Bladder augmentation using the gastrointestinal tract. Indication, follow up and complications

Area of Science:

• Urology
• Gastrointestinal Surgery
• Reconstructive Surgery

Background:

• Bladder augmentation aims to create a low-pressure, high-capacity reservoir for urinary continence and voiding.
• Preservation of upper urinary tract function is a key goal in managing lower urinary tract dysfunction.

Purpose of the Study:

• To analyze the indications, complications, and outcomes of augmentation enterocystoplasty.
• Evaluate the efficacy of using gastrointestinal segments for bladder augmentation.

Main Methods:

• Retrospective review of 24 patients undergoing augmentation enterocystoplasty (1997-2010).
• Indications included interstitial cystitis, neurogenic bladder, and inflammatory bladder retraction.
• Procedures involved detubularized ileum segments, with gastric wedge addition in cases of kidney failure.

Main Results:

• No intraoperative complications; postoperative complications included Clavien I-IIIB.
• Long-term issues: urinary incontinence (3), metabolic acidosis (2), self-catheterization (5), bladder stones (6), UTIs (2), anastomotic stricture (1).
• Ileogastrocystoplasty in 3 cases showed no hydroelectrolytic or kidney function impairment.

Conclusions:

• Augmentation enterocystoplasty is an effective treatment for lower urinary tract dysfunction in selected patients.
• The procedure demonstrates low morbidity and a manageable complication profile.
• It successfully creates a functional, high-capacity bladder reservoir.