Our experience with ureterocystoplasty in bilateral functional kidneys

Area of Science:

• Urology
• Pediatric Surgery
• Nephrology

Background:

• Augmentation cystoplasty is crucial for managing refractory bladder dysfunction.
• Traditional methods like ileal augmentation carry risks of metabolic complications and urolithiasis.
• Ureterocystoplasty presents an alternative approach to bladder augmentation.

Purpose of the Study:

• To evaluate the effectiveness of augmentation ureterocystoplasty.
• To assess the functional outcomes of this surgical technique in pediatric patients.
• To determine if ureterocystoplasty avoids complications seen with ileal augmentation.

Main Methods:

• Retrospective review of 16 patients undergoing augmentation ureterocystoplasty (1995-2018).
• Pre-operative and post-operative assessment of renal function using USG, BUN, creatinine, and Tc-99 DTPA scans.
• Evaluation of ureters with IVP and USG; MR urography performed.
• Urodynamic studies to assess bladder capacity and compliance pre- and post-operatively.

Main Results:

• 16 patients (10 male, 6 female; ages 1-24) with neurogenic bladder (meningomyelocele most common).
• Pre-operative bladder capacity: 40-180 mL; compliance: 1.0-4.0 cc/cmH2O.
• Post-operative (3 months) bladder capacity: 180-330 mL; compliance: 6.0-24.0 cc/cmH2O.

Conclusions:

• Augmentation ureterocystoplasty is an effective technique for bladder augmentation.
• Successful outcomes are achievable with careful patient selection.
• This method successfully avoids complications associated with ileal segment use.