Is successful augmentation of urinary bladder without bowel involvement possible?
Article published in Urologia Polska 2007/60/1.

authors

Wojciech Apoznański, Jerzy Czernik, Wojciech Jaworski: Katedra i Klinika Chirurgii i Urologii Dziecięcej Akademii Medycznej we Wrocławiu

keywords

lower urinary tract, neurogenic voiding dysfunction, children, surgical treatment

summary

Introduction. Injury of the nervous system areas responsible for normal lower urinary tract function leads to neurogenic voiding dysfunction. For many years children suffering from this condition are treated by surgery and the mean aim of this treatment is to create the bladder of low pressure and high volume. Classic augmentation of the urinary bladder is realized by using the isolated and reconfigured part of the bowel. Searching of the perfect material for augmentation of the urinary bladder is still unfinished

The aim of the study. Authors presented results of the bladder augmentation using other than bowel material.

Material and method. In the Department of Pediatric Surgery and Urology of University of Medicine in Wroclaw from 2000 to 2006, 70 children were treated due to neurogenic voiding dysfunction. In 50 cases classic augmentation using part of the bowel was performed and in 20 cases autoaugmentation with the peritoneum sling, ureterocystoplasty and gastrocystoplasty were carried on.

Results. Described above surgical techniques created excellent therapeutic results. Volume of the urinary bladder increased from (middle) 106.25 ml to 327.25 using gastrocystoplasty and the intravesical pressure decreased from 100.37 cm H20 to normal (lower than 15 cm H20), after ureterocystoplasty volume changed from 97 ml to 215 and intravesical pressure decreased from 74.5 cm H20 to 29 cm H20 and finally after autoaugmentation volume from 86.3 ml to 180 ml and pressure from 85 cm H20 to 26.6 H20.

Conclusion. Described above surgical techniques are excellent alternative to classic augmentation of the urinary bladder using bowel. They are safe and very effective methods of surgical treatment

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