Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: a long-term retrospective study.

Area of Science:

• Urology
• Pediatric Surgery
• Reconstructive Urology

Background:

• Refractory lower urinary tract dysfunction (LUTD) often requires complex reconstructive surgery.
• Augmentation cystoplasty with simultaneous ureteral reimplantation addresses severe bladder dysfunction and associated upper tract issues.

Purpose of the Study:

• To evaluate the long-term efficacy and complications of augmentation uretero-enterocystoplasty (AUEC).
• To assess AUEC's role in managing refractory LUTD with ureteral abnormalities and vesicoureteral reflux (VUR).

Main Methods:

• Retrospective review of 210 patients undergoing AUEC from 2003-2019.
• Analysis of clinical records, video-urodynamics, and MRI; assessment using international VUR and upper urinary tract dilatation (UUTD) grading systems.

Main Results:

• Significant improvements in bladder capacity, compliance, and pressure post-surgery.
• High success rates for VUR (97.7%) and UUTD (72.5%) improvement; improved serum creatinine levels.
• Complications included metabolic acidosis (9.5%) and surgical site stenosis (6.2%); 1% experienced persistent incontinence.

Conclusions:

• AUEC is effective for refractory LUTD with hydronephrosis, ureteral dilatation, or VUR.
• The procedure improves renal function and protects upper urinary tract function in most patients.
• AUEC offers a viable surgical option for complex urological reconstruction.