Published: 2020-03-26

Ten years’ experience of augmentation cystoplasty for varied indications and its outcome

Hemangi R. Athawale, Shivaji B. Mane, Natasha Vagheriya, Prathamesh More, Taha Daginawala


Background: The aim of the study was to evaluate long term efficacy and complications of augmentation cystoplasty in patients with bladder dysfunction.  

Methods: Our series comprises of 30 patients undergoing enterocystoplasty from March 2009 till December 2019. Clinical findings and investigations result along with surgical techniques used were noted for these patients. Postoperative complications along with urinary continence and renal outcome were evaluated.

Results: Mean age of patients was 7 years and their mean follow up was for 4 years. Major complications occurred in 5 patients which were successfully managed and minor complication in 8 patients. Of these 16 patients were with neurogenic bladder and 14 with non-neurogenic bladder. The primary etiology of non-neurogenic bladder was extrophy epispadias complex (10 patients), posterior uretheral valves (2 patients), anterior uretheral valve (1 patient), and bilateral ectopic ureter (1 patient). The primary etiology of neurogenic bladder was meningomyocele (4 patients), anorectal malformation with vertebral anomalies (7 patients), partial sacral ageneis (4), nonneurogenic neurogenic bladder (1 patient). Relative continence was achieved in 97%. The preoperative serum creatinine and blood urea nitrogen (BUN) at the time of bladder augmentation (termed  creatinine-1 and BUN-1)and the serum  creatinine and BUN at the last follow up after bladder augmentation (termed  creatinine-2 and BUN-2)were sought and compared using chi square test showed statistically significant improvement (p<0.01).

Conclusions: Augmentation cystoplasty is a necessary and safe procedure to increase the functional capacity of small contracted and poorly compliant bladder and allows patients to achieve relative continence and preserves renal function.


Augmentation cystoplasty, Bladder dysfunction, Continence

Full Text:



Mikulicz J. Zur Operation der angeborenen Blasenspalte. Zentralbl Chir. 1899;26:641.

Duckett JW, Lotfi AH. Appendicovesicostomy and variations in bladder reconstruction. J Urol. 1993;149:567.

Winslow BH, Jordan GH. Continent cutaneous stoma. Dial Ped Urol. 1989;12:1.

Hanna MK. Bloiso G. Continent diversion in children: modification of Kock pouch. J Urol. 1987;137:1206.

King LR. Continent urinary diversion in children: the American experience. Scand J Urol Nephrol. 1992;142:85.

Couvelaire R. Lapetite vessie des tuberculeux genitourínaires, essai de classification place et variantes des cystointestino-plasties. J d’Urol. 1950;56:381-434.

Stoeckel W. Demonstration eines Falles von Maydlscher Operation bei tuberkuloser Schrumpfblase. Zentralbl Gyna-kol. 1918;42:720.

Birnbaum R. Zur operativen Therapie der Schrumpfblase. Munch Med Wochenschr. 1920;67:841-4.

Mathisen W. Open-loop sigmoido-cystoplasty. Acta Chir Scand. 1955;110:227-31.

Thomas JC, Dietrich MS, Trusler L, DeMarco RT, Pope JCT, Brock JW, et al. Continent catheterizable channels and the timing of their complications. J Ur. 2006;176:1816-20.

Narayanaswamy B, Wilcox DT, Cuckow PM, Duffy PG, Ransley PG. The Yange Monti ileovesicostomy: a problematic. BJU Int. 2001;87:861-5.

Castellan MA, Gosalbez R, Labbie A, Ibrahim E, Di Sandro M. Outcomes of continent catheterizable stomas for urinary and fecal incontinence: comparison among different options. BJU Int. 2005;95:1053-7.

Piaggio L, Myers S, Figueroa TE, Barthold JS, Gonzalez R. Influence of type of conduit and site of implantation on the outcome of continent catheterizable channels. J Pediatr Uro. 2007;3:230-4.

Surer I, Fernando A. Continent urinary diversion and the exstrophy-epispadias complex. J Urol. 2003;169:1102-5.

Khoury JM, Timmons SL, Corbel L, Webster GD. Complications of enterocystoplasty. Urology. 1992;40:9-14.

Blyth B, Ewalt DH, Duckett JW, Snyder III HM. Lithogenic properties of enterocystoplasty. J Urol. 1992;148:575-7.

Kronner KM, Casale AJ, Cain MP, Zerin MJ, Keating MA, Rink RC. Bladder calculi in the pediatric augmented bladder. J Urol. 1998;160:1096-8.

Schlomer BJ, Copp HL. Cumulative incidence of outcomes and urologic procedures after augmentation cystoplasty. J Pediatr Urol. 2014;10:1043-50.

Fontaine E, Leaver R, Woodhouse CR. The effect of intestinal urinary reservoirs on renal function: a 10-year follow-up. BJU Int. 2000;86:195-8.

Singh P. Can baseline serum creatinine and e-GFR predict renal function outcome after augmentation cystoplasty in children. Int Braz J Urol. 2018;44(1):156-62.

Bhattia W, Sen S. Does bladder augmentation stabilize serum creatinine in urethral valve disease. A series of 19 cases. J Pediatric Urol. 2007;3:122-6

William D, Leslie T, Eugene M, Paul M, David K, Deborah R, et al. Successful renal transplantation in children with posterior urethral valves. J Urol. 2003;170:2402-4.

Lopez Pereira P, Jaureguizar E, Martinez Urrutia MJ, Messegue C, Navarro M. Does treatment of bladder dysfunction prior to renal transplant improve outcome in patients with posterior urethral valves. Pediatr Transpl. 2000;4:118-22.