Augmentation cystoplasty in children without preoperative mechanical bowel preparation

Area of Science:

• Pediatric Urology
• Surgical Oncology
• Gastroenterology

Background:

• Augmentation cystoplasty is a surgical procedure to enlarge the urinary bladder.
• Preoperative mechanical bowel preparation (MBP) is a common practice before gastrointestinal surgeries.
• The necessity of MBP for augmentation cystoplasty in pediatric patients is not well-established.

Purpose of the Study:

• To evaluate the safety and efficacy of augmentation cystoplasty without preoperative mechanical bowel preparation (MBP) in children.
• To assess the rate of early postoperative complications in pediatric patients undergoing augmentation cystoplasty without MBP.

Main Methods:

• Retrospective analysis of 162 augmentation cystoplasties performed in 158 children between May 1987 and May 2006.
• Patients received preoperative and postoperative antibiotics but no preoperative mechanical bowel preparation (MBP).
• Segments used included sigmoid colon, ileum, and ileocecum.

Main Results:

• No intraoperative complications were reported.
• The overall postoperative complication rate was 9.87%, with urinary fistula being the most common (2.4%).
• Wound infection occurred in 1.85% of patients, and 5 patients required reoperation for various reasons.

Conclusions:

• Preoperative mechanical bowel preparation (MBP) can be safely omitted in pediatric augmentation cystoplasty.
• Omitting MBP does not appear to increase the risk of infectious or anastomotic complications.
• Further prospective, randomized trials are recommended to validate these findings in the pediatric population.