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Augmentation cystoplasty: Contemporary indications, techniques and complications.

Veeratterapillay R, Thorpe AC, Harding C - Indian J Urol (2013)

Bottom Line: The use of intravesical botulinum toxin and sacral neuromodulation in detrusor overactivity has reduced the number of AC performed for this indication.A variety of intestinal segments can be used although ileocystoplasty remains the most common performed procedure.Early complications include thromboembolism and mortality, whereas long-term problems include metabolic disturbance, bacteriuria, urinary tract stones, incontinence, perforation, the need for intermittent self-catheterization and carcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK.

ABSTRACT
Augmentation cystoplasty (AC) has traditionally been used in the treatment of the low capacity, poorly compliant or refractory overactive bladder (OAB). The use of intravesical botulinum toxin and sacral neuromodulation in detrusor overactivity has reduced the number of AC performed for this indication. However, AC remains important in the pediatric and renal transplant setting and still remains a viable option for refractory OAB. Advances in surgical technique have seen the development of both laparoscopic and robotic augmentation cystoplasty. A variety of intestinal segments can be used although ileocystoplasty remains the most common performed procedure. Early complications include thromboembolism and mortality, whereas long-term problems include metabolic disturbance, bacteriuria, urinary tract stones, incontinence, perforation, the need for intermittent self-catheterization and carcinoma. This article examines the contemporary indications, published results and possible future directions for augmentation cystoplasty.

No MeSH data available.


Related in: MedlinePlus

(a) Bivalving of bladder, (b) Anastomosis of detubularized ileal patch
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Figure 1: (a) Bivalving of bladder, (b) Anastomosis of detubularized ileal patch

Mentions: AC has traditionally been performed via an open approach with sagittal bivalving of the bladder and anastomosis of the bowel segment onto the native bladder [Figure 1].[16] The most widely used bowel segment for AC is a detubularized patch of ileum, usually taken about 25-40 cm from the ileocecal valve.[626] If cecum is used, it is often used in conjunction with the terminal ileum as an ileocaecocystoplasty.[27] Alternatives to using gastrointestinal tissue have been auto-augmentation (detrusor myomectomy) where detrusor muscle is stripped from the bladder with an overall success of 50-70%[28] or ureterocystoplasty using a pre-existing dilated ureter, but up to 24% of those require revision surgery.[2930] Advances in surgical technique have seen laparoscopic gastrocystoplasty and ileocystoplasty[31] and more recently robotic augmentation ileocystoplasty being performed.[32]


Augmentation cystoplasty: Contemporary indications, techniques and complications.

Veeratterapillay R, Thorpe AC, Harding C - Indian J Urol (2013)

(a) Bivalving of bladder, (b) Anastomosis of detubularized ileal patch
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3822349&req=5

Figure 1: (a) Bivalving of bladder, (b) Anastomosis of detubularized ileal patch
Mentions: AC has traditionally been performed via an open approach with sagittal bivalving of the bladder and anastomosis of the bowel segment onto the native bladder [Figure 1].[16] The most widely used bowel segment for AC is a detubularized patch of ileum, usually taken about 25-40 cm from the ileocecal valve.[626] If cecum is used, it is often used in conjunction with the terminal ileum as an ileocaecocystoplasty.[27] Alternatives to using gastrointestinal tissue have been auto-augmentation (detrusor myomectomy) where detrusor muscle is stripped from the bladder with an overall success of 50-70%[28] or ureterocystoplasty using a pre-existing dilated ureter, but up to 24% of those require revision surgery.[2930] Advances in surgical technique have seen laparoscopic gastrocystoplasty and ileocystoplasty[31] and more recently robotic augmentation ileocystoplasty being performed.[32]

Bottom Line: The use of intravesical botulinum toxin and sacral neuromodulation in detrusor overactivity has reduced the number of AC performed for this indication.A variety of intestinal segments can be used although ileocystoplasty remains the most common performed procedure.Early complications include thromboembolism and mortality, whereas long-term problems include metabolic disturbance, bacteriuria, urinary tract stones, incontinence, perforation, the need for intermittent self-catheterization and carcinoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Freeman Hospital, Newcastle Upon Tyne, UK.

ABSTRACT
Augmentation cystoplasty (AC) has traditionally been used in the treatment of the low capacity, poorly compliant or refractory overactive bladder (OAB). The use of intravesical botulinum toxin and sacral neuromodulation in detrusor overactivity has reduced the number of AC performed for this indication. However, AC remains important in the pediatric and renal transplant setting and still remains a viable option for refractory OAB. Advances in surgical technique have seen the development of both laparoscopic and robotic augmentation cystoplasty. A variety of intestinal segments can be used although ileocystoplasty remains the most common performed procedure. Early complications include thromboembolism and mortality, whereas long-term problems include metabolic disturbance, bacteriuria, urinary tract stones, incontinence, perforation, the need for intermittent self-catheterization and carcinoma. This article examines the contemporary indications, published results and possible future directions for augmentation cystoplasty.

No MeSH data available.


Related in: MedlinePlus