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Bowel problems after enterocystoplasty

G Singh1, D G Thomas

  • 1Royal Hallamshire Hospital, Sheffield, UK.

British Journal of Urology
|March 1, 1997
PubMed
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Enterocystoplasty surgery significantly alters bowel habits, with many patients experiencing increased frequency, looser stools, and more incontinence episodes, particularly those with neurogenic bladders. Bowel function often does not return to normal post-surgery.

Area of Science:

  • Urology
  • Gastroenterology
  • Surgical Outcomes

Background:

  • Enterocystoplasty is a surgical procedure to augment bladder capacity.
  • Changes in bowel habit following enterocystoplasty are a known complication.
  • Understanding these changes is crucial for patient management and counseling.

Purpose of the Study:

  • To document and analyze changes in bowel habits after enterocystoplasty.
  • To compare bowel habit changes in patients with neuropathic (NP) versus non-neuropathic (NNP) bladder dysfunction.
  • To identify factors influencing post-enterocystoplasty bowel dysfunction.

Main Methods:

  • A questionnaire-based study assessed 69 NP and 44 NNP patients (mean age 26 years) with at least 36 months follow-up post-cystoplasty.
  • The questionnaire evaluated faecal frequency, consistency, evacuation methods, and incontinence episodes before and after surgery.

Related Experiment Videos

  • Patient data included bladder dysfunction type, age, continent status, and type of bowel segment used for cystoplasty (ileum, ileocaecal, sigmoid).

    • Main Results:

    • In NP patients, 38% reported increased bowel frequency, 38% looser stools, and 23% more incontinence episodes post-surgery.
    • 52% of NP patients had unchanged bowel frequency, and 55% had unchanged stool consistency.
    • A significant percentage of NNP patients also experienced bowel problems, including increased frequency (41%) and looser stools (46%), with 27% reporting increased incontinence.

    Conclusions:

    • Enterocystoplasty, particularly using ileal segments, can lead to malabsorption and significant bowel habit changes, including increased frequency, looser stools, and incontinence.
    • Patients with neurogenic bladders are particularly susceptible to bowel dysfunction post-surgery, as their delicate bowel balance is easily disrupted.
    • A notable proportion of non-neuropathic bladder patients also experienced persistent bowel issues after cystoplasty, highlighting the need for careful patient selection and management.