bladder exstrophy and myelomeningocele.
- Concerns exist regarding potential negative impacts on linear growth and bone metabolism.
Purpose of the Study:
- To evaluate the effects of bladder augmentation on calcium metabolism, linear growth, and bone density in patients with bladder exstrophy and myelomeningocele.
Main Methods:
- Prospective study of 33 patients undergoing bladder augmentation.
- Analysis of calcium metabolism markers, electrolytes, height, and bone density (dual radiograph bone densitometry).
- Comparison with nonaugmented patients and normal children.
Main Results:
- No significant differences in percentile height or bone density were observed between augmented and nonaugmented groups.
- While some electrolyte differences were noted in myelomeningocele patients, they did not affect growth or bone density.
- Gastrocystoplasty augmentation showed no significant differences compared to other methods.
Conclusions:
- Bladder augmentation is a safe procedure for patients with bladder exstrophy and myelomeningocele.
- The procedure does not adversely affect linear growth or bone density.
Objective:
Bladder augmentation using intestinal segments is reported to cause decreased linear growth in bladder exstrophy and myelomeningocele patients. We studied changes in calcium metabolism, height, bone chemistry, and bone density in exstrophy and myelomeningocele patients after bladder augmentation.
Methods:
Thirty-three patients were prospectively admitted to the Pediatric Clinical Research Center at the University of California San Francisco for 24 hours. Blood and urine were analyzed for electrolytes, and serum was obtained for markers of calcium metabolism. Dual radiograph bone densitometry of the forearm was performed. Myelomeningocele patients were compared with nonaugmented myelomeningocele patients matched by age, gender, level of defect, and ambulatory status. Exstrophy augmented patients were compared with nonaugmented exstrophy patients. The bone densities in both groups were compared with normal children. Laboratory values and percentile heights were statistically analyzed using the Student t test; bone densitometry was analyzed using the Tukey test.
Results:
Twenty-two patients with myelomeningocele and 11 with bladder exstrophy were studied. Mean follow-up was 3.7 years postaugmentation (range: 1-13 years). The results indicate a significant difference in serum bicarbonate and chloride levels between myelomeningocele patients who underwent ileal augmentation and those who did not. Although this may be indicative of chronic metabolic acidosis, there was no affect on growth or bone density when compared with controls. There were no other significant differences in laboratory values, or percentile heights, nor were any differences noted in patients who underwent gastrocystoplasty. In the exstrophy group, there were no observable differences in percentile height or laboratory values between the augmented and nonaugmented group. There were no significant differences in bone density between these 2 groups when matched for age and gender. No significant difference was seen in bone density when these groups were compared with normal children.
Conclusion:
Bladder augmentation is safe and does not impact negatively on the linear growth or bone densities of patients with myelomeningocele or bladder exstrophy.
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