Related Experiment Video
Updated: Dec 17, 2025
Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
Published on: August 9, 2012
The search for continence in bladder exstrophy: Bladder neck transection and Macedo catheterizable reservoir to
Antonio Macedo1, Sérgio Leite Ottoni2, Gilmar Garrone2
1Department of Urology, CACAU-NUPEP, São Paulo, Brazil; Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.
Introduction:
Bladder exstrophy remains one of the most challenging abnormalities in pediatric urology. We propose bladder neck transection and bladder augmentation with a catheterizeable reservoir technique to achieve continence after previous anatomic reconstruction in stages.
Methods:
At the age of 5-6 years, we offer the transection of bladder neck and enterocystoplasty to achieve continence. We report on a 6-year-old boy that underwent this procedure. We perform the reservoir from ileum according to Macedo-technique that constructs a catheterizeable channel from the same bowel segment. The continence mechanism of the efferent tube is based on angulation and a serous lined tunnel created with 3.0 prolene sutures. The stoma is placed in the midline.
Results:
Patient had an uneventful evolution and is continent performing CIC every 4 h with 9 months of follow up.
Discussion:
In spite of continuous development of bladder exstrophy surgery, the urethral continence and voluntary micturition is still not possible in the majority of patients. We discuss with our patients honestly and offer this method as a viable alternative to achieve continence.
Conclusion:
In our experience, most patients accept urethral transection and suprapubic CIC when educated about results with other alternatives of bladder neck plasty.
Related Concept Videos
01:23Urinary Bladder
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
01:26The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography
01:19Anatomy of the Genitourinary System II: Bladder and Urethra