Augmentation Cystoplasty in Children

Summary:

We reviewed our experience with augmentation cystoplasty in 20 children with intractable voiding dysfunction. The primary reason for bladder augmentation was upper urinary tract deterioration in 13 children (group 1) or poor urinary control without upper tract problem in 6 (group 2), both of which were refractory to conservative management. In group 1 VUR disappeared and hydronephrosis ameliorated in the majority (12) of the patients. In group 2 three children achieved full time dryness and two had marked improvement in incontinence. Characteristics of postoperative urodynamic studies were marked increase in bladder capacity and compliance. Metabolic derangement has not been observed postoperatively, while vesical stone developed in four children. It is concluded that augmentation cystoplasty is effective and suitable for the management of children with refractory voiding dysfunction. The role of concomitant antireflex surgery and the ancillary procedure of fascial sling was discussed.

Key words:

Augmentation cystoplasty - Bladder augmentation - Voiding dysfunction - Neurogenic voiding dysfunction - Myelodysplasia