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Updated: Jul 25, 2026
Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
Published on: August 9, 2012
[Spontaneous urinary bladder perforation after pediatric cystoplasty]
M L Martínez del Castillo1, C Miguélez Lago, M García Mérida
1Cirugia Pediátrica, Hospital Materno-Infantil, del Hospital Regional Universitario Carlos Haya, Málaga.
Insights
Spontaneous bladder augmentation (cystoplasty) perforation occurred in 16.6% of patients, often due to high urethral resistance and inadequate catheterization. Early diagnosis and awareness of symptoms are crucial for prevention and timely treatment.
Area of Science:
- Urology
- Pediatric Surgery
Context:
- Spontaneous bladder augmentation (cystoplasty) perforation is a rare but serious complication.
- Delayed diagnosis and treatment can lead to severe outcomes.
Purpose:
- To analyze risk factors for spontaneous bladder augmentation perforation.
- To identify key diagnostic signs.
- To evaluate treatment outcomes.
Summary:
- This study reviewed 5 children with cystoplasty who experienced 8 perforations (16.6%). Key risk factors identified were high urethral resistance and insufficient intermittent catheterization.
- Abdominal pain and distension were common symptoms. Ultrasonography and cystography aided in diagnosis, with varying rates of detecting intraperitoneal extravasation.
- Initial conservative management was successful in 42.8% of cases diagnosed pre-operatively, while others required surgery. Relapses occurred in 40% of patients.
Impact:
- Highlights the significant incidence of spontaneous bladder augmentation perforation in this cohort.
- Emphasizes the importance of recognizing risk factors like urethral resistance and catheterization adequacy.
- Underscores the need for patient and family education regarding this complication for early detection and improved outcomes.
Objective:
The spontaneous cystoplasty perforation is a serious and potentially fatal problem if a delay in diagnosis and treatment occurs. We pretend: 1) to look for prevention analyzing the risk factors, 2) to identify the main data of diagnostic suspicion and 3) to evaluate the result of the treatments done.
Material And Methods:
Out of 30 children with cystoplasty 5 of them have presented 8 perforations (16,6%). Several influential factors, the symptoms, the treatments and the evolution are reviewed.
Results:
The average time between cystoplasty and the perforation was 8,2 years. A urethral resistance that allows continence, and an insufficient intermittent catheterization, have been the main risk factors. In the 8 episodes there were abdominal pain and distension. The ultrasonography showed intraperitoneal extravasation in 5 episodes, multiple peritoneal cysts in one, and suggestive image of appendicular plastron in another one. The cystography showed intraperitoneal extravasation only in 3 cases. The initial management was conservative in the 7 episodes diagnosed before surgery, and 3 had a good evolution (42,8%); the other 4 needed surgery with good evolution in all cases. Two of 5 patients (40%) presented 3 relapses in an average time of 5 years. The survival is 100%.
Conclusions:
16,6% of patients with cystoplasty of this series had one or more episodes of spontaneous bladder perforation. The more significant risk factors are a high urethral resistance and an inadequate intermittent catheterization. The patients with cystoplasty, and their families, must know this complication, their risk factors and symptoms to prevent it, or to facilitate an early diagnosis.
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