Original Clinical Article
Long-term results and complications using augmentation cystoplasty in reconstructive urology
Version of Record online: 19 OCT 2005
Copyright © 1995 Wiley-Liss, Inc., A Wiley Company
Neurourology and Urodynamics
Volume 14, Issue 4, pages 297–309, 1995
How to Cite
Flood, H. D., Malhotra, S. J., O'Connell, H. E., Ritchey, M. J., Bloom, D. A. and McGuire, E. J. (1995), Long-term results and complications using augmentation cystoplasty in reconstructive urology. Neurourol. Urodyn., 14: 297–309. doi: 10.1002/nau.1930140402
- Issue online: 19 OCT 2005
- Version of Record online: 19 OCT 2005
- Manuscript Accepted: 7 APR 1995
- Manuscript Received: 7 FEB 1995
- augmentation cystoplasty;
- reconstructive urology
One hundred and twenty-two augmentation cystoplasties performed over an 8-year period were reviewed. Mean age at surgery was 37 years (range 2–82 years). There were 82 female patients. The primary urodynamic diagnosis was reduced compliance in 92 (77%) pattenls and detrusor hyperreflexia/instability in the remainder. The clinical diagnostic groups were: spinal cord injury/disease in 32 (27%), myelodysplasia in 27 (22%), interstitial cystitis in 21 (17%), idiopathic detrusor instability in 13 (11%), radiation cystitis in 8 (7%). Hinman-Allen syndrome in 5 (4%), and miscellaneous in 11 (9%). A detubularized, ileal augmentation was used in 82 (67%) patients. In 36 (30%) a detubularized ileocecocystoplasty was fashioned and in the remainder detubularized sigmoid was used. In 19 patients augmentation accompanied undiversion. Sixteen patients had a simultaneous fascial sling for urethral incompetence. Mean follow-up was 37 months (range 6–96 months). There was no postoperative mortality. During follow-up 4 patients died from unrelated causes, 11 have been lost to follow-up, and 5 patients await planned transplantation. Bladder capacity was increased from a preoperative mean of 108 ml (range 15–500 ml) to 438 ml (200–1,200 ml) postoperatively. Of the 106 assessable patients, 80 (75%) had an excellent result, 21 (20%) were improved, and 5 (5%) had major ongoing problems.
During the period of follow-up, 17 (16%) patients underwent revision of their augmentation. Twenty-four (21%) patients developed bladder stones and 30% of these did so more than once. Urinary incontinence became manifest in 15 (13%) patients but required surgical treatment in only half of these. Pyelonephritis occurred in 13 (11%) patients. Five patients developed small bowel obstruction following discharge from hospital. There were 7 instances of reservoir rupture in 5 (4%) patients. Augmentation cystoplasty has a pivotal role in the treatment of a broad range of lower and upper urinary tract problems. Careful patient selection and close follow-up are essential. © 1995 Wiley-Liss, Inc.