EXPERIMENTAL EVALUATION OF BLADDER AUGMENTATION BY DEMUCOSULATED GASTROCYSTOPLASTY

Abstract

The idea of bladder augmentation is to increase bladder capacity and compliance.

Indications include clinical symptoms such as incontinence caused by bladder dysfunction unresponsive to medical therapy, and upper urinary tract deterioration due to inadequate low-pressure storage volume. Also suggestive is a measured bladder capacity that is significantly less than that expected for the patient age.

Alternatives for bladder augmentation include the use of ileocystoplasty, sigmoid colocystoplasty, ileocecocystoplasty, gastrocytstoplasty, the use of ureter, and the removal of detrusor, which essentially leaves a large urothelial diverticulum.

Many of these techniques may be associated with some drawbacks. Ileocystoplasty and colocystoplasty may lead to absorptive acidosis, infection and excessive mucus production with subsequent stone formation. Autoaugmentation has the risk of failure to attain adequate compliance and capacity (Dayanc et al., 1999).

As for gastrocystoplasty using a full gastric patch, it has the complication of haematuria-dysuria syndrome and the occasional development of hyponatremic dehydration or systemic alkalosis (Adams et al., 1988).