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Lithogenic properties of enterocystoplasty
B Blyth1, D H Ewalt, J W Duckett
1Division of Urology, Children's Hospital of Philadelphia, Pennsylvania.
The Journal of Urology
|August 1, 1992
Summary
Bladder stones (calculi) frequently form after augmentation enterocystoplasty, primarily within the reservoir. Triple phosphate composition suggests bacteriuria and urease activity are key causes, with open cystolithotomy being the most effective removal method.
Area of Science:
- Urology
- Surgical Innovation
- Biomedical Engineering
Background:
- Augmentation enterocystoplasty is a complex surgical procedure to reconstruct the urinary bladder.
- The formation of bladder stones (calculi) is a known complication following this type of surgery.
- Understanding the etiology and effective management of post-augmentation calculi is crucial for patient outcomes.
Purpose of the Study:
- To investigate the incidence, characteristics, and etiological factors of calculi formation after augmentation enterocystoplasty.
- To evaluate the efficacy of different surgical methods for calculi removal.
Main Methods:
- Retrospective analysis of 87 patients who underwent augmentation enterocystoplasty.
- Identification and analysis of calculi composition.
- Review of surgical interventions for calculi removal.
Main Results:
- Calculi formed in 30% of patients (26/87), with 23 occurring within the bladder reservoir at a mean of 25 months post-surgery.
- Calculi were predominantly composed of triple phosphates.
- Open cystolithotomy demonstrated the highest success rate for calculi removal.
Conclusions:
- Augmentation enterocystoplasty is associated with a significant risk of calculi formation, particularly within the reservoir.
- The triple phosphate composition points to bacteriuria and urease activity as primary etiological factors.
- Open cystolithotomy is the preferred surgical approach for managing these calculi.