Augmentation Cystoplasty

What is it?

It is a surgical procedure used in patients who lack adequate bladder capacity or detrusor compliance. It expands the size of the bladder by adding a piece of the intestine to the bladder. Because the intestine is stretchy and not connected to the same nerves as the bladder this increases the size of the bladder and decreases how often the intermittent catheterization needs to be done.

How it is done?

This operation may be combined with the creation of a continent stoma to make intermittent catheterization easier to perform. Conservative management for these patients usually consists of intermittent self-catheterization and anticholinergic medications. Augmentation cystoplasty is considered when bothersome symptoms impair a patient’s lifestyle despite medical treatment or when high-pressure urinary storage places the upper urinary tracts at risk.

Decreased bladder capacity or abnormal compliance may manifest as debilitating urgency, frequency, incontinence, recurrent urinary tract infections, pyelonephritis, or progressive renal insufficiency.

Benefits

Augmentation cystoplasty can provide a safe functional reservoir that allows for urinary continence and prevention of upper tract deterioration.

Risk

Patients who are unable or unwilling to perform life-long intermittent catheterization should not undergo augmentation cystoplasty because of the high likelihood of ultimately requiring catheterization. In addition, patients with inflammatory bowel disease, short or irradiated bowel, bladder tumors, severe radiation cystitis or severe renal insufficiency should not undergo augmentation cystoplasty.