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Related Experiment Videos

Gastrocystoplasty: long-term followup

E A Kurzrock1, L S Baskin, B A Kogan

  • 1Department of Urology, University of California San Francisco, USA.

The Journal of Urology
|November 17, 1998
PubMed
Summary

Gastrocystoplasty offers advantages over intestinal augmentation, showing stable upper tracts and improved bladder capacity. While metabolic alkalosis and hematuria-dysuria syndrome can occur, they are manageable with careful patient selection and monitoring.

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Area of Science:

  • Urology
  • Pediatric Surgery
  • Gastroenterology

Background:

  • Gastrocystoplasty, a bladder augmentation technique using stomach tissue, has faced declining favor due to complications like hematuria-dysuria syndrome and metabolic alkalosis.
  • Evaluating the long-term efficacy and safety of gastrocystoplasty is crucial for understanding its role in reconstructive urology.

Purpose of the Study:

  • To review institutional experience with gastrocystoplasty for bladder augmentation.
  • To determine the advantages and disadvantages of using stomach body wall for bladder augmentation in pediatric patients.

Main Methods:

  • Retrospective review of medical records, urodynamic studies, X-rays, and laboratory evaluations for 47 children who underwent gastrocystoplasty (1986-1997).
  • Follow-up included telephone interviews with patients/parents, with a mean follow-up of 4.4 years (range: 9 months to 11 years).
  • Primary indication for bladder augmentation was neurogenic bladder dysfunction secondary to spinal dysraphism (38 children).

Main Results:

  • Upper urinary tracts remained stable or improved in 95% of renal units post-surgery.
  • Significant changes in serum electrolytes were not observed, though mean chloride decreased and bicarbonate increased.
  • Complications included symptomatic bladder infections (25%), hematuria-dysuria syndrome (27%, higher in non-neurogenic bladders), and one case of bladder stone.

Conclusions:

  • Gastrocystoplasty demonstrates advantages over intestinal augmentation, including reduced chloride reabsorption, mucous production, and urinary infections, with low rates of stones and perforation.
  • Metabolic alkalosis and hematuria-dysuria syndrome are potential complications but can be managed with appropriate patient selection and follow-up.
  • The procedure is not recommended for sensate patients with adequate bowel for augmentation.

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