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Laparoscopic gastrocystoplasty for tuberculous contracted bladder.
Manickam Ramalingam1, Kallappan Senthil1, T S Balashanmugam1
1Department of Urology and General Surgery, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
Summary
Gastrocystoplasty using a stomach flap is a viable surgical option for patients with renal failure and a contracted bladder. This minimally invasive laparoscopic technique effectively augments bladder capacity and improves renal function.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- A contracted bladder and renal failure present significant challenges in patient management.
- Tuberculous ureteric stricture can lead to bladder dysfunction and impaired renal function.
Observation:
- A 49-year-old female with a solitary functioning kidney, tuberculous lower ureteric stricture, and contracted bladder presented with elevated creatinine (2.8 mg%).
Findings:
- Laparoscopic gastrocystoplasty utilizing a right gastroepiploic artery-based gastric flap was performed for bladder augmentation and ureteric replacement.
- Postoperatively, at 6 months, the patient's creatinine improved to 1.9 mg%, and bladder capacity increased to 250 ml.
- The patient experienced mild hematuria, which resolved with proton pump inhibitors.
Implications:
- Laparoscopic gastrocystoplasty is a feasible and effective treatment for contracted bladders in patients with renal failure.
- This minimally invasive approach offers benefits in terms of recovery and patient outcomes.
- Gastric tissue serves as a suitable option for bladder augmentation and ureteric reconstruction.
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