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Bladder autoaugmentation by vesicomyotomy in the pediatric neurogenic bladder
L Stothers1, H Johnson, W Arnold
1Section of Surgery, British Columbia's Children's Hospital, Vancouver, Canada.
Urology
|July 1, 1994
Summary
Bladder autoaugmentation using vesicomyotomy is a safe and effective procedure for pediatric neurogenic bladders. This technique improved bladder capacity and reduced leak point pressure, avoiding the need for more complex surgeries.
Area of Science:
- Pediatric Urology
- Surgical Procedures
- Bladder Augmentation
Background:
- Neurogenic bladder is a common condition in children, often leading to low bladder capacity and high pressures.
- Incontinence in neurogenic bladders can be challenging to manage, even with anticholinergic therapy.
- Surgical augmentation may be necessary when conservative treatments fail.
Purpose of the Study:
- To describe the procedure of bladder autoaugmentation by vesicomyotomy in pediatric patients.
- To evaluate the safety and efficacy of vesicomyotomy for neurogenic bladders.
- To assess the impact of vesicomyotomy on bladder capacity and function.
Main Methods:
- The study involved 12 pediatric patients with neurogenic bladders.
- Vesicomyotomy, a simple incision into the detrusor muscle, was performed.
- Clean intermittent catheterization was reinstituted postoperatively.
Main Results:
- No major complications were reported.
- Mean bladder capacity increased by 40% post-procedure.
- Mean leak point pressure decreased by 33% post-procedure.
- Eight patients underwent concurrent bladder procedures.
Conclusions:
- Vesicomyotomy is a simple and safe technique for bladder autoaugmentation in pediatric patients.
- The procedure effectively increased bladder capacity and reduced pressure.
- Vesicomyotomy offers a viable alternative to more complex surgeries like enterocystoplasty.