Surgical outcomes of bladder augmentation: A comparison of three different augmentation procedures

Abstract

BACKGROUND Augmentation cystoplasty is indispensable in many pediatric diseases, especially neurogenic bladder. Various methods and materials are used to augment the bladder, and these methods are associated with different shortcomings and complications. AIM The present study reported the mid-term outcomes of patients undergoing various bladder augmentation procedures in a single institution, and assessed whether seromuscular cystoplasty lined with urothelium (SCLU) provided better urodynamic results than auto-augmentation (AA). METHODS A retrospective review of 96 patients undergoing various augmentation methods between 2003 and 2018 was performed. The patients were divided into three groups according to the type of augmentation, and their outcomes were compared. All patients developed neurogenic bladder due to myelomeningocele or sacrococcygeal teratoma. The clinical data of all patients were collected. RESULTS The mean ages at surgery in the three groups (standard cystoplasty [SC], SCLU, AA) were 10.8, 7.5, and 4.8 years, respectively, with mean follow-ups of 36, 61, and 36 mo, respectively. The mean preoperative and postoperative bladder capacities of the SC, SCLU, and AA groups were 174 ± 11.7 vs . 387 ± 13.7 ( P < 0.0001), 165 ± 12.2 vs. 240 ± 14.7 ( P = 0.0002), and 138 ± 16.7 vs. 181 ± 9.9 ( P = 0.0360), respectively. Compared with the AA group, the SCLU procedure did not have better postoperative urodynamic parameters. Incontinence was reduced in most patients. The mean times of clean intermittent catheterization per day in the SC, SCLU, and AA groups were 5.6, 7.8, and 8.2, respectively. The main complications of the SC group were recurrent urinary tract infections (8%) and bladder calculi (6%). Re-augmentation was done in patients in the SCLU (8) and AA (3) groups. CONCLUSION SC provided sufficient bladder capacity and improved compliance with acceptable complications. After AA and SCLU, the patients acquired limited increases in bladder capacity and compliance with a high rate of re-augmentation. Compared with AA, SCLU did not yield better postoperative urodynamic parameters.

The Effect of Narrative Nursing Intervention on Shame in Elderly Patients with Bladder Cancer after Ileal Bladder Replacement: A Cohort Study

“…In recent years, clinical medical staff have gradually started to realize that the evaluation of the therapeutic effectiveness of cancer patients is not only to prolong the survival time but also to satisfy the patients' needs such as the health-related life quality. Although ileal bladder surgery is an effective method to save the patient's life and relieve the patient's symptoms, the psychological and physical changes in the patient cause great mental stress and negative emotions, resulting in inconvenience to the patient's life [ 6 ].…”

Current Surgical Treatment for Neurogenic Lower Urinary Tract Dysfunction in Patients with Chronic Spinal Cord Injury

“…The best outcome of bladder auto-augmentation could be expected in patients with NLUTD with a fair bladder capacity but poor bladder compliance [ 21 ]. However, because the presence of secondary fibrosis and the healing process of the divided detrusor muscle might occur, auto-augmentation yielded limited long-term improvement in the maximum cystometric capacity, maximum detrusor pressure, and bladder compliance compared to AC [ 42 ]. Additionally, the effectiveness of auto-augmentation in the long-term is not as high as AC, with a repeat of the AC procedure being required for 15–45% of patients [ 21 , 43 , 44 , 45 ].…”