Complications after bladder augmentation in children

Abstract

PURPOSE:Bladder augmentation is an effective surgical procedure for increasing bladder capacity and reducing pressure on the urinary system. It is indicated for patients with anomalies such as spina bifida, myelomeningocele, urethral valve and bladder exstrophy, who progress with low tolerance of medication. CASES:This was a retrospective study conducted on pediatric patients submitted to bladder augmentation from 2000 to 2011.RESULTS: 34 patients aged 4 to 17 years were submitted to bladder augmentation, 30 of them with an ileal loop and 4 with a ureter.A continent urinary shunt was performed in 16 patients, the Mitrofanoff conduit was associated in 15, and the Macedo technique was used in one. Mean follow-up was 34.35 months (1 to 122 months). Mean creatinine was 1.5 ng/ml (0.4 to 7.5 ng/ml) preoperatively and 1.78 ng/ml postoperatively. Three patients required a renal transplant during follow-up. There was improvement or resolution of vesicoureteral reflux in 83.5% of the kidneys on the right and in 75% on the left. Bladder capacity increased, on average, from 152.5 ml to 410 ml. The main complications were vesical lithiasis in 3 patients and conduit perforation in one. CONCLUSION:Bladder augmentation showed good results in this series, preserving renal function in most of the patients.

A cross sectional single institution study of quality of life in adult patients with spina bifida

“…The goal of urinary reconstruction in patients with congenital disease such as SB is to improve their healthcare burden and ease of caring for themselves. However, reconstruction procedures can be large surgical endeavors necessitating specialized upkeep and can result in complications such as vesical lithiasis and upper tract deterioration if not cared for properly . Therefore, it is of the utmost importance to ascertain whether or not patients feel their surgical outcome has been beneficial in their care.…”

“…However, reconstruction procedures can be large surgical endeavors necessitating specialized upkeep and can result in complications such as vesical lithiasis and upper tract deterioration if not cared for properly. 11 Therefore, it is of the utmost importance to ascertain whether or not patients feel their surgical outcome has been beneficial in their care. This topic is of interest to several groups who have sought to answer the same question with varying methods and more importantly results.…”