Bladder augmentation: Complications in the pediatric population

Metcalfe, Peter; Rink, Richard C.

doi:10.1007/s11934-007-0065-x

Cited by 48 publications

(30 citation statements)

References 48 publications

(51 reference statements)

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“…The structural components of these artificial bladders have been derived from bowel tissue to increase compliance and decrease leak point pressure while simultaneously increasing overall bladder capacity [3,4]. The risks involved with using bowel tissue include perforation, electrolyte imbalances, excessive mucus production, and malignant transformation [4,5].…”

Section: Introductionmentioning

confidence: 99%

A Nonhuman Primate Model for Urinary Bladder Regeneration Using Autologous Sources of Bone Marrow-Derived Mesenchymal Stem Cells

et al. 2011

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Animal models that have been used to examine the regenerative capacity of cell-seeded scaffolds in a urinary bladder augmentation model have ultimately translated poorly in the clinical setting. This may be due to a number of factors including cell types used for regeneration and anatomical/ physiological differences between lower primate species and their human counterparts. We postulated that mesenchymal stem cells (MSCs) could provide a cell source for partial bladder regeneration in a newly described nonhuman primate bladder (baboon) augmentation model. Cell-sorted2 baboon MSCs transduced with green fluorescent protein (GFP) were seeded onto small intestinal submucosa (SIS) scaffolds. Baboons underwent an approximate 40%-50% cystectomy followed by augmentation cystoplasty with the aforementioned scaffolds or controls and finally enveloped with omentum. Bladders from sham, unseeded SIS, and MSC/SIS scaffolds were subjected to trichrome, H&E, and immunofluorescent staining 10 weeks postaugmentation. Immunofluorescence staining for muscle markers combined with an anti-GFP antibody revealed that >90% of the cells were GFP Disclosure of potential conflicts of interest is found at the end of this article.

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Section: Introductionmentioning

confidence: 99%

A Nonhuman Primate Model for Urinary Bladder Regeneration Using Autologous Sources of Bone Marrow-Derived Mesenchymal Stem Cells

et al. 2011

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“…If even the best operation is performed in the wrong patient, the results can be disastrous. 6,26,27 It has been shown that the most important factor in successful outcomes is proper family selection. [7][8][9]28 Bladder neck procedures range from endoscopic injections of the bladder neck to outpatient suburethral slings, to bladder neck reconstruction, to ligation or closure of the bladder neck.…”

Section: Elementary Schoolmentioning

confidence: 99%

“…9,26 A review of 500 patients from Indiana University demonstrated a 34% need for subsequent surgery (Fig. 1).…”

Section: Elementary Schoolmentioning

confidence: 99%

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Neuropathic bladders: Investigation and treatment through their lifetime

Metcalfe¹

2017

CUAJ

Self Cite

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The child with a neuropathic bladder requires lifelong dedicated care. Just as each patient presents with unique physiology, each phase of their life presents varying challenges. The primary concern for our patients is their renal health, but continence and independence also play significant roles. Most patients can be managed conservatively, but a myriad of surgical options are also available, reinforcing our emphasis on individualized care. Appropriate presurgical planning is required to ensure the right patient receives the best operation for his/her wants and needs. Furthermore, the numerous potential complications must be understood and longterm followup and surveillance is required.This review outlines the basic pathophysiology, investigations, and treatments, with a focus on the changing needs throughout their lives.

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“…Some physicians recommend yearly endoscopy for potential early detection of malignant bladder tumors in the augment population (13,(75)(76)(77). However, others argue that yearly endoscopy is not cost effective and the potential morbidity makes it an ineffective screening procedure (78,79).…”

Section: Malignancymentioning

confidence: 99%

Long-Term Sequela of Pediatric Bladder Reconstruction

Roth

Keenan

Cain

et al. 2015

Curr Bladder Dysfunct Rep

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Children with refractory neurogenic bladder (NGB) who have failed maximal medical management are presented with options for bladder reconstruction. It is critical to understand the long-term sequela of bladder augmentation and bladder neck reconstruction to properly counsel families regarding these procedures. Benefits may include preservation of renal function, continence, reduced risk of renal-related mortality and potential improvements in quality of life (QOL). However, these advantages must be balanced with the risks of bladder calculi, perforation, need for additional surgery, acid/base disturbances, vitamin B12 deficiency and malignancy. Therefore, careful patient selection and preoperative counseling are paramount for those undergoing bladder reconstruction which includes intestinal bladder augmentation, as these patients require lifelong vigilant follow-up. IntroductionChildren with neurogenic bladders (NGB) are initially managed with clean intermittent catheterization (CIC) and anticholinergic medications in order to maintain a sizable, continent, and compliant urinary reservoir. Despite early and aggressive intervention, some patients undergo lower urinary tract reconstruction (bladder augmentation, catheterizable channel and/or bladder neck reconstruction) to protect their upper tracts and achieve continence. In a few select patients with favorable urodynamics (UDS) and low outlet resistance, a bladder neck procedure (BNP) can be performed without bladder augmentation to achieve continence. Myelodysplasia, specifically spina bifida (SB), remains the most common etiology of NGB in the pediatric population. Due to medical advances, particularly in the realm of Urology, more SB patients with bladder reconstruction are surviving into adulthood. We review current literature regarding long-term sequela of bladder reconstruction in pediatric patients with neurogenic bladder, with a primary focus on bladder augmentations for refractory NGB secondary to SB.

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Bladder augmentation: Complications in the pediatric population

Cited by 48 publications

References 48 publications

A Nonhuman Primate Model for Urinary Bladder Regeneration Using Autologous Sources of Bone Marrow-Derived Mesenchymal Stem Cells

A Nonhuman Primate Model for Urinary Bladder Regeneration Using Autologous Sources of Bone Marrow-Derived Mesenchymal Stem Cells

Neuropathic bladders: Investigation and treatment through their lifetime

Long-Term Sequela of Pediatric Bladder Reconstruction

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