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Related Experiment Videos

Post-augmentation bladder perforation during urodynamic investigation.

Bertil F M Blok1, Ahmed Al Zahrani1, John Paul Capolicchio1

  • 1Department of Urology, Shriners Hospital Canada, Montreal, Quebec, Canada.

Neurourology and Urodynamics
|February 3, 2007
PubMed
Summary

Bladder augmentation with ileocystoplasty can rarely rupture during urodynamic testing, even years after surgery. Careful monitoring of bladder pressure during cystometry is crucial for patients with neurogenic bladder.

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Area of Science:

  • Urology
  • Pediatric Surgery
  • Neurourology

Background:

  • Augmentation ileocystoplasty is a common procedure for managing neurogenic bladder dysfunction, aiming to increase bladder capacity and reduce intravesical pressures.
  • Long-term follow-up of these patients typically shows stable bladder function with good compliance and low pressures.

Observation:

  • A 17-year-old female with a history of meningomyelocele and ileocystoplasty experienced sudden abdominal discomfort and shoulder pain during filling cystometry.
  • Urodynamic monitoring revealed a significant increase in detrusor pressure at 620 ml, despite previous years of normal urodynamic findings.

Findings:

  • The patient sustained an intraperitoneal bladder rupture at the lateral aspect and the Mitrofanoff insertion site.
  • Surgical repair was successful, with no postoperative complications and no leakage on follow-up cystography.

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Implications:

  • This case highlights the potential for late-onset bladder rupture during urodynamic evaluation in augmented bladders.
  • Clinicians should exercise extreme caution during filling cystometry in patients with augmented bladders, especially if decreased compliance is detected, irrespective of prior urodynamic stability.