Bladder augmentation and bladder neck reconstruction in bladder exstrophy patients: a single center experience

Bladder augmentation with gastrointestinal tissue accompanied by bladder neck repair are important tools for pediatric surgeons in the management of children with Bladder exstrophy for urinary incontinence. The goal of bladder augmentation is to create a reservoir with an adequate functional capacity with low end-filling pressure. The aim of this study is to evaluate the efficacy, safety, and outcomes of ileocystoplasty with modified Young-Dees-Leadbetter bladder neck reconstruction and continent catheterizable channel in children born with bladder exstrophy at Pediatric Surgery Unit, Children's Hospital, Faculty of Medicine, Alexandria University, Egypt.

This prospective study included 20 patients with bladder exstrophy after successful bladder closure and who had small bladder capacity less than 100 ml with incontinence and needed augmentation cystoplasty and bladder neck reconstruction.

As regards daytime continence, 16 patients (80%) were dry between clean intermittent catheterization CIC sessions, while 4 patients (20%) were wet between clean intermittent catheterization at resting time. During stress, 14 patients (70%) were dry, while 6 patients (30%) were wet (4 of them were wet at resting time). Reflux resolution (100%), and significant improvement in bladder capacity (mean increase from 60.2 ml to 348.5 ml, p < 0.001).

For patients with bladder exstrophy, bladder augmentation and bladder neck reconstruction remain crucial for maintaining continence and enhancing their quality of life.