Augmentation cystoplasty: Urodynamic and metabolic outcomes at 10-year follow-up

Int J Urol. 2015 Dec;22(12):1149-54. doi: 10.1111/iju.12943. Epub 2015 Sep 22.

Abstract

Objective: To review the urodynamic outcomes, renal function and metabolic complications after augmentation cystoplasty with at least 10 years of follow-up.

Methods: Augmentation cystoplasty performed in two tertiary referral centers from 1995 to 2004 were reviewed. Ten years or more postoperative course was studied by review of the clinical notes, urodynamic reports and laboratory results.

Results: A total of 40 patients were included in this study. The mean age at surgery was 43 years, and 47.5% of patients were female. Median follow up was 13 years. Bladder capacity significantly increased from 283 ± 151 to 492 ± 123 mL (P < 0.01), with a percentage change of +130%. The compliance of the bladder was increased by 87%, and detrusor overactivity decreased by 54.2%. There were no significant changes in preoperative and postoperative estimated glomerular filtration rate (68.3 mL/min vs. 76.6 mL/min, P = 0.798). Three patients (7.5%) had more than one episode of symptomatic urinary tract infection per year.

Conclusion: The present study confirms the effectiveness of augmentation cystoplasty in increasing bladder capacity, improving bladder compliance and reducing detrusor overactivity. The preservation of renal function and low metabolic complication rate provide solid evidence for carrying out this time-honored procedure in patients with neurogenic or non-neurogenic bladder dysfunction.

Keywords: bladder augmentation; enterocystoplasty; urinary bladder, neurogenic; urinary bladder, overactive.

MeSH terms

  • Acidosis / drug therapy
  • Acidosis / etiology*
  • Adult
  • Colon / transplantation
  • Compliance
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Ileum / transplantation
  • Kidney Calculi / etiology*
  • Male
  • Organ Size
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology*
  • Retrospective Studies
  • Stomach / transplantation
  • Urinary Bladder / pathology*
  • Urinary Bladder / physiopathology
  • Urinary Bladder / surgery*
  • Urinary Bladder, Neurogenic / pathology
  • Urinary Bladder, Neurogenic / physiopathology
  • Urinary Bladder, Neurogenic / surgery
  • Urinary Bladder, Overactive / pathology
  • Urinary Bladder, Overactive / physiopathology
  • Urinary Bladder, Overactive / surgery
  • Urinary Tract Infections / etiology*
  • Urodynamics