Pediatric bladder augmentation – Panacea or Pandora’s box?

Authors

  • James P.J. Ross University of Ottawa
  • Melise Keays The Children's Hospital of Eastern Ontario
  • Christopher Neville The Children's Hospital of Eastern Ontario
  • Michael Leonard The Children's Hospital of Eastern Ontario
  • Luis Guerra CHEO

DOI:

https://doi.org/10.5489/cuaj.6024

Keywords:

Paediatric Urology, Neurogenic Bladder, Augmentation Cystoplasty, Bladder Augmentation

Abstract

Introduction: Bladder augmentation is a surgery that can increase bladder capacity and compliance. The objective of this study was to provide a longitudinal review of pediatric bladder augmentation at a tertiary Canadian center.

Methods: A retrospective review was performed on patients who underwent bladder augmentation at a tertiary pediatric hospital between 1986 and 2014. The primary objective was short- and long-term complications of augmentation. Secondary objectives were to review number of augmentation procedures performed over time and the utility of routine postoperative cystograms.

Results: A total of 56 procedures were performed on 54 patients (28 males, 26 females) of mean age 10 years (standard deviation [SD] 5) and mean followup eight years (SD 5). The most common bowel segment used was ileum (87.5%). Twenty-eight patients (50%) received catheterizable channels. Overall complication rate was 15% and the most common complications were urinary tract infections (68.5%), worsening hydronephrosis (14.8%), bladder stone formation (14%), and hematuria (13%). In total, 19 of 54 (35.2%) patients returned to the operating room. The incidence of bladder perforation was 3.6%. Complications with the catheterizable channel occurred in 13 of 28 (46.4%), of which 10 were related to stomal stenosis. Forty patients had postoperative cystograms and extravasation was seen in three (7.5%). There was no malignancy during the followup. Only four augmentations were performed from 2008–2014.

Conclusions: Bladder augmentation likely represents a safe surgical treatment option. Extravasation on postoperative cystogram was uncommon and, thus, it may not be indicated routinely. The number of augmentation procedures performed has declined in recent years.

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Published

2020-01-20

How to Cite

Ross, J. P., Keays, M., Neville, C., Leonard, M., & Guerra, L. (2020). Pediatric bladder augmentation – Panacea or Pandora’s box?. Canadian Urological Association Journal, 14(6), E251–6. https://doi.org/10.5489/cuaj.6024

Issue

Vol. 14 No. 6 (2020): CUAJ June

Section

Original Research

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