The use of gastrocystoplasty in patients with bladder exstrophy

The authors report the use of a stomach segment vascularized via the right gastroepiploic artery in order to increased bladder capacity in 18 patients with bladder exstrophy. The morphological and functional results were good in 15 patients (83.4%); 13 (72.2%) continue to use intermittent catheterization to empty the bladder, while 5 (27.7%) have spontaneous voiding. Seven patients are completely continent, 8 partially continent (<3 h), and 2 are still incontinent. We encountered no metabolic complications and no patient complained of mucus production. Ten patients had a dysuria-hematuria syndrome, 8 only slight and 2 marked. We believe that even though gastrocystoplasty is a valid alternative compared with other tissues used to date for bladder augmentation, attention should be paid to this new pathological sequela, which has proved to occur quite frequently, as seen from the long- and short-term follow-up of patients who have had this operation.