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10:19
Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
Published on: August 9, 2012
What is the need for additional bladder surgery after bladder augmentation in childhood?
P D Metcalfe1, M P Cain, M Kaefer
1Department of Pediatric Urology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, 702 North Barnhill Drive, Indianapolis, IN 46202, USA.
The Journal of Urology
|September 2, 2006
Summary
Bladder augmentation surgery for neuropathic bladder in children requires lifelong care. While 34% needed further surgery for complications like stones or perforation, most patients experience improved quality of life.
Area of Science:
- Pediatric Urology
- Surgical Reconstruction
- Nephrology
Background:
- Bladder augmentation significantly improves quality of life for children with neuropathic bladder.
- It is a major surgical procedure with potential long-term complications.
- Long-term data on subsequent surgeries after bladder augmentation is limited.
Purpose of the Study:
- To define the long-term need for subsequent bladder surgery after augmentation in a large pediatric cohort.
- To identify the types and frequency of complications requiring reoperation.
Main Methods:
- Retrospective review of 500 bladder augmentations performed between 1978 and 2003.
- Analysis of complications including malignancy, perforation, repeat augmentation, obstruction, and calculi.
- Mean and median follow-up of 13.3 years.
Main Results:
- 34% of patients (169/500) experienced complications requiring 254 additional surgeries.
- Cumulative risk of reoperation was 0.04 per patient-year.
- Complications included bladder stones (15%), perforation (8.6%), repeat augmentation (9.4%), and bowel obstruction (3.2%). Three cases of metastatic transitional cell carcinoma occurred.
Conclusions:
- Bladder augmentation offers substantial quality of life benefits but necessitates lifelong patient and healthcare commitment.
- While subsequent surgeries are not uncommon, 66% of patients did not require further operations on the augmented bladder.
- Long-term surveillance is crucial for managing potential complications.
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