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