Surgical complications of bladder augmentation: comparison between various enterocystoplasties in 133 patients

Shekarriz, Bijan; Upadhyay, Jyoti; Demirbilek, Semra; Barthold, Julia Spencer; González, Ricardo

doi:10.1016/s0090-4295(99)00443-4

Cited by 160 publications

(94 citation statements)

References 25 publications

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“…Various congenital conditions can result in small poorly compliant bladders that require augmentation cystoplasty. This diverse group of conditions includes bladder and cloacal exstrophy, PUV and epispadias [21,28,29].…”

Section: Indicationsmentioning

confidence: 99%

Augmentation cystoplasty

Greenwell¹,

Venn²,

Mundy³

2001

BJU International

191

137

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Section: Indicationsmentioning

confidence: 99%

Augmentation cystoplasty

Greenwell¹,

Venn²,

Mundy³

2001

BJU International

191

137

View full text Add to dashboard Cite

“…In both groups, the most common and important reason for graft failure is immunity-associated acute and chronic rejection episodes. 16 Bladder dysfunction and problems in storing and excretion first cause deterioration in internal bladder functions. Increased bladder pressure causes increased frequency of urination, urgency, and incontinence and repeat urinary tract infections.…”

Section: Exp Clin Transplantmentioning

confidence: 99%

Untitled

Haberal

Kırnap²,

Gökçe³

et al. 2018

Exp Clin Transplant

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Objectives: Kidney transplant is the best choice for treatment of patients with advanced chronic renal disease. However, small, poorly compliant, and unstable bladders can result in major problems for patients. Here, we aimed to develop and evaluate a new ileobladder model. Materials and Methods: Fifteen rats (250-300 g) and 5 pigs (~100 kg) were cared for according to institutional and published guidelines. After general anesthesia, laparotomy was done through midline incision. Ileal loops were prepared for ileobladder. After cystectomy (0.5 cm above the trigone in rats, 1 cm above the trigone in pigs), anastomoses were done between antimesenteric sides of ileal loops and bladder remnant with 6/0 Prolene suture. Three other pigs received simultaneous renal transplant. Results: One rat died on day 1 postsurgery from multiorgan hemorrhage. Two rats survived for 5 days, 3 rats for 7 days, and 3 rats for 11 days; 6 rats were killed for pathologic evaluation after 3 months. One pig survived for 22 days and 1 for 9 days. Of the 3 pigs that received a simultaneous renal transplant, 2 pigs were alive and doing well 80 and 72 days after surgery with normal urinary discharge (1 pig was killed for pathologic evaluation after 3 days). When ileobladder was opened, complete recovery of the anastomosis line was observed. Pathologic examination of the anastomosis sites reported a normal healing process with moderate inflammation and the muscular wall of the intestine showed hypertrophia that nearly reached the size of the bladder muscularis propria. Conclusions: Although we had some complications because no draining procedure was used, in terms of technique, our new ileobladder model is promising for providing functional bladder volume. A larger scale series in the clinical setting is planned. This technique can be useful for small bladders and bladder physiology disorders.

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“…Reported rates of bladder perforation following augmentation range between 6-13% (9,22,(46)(47)(48)(49). Perforation occurs due to increased intravesical pressure, which may result from chronic bladder over-distention, chronic infection, traumatic catheterization, and ischemic necrosis of the intestinal segment used for the augmentation (50)(51)(52)(53)(54)(55)(56).…”

Section: Perforationmentioning

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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Surgical complications of bladder augmentation: comparison between various enterocystoplasties in 133 patients

Cited by 160 publications

References 25 publications

Augmentation cystoplasty

Augmentation cystoplasty

Untitled

Long-Term Sequela of Pediatric Bladder Reconstruction

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