Cecocystoplasty for Bladder Augmentation

Abstract

Augmentation of the bladder by cecocystoplasty has been studied in 37 patients during a 15-year period. The indications for an operation were a small contracted bladder secondary to tuberculosis in 31 cases, interstitial cystitis in 5 and carcinoma of the bladder in 1. Results were studied by the assessment of symptomatic improvement, the effect on renal function, urinary tract infection and the postoperative complications. Urodynamic studies also were done on 23 patients with tuberculosis of the renal tract and the results are discussed. Azotemia was not a contraindication to an operation but patients with enuresis or those who have evidence of psychiatric disturbance should be assessed carefully.

Colocystoplasty for the Treatment of Severe Interstitial Cystitis

“…In order to balance the system, there fore, some authors recommend bladder neck incision as a routine procedure to reduce outlet resistance [23], The risk of incontinence acts as a deterrent, however; as seen in 1 of our patients. In the women voiding was mostly efficient after subtotal bladder substitution, and bladder neck incision was necessary only for 1 of the 9 females with functioning colocystoplasty, which agrees with many of the recent reports [3,10,24]. We find it to be limited to selected cases with poor bladder emptying due to infravesical obstruction.…”

Clinical Aspects of Augmentation Enterocystoplasties

“…The improvement of the frequency and disappearance of incontinence that we observed in patients treated with enterocystoplasty are in accord with other published se ries reporting a cure rate ranging between 58 and 78% [6][7][8][9][10][11]. In patients with tuberculous, radiation and chronic cystitis, the symptomatic improvement was good: 1 patient with interstitial cystitis obtained conti nence and another patient was considered a failure be cause of the persistence of severe symptoms.…”

“…This finding is not in accord with the proposed treatment of young enuretics by this procedure [12,13]. However, if an enuretic patient needs enterocystoplasty for another reason, we believe that enuresis is not a contraindication [7] and its outcome is completely independent from blad der augmentation.…”

“…a Preoperative IVP shows a small capacity bladder due to interstitial cystitis, b IVP after augmentation using the sigmoid, c The urine-filled loop caused disturbances to the patient even in the absence of outflow obstruction (d). formed by some authors [17], while others use it in 20-50% of cases [6,10,18], seldom [11], or in male patients over 45 years old [7,8], In these patients voiding difficul ties are due to dyssynergia between the enteric and the bladder neck urethral segment, which is generally com pletely normal. When a tendency to cystoplasty dilatation or residual urine over 200 ml is present, we favor initial medical treatment in order to reduce outflow tract resis tance, and in some cases we observed voiding improve ment and reduction of residual urine ( fig.…”

Carcinoma Associated with Augmentation Cystoplasty

“…Bowel segments have been used for reconstruction of the lower urinary tract for many years and the need for sphincter balancing procedures to achieve satisfactory voiding in these patients was clearly identified as long ago as 1967 (Turner-Warwick and Ashken, 1967). Most patients in this era were reconstructed for contracted tuberculous bladders (Dounis et al, 1980) and most surgeons at that time preferred augmentation to substitution cystoplasty, usually using an intact ileal segment attached to the opened dome of the bladder.…”