The past, present and future of augmentation cystoplasty

Abstract

What's known on the subject? and What does the study add? There is a wealth of evidence on the development, indications, outcomes and complications of augmentation cystoplasty (AC). Over the last decade, new evidence has been emerging to influence our clinical practice and application of this technique. AC is indicated as part of the treatment pathway for both neurogenic and idiopathic detrusor overactivity, usually where other interventions have failed or are inappropriate. The most commonly used technique remains augmentation with a detubularised patch of ileum (ileocystoplasty). Controversy persists over the role of routine surveillance following ileocystoplasty for the detection of subsequent bladder carcinoma; however the indication for surveillance after gastrocystoplasty is clearer due to a rising incidence of malignancy in this group. Despite a reduction in the overall numbers of AC operations being performed, it clearly still has a role to play, which we re‐examine with contemporary studies from the last decade.

Ogmentasyon Sistoplasti

“…Ogmentasyon sistoplastisi için mide, ileum, çekum ve kolon kullanılabilir (10). Geniş pelvik radyoterapi uygulanmış hastalarda ince bağırsak kullanımı uygun değildir.…”

“…Mukus birikimi drenaj bozukluğuna, enfeksiyona ve içerisinde taş oluşumuna zemin hazırlamaktadır (17). Ogmentasyon sistoplasti sonrası sık görülen (%40) komplikasyonlardan biri de mesane taşı oluşumudur (10). Mesanenin sık aralıklarla irrigasyonu ve enfeksiyonun engellenmesi taş oluşumunu önemli oranlarda azaltacaktır.…”

Efficacy and safety of augmentation ileocystoplasty combined with supratrigonal cystectomy for the treatment of refractory bladder pain syndrome/interstitial cystitis with Hunner's lesion

“…19 AIC/SC has been shown to relieve pain, improve voiding symptoms, and stabilize renal function in most cases, but the success rate of AIC/SC varies widely from 25% to 96%. 10,14,19,20 Such wide variation in the success rate could be explained by the following reasons. First, some of the reports have failed to acknowledge the importance of subtyping BPS/IC according to the presence of Hunner's lesion.…”

The management of urinary incontinence in the male neurological patient

“…Although there are no RCT, augmentation cystoplasty is a recommended and established treatment option for intractable urinary incontinence due to NDO but requires major abdominal surgery with interposition of an intestinal segment (usually ileum) into the bladder and/or partial replacement of bladder by an intestinal substitute, and should be preserved for patients in whom conservative or lessinvasive treatment options failed to achieve an adequate level of continence [65,66]. Importantly, this treatment should only be offered to patients who are able and willing to perform ISC.…”