Ureterocystoplasty: the ‘bladder’ augmentation of choice

Abstract

OBJECTIVE: To reduce the complications of enterocystoplasty by augmenting the bladder with a megaureter. PATIENTS AND METHODS: Ureterocystoplasty was performed in eight children aged 20 months-15 years. Three had impaired renal function and three were in established chronic polyuric renal failure. RESULTS: The seven older children were dry by day with clean intermittent catheterization and the youngest, at the age of 3 1/2 years, had a dry interval of 2 h after catheterization. The three children with polyuric renal failure required nocturnal catheterization or were wet at night. The post-operative urodynamics showed a significant improvement in all cases with abolition of detrusor instability in seven patients and a reduction in end filling pressure. Bladder volume increased from a mean of 100 ml (range 45-215) to 311 ml (range 150-450) (P = 0.01). There was no deterioration in renal function. CONCLUSION: The early results of ureterocystoplasty compare favourably with those of enterocystoplasty without the risks of long-term metabolic and neoplastic complications.